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Peer-reviewedCC BY 4.0Cells

Chromosomal Radiosensitivity in Sjögren’s Syndrome with and Without Concomitant Malignancy

  • Elena Strljic1,2
  • Lukas Kuhlmann1,2
  • Jochen Wacker3
  • Hans Geinitz4,5
  • Stefanie Corradini1,2
  • Georg Schett3,6
  • Luitpold V Distel1,2
  • Hannah Schenker3,6,7
7 affiliations
  1. 1Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
  2. 2Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany.
  3. 3Department of Internal Medicine 3-Rheumatology and Clinical Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
  4. 4Department of Radiation Oncology, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, Austria.
  5. 5Medical Faculty, Johannes Kepler University, 4020 Linz, Austria.
  6. 6Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
  7. 7Department of Internal Medicine 1-Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
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Abstract

Connective tissue diseases have long been hypothesized to confer increased radiosensitivity and radiotherapy-related toxicity, although findings vary between disease entities. In a previous institutional study, we found increased radiosensitivity in patients suffering from systemic lupus erythematosus (SLE), primarily in patients with concomitant malignancy. We therefore investigated Sjögren’s syndrome, an autoimmune disease for which evidence has been limited. Ex vivo chromosomal radiosensitivity was assessed in 45 patients with Sjögren’s syndrome (27 non-oncological, 18 oncological) by three-color fluorescence in situ hybridization after 2 Gy irradiation of G0 peripheral blood lymphocytes. Results were compared with 211 healthy controls, 129 breast cancer patients, and the previously characterized SLE cohorts (37 non-oncological, 33 oncological). Demographic, clinical, serological, and treatment-related associations were explored in 31 deeply phenotyped patients. Radiosensitivity was significantly increased in non-oncological Sjögren patients (0.527 breaks per metaphase (B/M)) compared with healthy controls (0.411 B/M; p < 0.001) and non-oncological SLE patients (0.404 B/M; p = 0.001), and it remained similarly elevated in oncological Sjögren patients (0.527 B/M), whereas in SLE increased radiosensitivity was predominantly associated with concomitant malignancy. High-grade anti-SSB positivity was associated with increased radiosensitivity in the unadjusted analysis (p = 0.016), but did not withstand correction for multiple testing (q = 0.124). Sjögren’s syndrome is associated with increased ex vivo chromosomal radiosensitivity, with no further apparent increase in patients with concomitant malignancy. This pattern differs from SLE and may suggest a stronger contribution of disease-associated factors. High-grade anti-SSB positivity may represent a relevant serological signal in relation to radiosensitivity, but requires validation in larger cohorts. These findings support closer consideration of individual radiosensitivity in Sjögren’s syndrome and highlight the need for prospective studies integrating ex vivo radiosensitivity with radiotherapy-related toxicity and treatment outcomes in this patient population.

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Cite

BibTeXRIS
BibTeX
@article{strljic2026chromosomal,
  title = {{Chromosomal Radiosensitivity in Sjögren’s Syndrome with and Without Concomitant Malignancy}},
  author = {Elena Strljic and Lukas Kuhlmann and Jochen Wacker and Hans Geinitz and Stefanie Corradini and Georg Schett and Luitpold V Distel and Hannah Schenker},
  journal = {Cells},
  year = {2026},
  month = oct,
  doi = {10.3390/cells15201855},
  url = {https://www.mdpi.com/2073-4409/15/20/1855},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Chromosomal Radiosensitivity in Sjögren’s Syndrome with and Without Concomitant Malignancy
AU  - Elena Strljic
AU  - Lukas Kuhlmann
AU  - Jochen Wacker
AU  - Hans Geinitz
AU  - Stefanie Corradini
AU  - Georg Schett
AU  - Luitpold V Distel
AU  - Hannah Schenker
PY  - 2026
DA  - 2026/10/13
JO  - Cells
DO  - 10.3390/cells15201855
UR  - https://www.mdpi.com/2073-4409/15/20/1855
AB  - Connective tissue diseases have long been hypothesized to confer increased radiosensitivity and radiotherapy-related toxicity, although findings vary between disease entities. In a previous institutional study, we found increased radiosensitivity in patients suffering from systemic lupus erythematosus (SLE), primarily in patients with concomitant malignancy. We therefore investigated Sjögren’s syndrome, an autoimmune disease for which evidence has been limited. Ex vivo chromosomal radiosensitivity was assessed in 45 patients with Sjögren’s syndrome (27 non-oncological, 18 oncological) by three-color fluorescence in situ hybridization after 2 Gy irradiation of G0 peripheral blood lymphocytes. Results were compared with 211 healthy controls, 129 breast cancer patients, and the previously characterized SLE cohorts (37 non-oncological, 33 oncological). Demographic, clinical, serological, and treatment-related associations were explored in 31 deeply phenotyped patients. Radiosensitivity was significantly increased in non-oncological Sjögren patients (0.527 breaks per metaphase (B/M)) compared with healthy controls (0.411 B/M; p < 0.001) and non-oncological SLE patients (0.404 B/M; p = 0.001), and it remained similarly elevated in oncological Sjögren patients (0.527 B/M), whereas in SLE increased radiosensitivity was predominantly associated with concomitant malignancy. High-grade anti-SSB positivity was associated with increased radiosensitivity in the unadjusted analysis (p = 0.016), but did not withstand correction for multiple testing (q = 0.124). Sjögren’s syndrome is associated with increased ex vivo chromosomal radiosensitivity, with no further apparent increase in patients with concomitant malignancy. This pattern differs from SLE and may suggest a stronger contribution of disease-associated factors. High-grade anti-SSB positivity may represent a relevant serological signal in relation to radiosensitivity, but requires validation in larger cohorts. These findings support closer consideration of individual radiosensitivity in Sjögren’s syndrome and highlight the need for prospective studies integrating ex vivo radiosensitivity with radiotherapy-related toxicity and treatment outcomes in this patient population.
SN  - 2073-4409
ER  -