A) In MSG from patients with advanced disease, the extensive lymphoid infiltrate with germinal centers leads to interstitial fibrosis (arrows) and acinar atrophy, as ECM and adipose cells impinge on structure and functionality, compared to noninflamed MSG (B) H&E, original magnification 10X. C) Trichrome stain delineating interstitial fibrosis, along with acinar loss and mononuclear infiltration. Original magnification 20X. D) By RT-PCR, a representative collagen molecule, Col1A1, expression was not increased in early/intermediate disease MSG, but was significantly enhanced in the MSG of subjects with chronic/severe SS relative to MSG of individuals without SS; p<0.01.