title: Are the B cells cast with the leading part in the Sjogren's syndrome scenario?
abstract: The autoimmune exocrinopathy Sjögren's syndrome (SS) is characterized by mononuclear cell (MNC) infiltrates of exocrine glands and overactivity of B lymphocytes. Although T cells have long been perceived as the prime effectors, increasing evidence indicates that the key role is rather served by B cells. Among related abnormalities are rheumatoid factor (RF), anti-SSA/Ro, and anti-SSB/La antibodies (Ab). Also, supporting this view is our finding of an increase in the number of circulating naïve mature B (Bm) cells, with a reciprocal decrease in that of memory B cells. Furthermore, a ratio of Bm2-plus-Bm2' cells to early Bm5-plus-late Bm5 above 5 is diagnostic. This variation partly reflects the migration of active memory B cells into the exocrine glands of the patients, as well as into their skin. More recently, the B-cell-activating factor of the TNF family (BAFF) has been endorsed with a pivotal role in B-cell survival and hence implicated in the pathogenesis of autoimmunity. In practice, B cells have turned quite attractive as a target for biotherapy. For example, treatment with anti-CD20 Ab has afforded some benefits in this disease, while BAFF blockers are still on the way, but should expand our armamentarium for treating SS. With such B-cell-directed biotherapies in mind, we delineate herein the distinguishing traits of B lymphocytes in SS.
authors.affiliation: EA2216, Research Unit of Immunopathology, University of Brest, Brest, France.
authors.forename: J O
authors.initials: JO
authors.lastname: Pers
authors.forename: P
authors.initials: P
authors.lastname: Youinou
mesh_terms: D015703:Antigens, CD / Q000032:analysis; D016175:B-Lymphocyte Subsets / Q000737:chemistry / Q000145:classification* / Q000276:immunology / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D018655:Lymphocyte Count; D012469:Salivary Glands / Q000276:immunology / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*
chemical_list: D015703:Antigens, CD; D016207:Cytokines
keywords: B lymphocytes; BAFF; Flt3 ligand; Sjögren's syndrome; non-Hodgkin's lymphoma