title: The histopathology of labial salivary glands in primary Sjögren's syndrome: focusing on follicular helper T cells in the inflammatory infiltrates.
abstract: Recently, we revealed the importance of follicular helper T cells (T(FH)) in the pathogenesis of primary Sjögren's syndrome (pSS). In the present study, we focused on the site of the inflammation and determined the composition of lymphocyte infiltration in labial salivary gland (LSG) biopsies with special emphasis on T(FH) and germinal center B cells. We selected tissue blocks obtained from ten patients at the time of disease onset. Detection of cell specific markers was performed with immunohistochemical and immunofluorescence stainings. We evaluated patients' clinical and laboratory features retrospectively and assessed the relation between disease course and early histopathological findings. LSG biopsies were graded based on the extension and arrangement level of periductal inflammatory cell infiltrates. T(FH) cell markers (CD84, PD-1, and Bcl-6) occurred predominantly in more organized structures with higher focus scores. The coexpression of CD3 and Bcl-6 markers clearly identified T(FH) cells close to Bcl-6(+) B cells with the typical formation of germinal centers. Systemic features were developed later in the disease course only in patients with highly structured infiltrates and the presence of T(FH) cells. Our observations suggest that the presence of T(FH) cells in LSGs at the disease onset may predict a more pronounced clinical course of pSS.
authors.affiliation: Division of Clinical Immunology, Medical Center, University of Debrecen, Moricz Zs. Street 22, Debrecen 4032, Hungary.
authors.forename: Krisztina
authors.identifier: 0000-0002-0079-3659
authors.initials: K
authors.lastname: Szabo
authors.affiliation: Division of Clinical Immunology, Medical Center, University of Debrecen, Moricz Zs. Street 22, Debrecen 4032, Hungary.
authors.forename: Gabor
authors.initials: G
authors.lastname: Papp
authors.affiliation: Department of Pathology, Medical Center, University of Debrecen, Nagyerdei Boulevard 98, Debrecen 4032, Hungary.
authors.forename: Balazs
authors.initials: B
authors.lastname: Dezso
authors.affiliation: Division of Clinical Immunology, Medical Center, University of Debrecen, Moricz Zs. Street 22, Debrecen 4032, Hungary.
authors.forename: Margit
authors.identifier: 0000-0002-4698-3351
authors.initials: M
authors.lastname: Zeher
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D066298:In Vitro Techniques; D007249:Inflammation / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012469:Salivary Glands / Q000276:immunology* / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000276:immunology* / Q000473:pathology*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology* / Q000473:pathology*