title: Histological improvement in salivary gland along with effector memory Th17-1 cell reduction in a primary Sjogren's syndrome patient with dermatomyositis and diffuse large B-cell lymphoma by R-CHOP therapy.
abstract: We treated a 45-year-old Japanese woman with primary Sjogren's syndrome (SS) complicated with dermatomyositis (DM) followed by diffuse large B-cell lymphoma. She was admitted to our hospital for further evaluation of fever, weight loss and peritoneal lymphadenopathy. The histological examination of her lymph node revealed diffuse large B-cell lymphoma. The patient was then treated with 8 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy, which resulted in histological and functional improvement of her salivary glands. Of note, the percentage of effector memory Th17-1 (CD3+CD4+CD45RA-CCR7-CXCR3+CCR6+) cells in the peripheral blood was decreased after the R-CHOP treatment. This case suggests that an altered Th17-1 cell subset by B-cell depletion therapy is critical for the improvement of tissue damage in patients with SS, and the case suggests that clinicians should consider measuring the effector memory Th-subsets to predict the disease activity in SS patients.
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8102, Japan. Electronic address: tkoga@nagasaki-u.ac.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Koga
authors.affiliation: Department of Rheumatology, Japan Community Health care Organization, Isahaya General Hospital, Isahaya 854-8501, Japan.
authors.forename: Akinari
authors.initials: A
authors.lastname: Mizokami
authors.affiliation: Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakashima
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Hematology, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Chiwata
authors.affiliation: Department of Pathology, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
authors.forename: Niino
authors.initials: N
authors.lastname: Daisuke
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000494:pharmacology / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D049109:Cell Proliferation / Q000187:drug effects; D003520:Cyclophosphamide / Q000494:pharmacology / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications*; D004317:Doxorubicin / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications*; D008875:Middle Aged; D011241:Prednisone / Q000494:pharmacology / Q000627:therapeutic use; D000069283:Rituximab; D012469:Salivary Glands / Q000187:drug effects / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000150:complications* / Q000188:drug therapy*; D058504:Th17 Cells / Q000166:cytology* / Q000276:immunology; D016896:Treatment Outcome; D014750:Vincristine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Dermatomyositis; Diffuse large B-cell lymphoma; Primary Sjogren's syndrome; R-CHOP therapy; Th17-1 cell