Memory B-cell aggregates in skin biopsy are diagnostic for primary Sjögren’s syndrome

Roguedas, A.-M.; Pers, Jacques‐Olivier; Lemasson, G.; Devauchelle, Valérie; Tobón, Gabriel J.; Saraux, Alain; Miséry, Laurent; Youinou, Pierre

doi:10.1016/j.jaut.2010.06.014

Cited by 27 publications

(12 citation statements)

References 74 publications

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“…The decrease in blood memory B cells in pSS patients may be explained by their accumulation within salivary glands. Indeed, this variation partly reflects their migration into the exocrine glands of the patients [7], as well as into their skin [14]. We had previously observed that Bm2/Bm2′ cells express CD19 at 55% and 61% higher levels than the same cell subsets in normal controls [8].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögren’s syndrome

Cornec

Saraux

Pers³

et al. 2014

Arthritis Res Ther

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IntroductionThe aims of this study were to evaluate the diagnostic accuracy of blood B-cell subset profiling and immune-system activation marker assays in primary Sjögren’s syndrome (pSS) and to assess whether adding these tools to the current laboratory item would improve the American-European Consensus Group (AECG) criteria.MethodsIn a single-center cohort of patients with suspected pSS, we tested the diagnostic performance of anti-SSA, antinuclear antibody (ANA), rheumatoid factor (RF), gammaglobulins, IgG titers, and B-cell ratio defined as (Bm2 + Bm2′)/(eBm5 + Bm5), determined using flow cytometry. The reference standard was a clinical diagnosis of pSS established by a panel of experts.ResultsOf 181 patients included in the study, 77 had pSS. By logistic regression analysis, only ANA ≥1:640 (sensitivity, 70.4%; specificity 83.2%) and B-cell ratio ≥5 (sensitivity, 52.1%; specificity, 83.2%) showed independent associations with pSS of similar strength. In anti-SSA-negative patients, presence of either of these two criteria had 71.0% sensitivity but only 67.3% specificity for pSS; whereas combining both criteria had 96.2% specificity but only 12.9% sensitivity. Adding either of these two criteria to the AECG criteria set increased sensitivity from 83.1% to 90.9% but decreased specificity from 97.1% to 85.6%, whereas adding both criteria in combination did not substantially modify the diagnostic performance of the criteria set. The adjunction of RF + ANA ≥1:320, as proposed in the new American College of Rheumatology (ACR) criteria, did not improve the diagnostic value of anti-SSA.ConclusionsBlood B-cell subset profiling is a simple test that has good diagnostic properties for pSS. However, adding this test, with or without ANA positivity, does not improve current classification criteria.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögren’s syndrome

Cornec

Saraux

Pers³

et al. 2014

Arthritis Res Ther

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“…Table 1 shows the percentage of xerosis in different series of pSS and secondary SS. In our recent study 22 pSS patients had a higher score for skin dryness on the visual analogue scale compared with 22 healthy controls (58.3 ± 10.1 vs 38.9 ± 7.6; p < 0.01) [10]. Although not reported spontaneously, xerosis was more common in patients (9/22) Sjögren's syndrome is an autoimmune disease characterized by disruption of epithelial cells and lymphoplasmocytic infiltration of exocrine glands throughout the body, mainly salivary and lacrimal glands.…”

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confidence: 81%

“…The most important finding was that two patients with noncontributive MSG biopsy had skin infiltrates (Figure 1a). By contrast, ten Roguedas et al 22 primary 40 [10] future science group Skin biopsy as a routine diagnostic tool for primary Sjögren's syndrome PersPective skin samples from matched healthy volunteers were absolutely devoid of lymphocytes. This result shows that MSG and skin biopsies may be complementary in the study of sicca symptoms and the diagnosis of pSS.…”

Section: Utility Of Skin Biopsy In the Diagnosis Of Pssmentioning

confidence: 96%

“…Recently, we have shown the utility of skin biopsy as a routine diagnostic tool in pSS [10]. This study was developed in 22 pSS patients, diagnosed by minor salivary gland (MSG) biopsy and autoantibodies anti-Ro and/or anti-La, according to the American-European Consensus Group criteria [3].…”

Section: Utility Of Skin Biopsy In the Diagnosis Of Pssmentioning

confidence: 99%

“…It seems that clinical xerosis is not associated with other extraglandular manifestations or immunological parameters[4,10].…”

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confidence: 99%

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Skin biopsy as a routine diagnostic tool for primary Sjögren’s syndrome

Tobón¹,

Roguedas²,

Miséry³

et al. 2011

International Journal of Clinical Rheumatology

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High-dose methylprednisolone pulse therapy upregulated FcγRIIb expression on B cells in primary Sjögren’s syndrome patients with thrombocytopenia

Chen

Zhou

et al. 2013

Clin Rheumatol

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Abnormalities in B cell are characteristic feature of primary Sjögren's syndrome (pSS). As FcγRIIb is a key regulator of B cells, the objective of this study is to investigate the role of the inhibitory receptor FcγRIIb in B cells from pSS patients, and whether glucocorticoid can affect B cell subpopulations or FcγRIIb expression. Thirty pSS patients and 15 healthy controls were enrolled in this study. The results showed that the percentage of memory CD19(+)CD27(+) B cells was significantly lower in pSS patients compared to in healthy controls. FcγRIIb expression on memory CD19(+)CD27(+) B cells from active pSS patients was significantly reduced compared with those from inactive or healthy controls. The level of FcγRIIb on memory CD19(+)CD27(+) B cells from active pSS patients was negatively correlated with anti-SSA antibody titers and Sjögren's syndrome disease activity index. After a high-dose methylprednisolone pulse therapy for 3 days, FcγRIIb expression on memory B cells was upregulated, with the raised level of platelets. In vitro, dexamethasone could elevate FcγRIIb expression on B cells of pSS patients in a dose-dependent manner. Taken together, our data suggest that the upregulation of FcγRIIb may be expected to be a new therapeutic strategy in pSS patients.

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Memory B-cell aggregates in skin biopsy are diagnostic for primary Sjögren’s syndrome

Cited by 27 publications

References 74 publications

Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögren’s syndrome

Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögren’s syndrome

Skin biopsy as a routine diagnostic tool for primary Sjögren’s syndrome

High-dose methylprednisolone pulse therapy upregulated FcγRIIb expression on B cells in primary Sjögren’s syndrome patients with thrombocytopenia

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