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Rheumatol Int. 2018 Jun;38(6):1063-1073. doi: 10.1007/s00296-018-4018-0. Epub 2018 Apr 6.

Association between memory B-cells and clinical and immunological features of primary Sjögren's syndrome and Sicca patients.

Author information

1
CEDOC, Chronic Diseases Research Center, Immunology, NOVA Medical School|FCM, Universidade Nova de Lisboa, Lisbon, Portugal. filipe.barcelos@nms.unl.pt.
2
Departement of Rheumatology, Instituto Português de Reumatologia, Lisbon, Portugal. filipe.barcelos@nms.unl.pt.
3
Department of Rheumatology, Hospital Cuf Descobertas, Lisbon, Portugal. filipe.barcelos@nms.unl.pt.
4
CEDOC, Chronic Diseases Research Center, Immunology, NOVA Medical School|FCM, Universidade Nova de Lisboa, Lisbon, Portugal.
5
CEAUL, Centro de Estatística e Aplicações, Universidade de Lisboa, Lisbon, Portugal.
6
NOVA Medical School|FCM, Universidade Nova de Lisboa, Lisbon, Portugal.
7
Department of Ophthalmology, Centro Hospitalar de Lisboa Central, Hospital de Santo António dos Capuchos, Lisbon, Portugal.
8
Department of Ophthalmology, Hospital Cuf Descobertas, Lisbon, Portugal.
9
Department of Rheumatology, Instituto Português de Reumatologia, Lisbon, Portugal.
10
Department of Rheumatology, Hospital Cuf Descobertas, Lisbon, Portugal.
11
Chronic Diseases Research Center, NOVA Medical School|FCM, Universidade Nova de Lisboa, Lisbon, Portugal.
12
Department of Rheumatology, Centro Hospitalar de Lisboa Ocidental, Hospital de Egas Moniz, Lisbon, Portugal.
13
Department of Immunoalergy, Hospital Cuf Descobertas, Lisbon, Portugal.

Abstract

B-cells play a pivotal role in primary Sjögren's syndrome (pSS) pathogenesis. We aim to (1) evaluate the distribution of B-lymphocyte subpopulations in pSS and Sicca patients, (2) establish cut-off points that discriminate pSS from controls, (3) evaluate the association between memory B-cells and phenotypic features in pSS. We included 57 pSS patients, 68 Sicca and 24 healthy controls. Circulating B-cells were characterized by flow cytometry as naïve and memory subsets and classified from Bm1 to Bm5. Compared to controls, pSS patients had lower percentages (29.5 vs 44.4%) and absolute numbers (47 vs 106 cells/µl) of memory B-cells. Through ROC curves, a cut-off of ≤ 58 total memory B-cells/µl yielded a specificity of 0.88 and a sensitivity of 0.60 for pSS, and was met by 59.6% of pSS patients, 38.8% of Sicca and 12.5% of controls. A cut-off of < 23.5 Switched-memory B-cells/µl yielded a specificity of 0.88 and a sensitivity of 0.54 and was met by 54.4% of pSS patients, 37.3% of Sicca and 12.5% of controls. In pSS, lower total memory B-cells count was associated with longer disease duration (14.3 vs 8.1 years, p = 0.006) and more active disease profile, as evaluated by the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) (3.1 vs 1.4, p = 0.043). Decreased numbers of memory B-cells clearly discriminated pSS from controls and can also have prognostic value. It remains to be clarified whether Sicca patients with decreased memory B-cells represent pSS and if B-cell profiling could help in the diagnosis of pSS.

KEYWORDS:

Autoimmunity; Diagnosis; Flow cytometry; Memory B cells; Sjögren’s syndrome

PMID:
29623391
DOI:
10.1007/s00296-018-4018-0
[Indexed for MEDLINE]

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