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When B cells break bad: development of pathogenic B cells in Sjogren's syndrome


Primary Sjogren's syndrome (pSS) is often considered a B cell-mediated disease, yet the precise role of B cells in the pathogenesis is not fully understood. This is exemplified by the failure of multiple clinical trials directed at B cell depletion or inhibition. To date, most prognostic markers for severe disease outcomes are autoantibodies, but the underlying mechanisms by which B cells drive diverse disease presentations in pSS likely extend beyond autoantibody production. Here we outline an expanded role of B cells in disease pathogenesis drawing on examples from animal models of SS, and from other autoimmune diseases that share similar clinical or immunological abnormalities. We focus on recent findings from the detailed analysis of pathogenic B cells in patients with pSS to propose strategies for patient stratification to improve clinical trial outcomes. We conclude that an integrated cellular, molecular and genetic analysis of patients with pSS will reveal the underlying pathogenic mechanisms and guide precision medicine.

Type Journal
ISBN 0392-856X (Print) 0392-856X (Linking)
Authors Reed, J. H.; Verstappen, G. M.; Rischmueller, M.; Bryant, V. L.
Responsible Garvan Author Dr Joanne Reed
Published Date 2020-08-01
Published Volume 38 Suppl 126
Published Issue 4
Published Pages 271-282
Status Published in-print
URL link to publisher's version