Master Theses UMCG - University of Groningen
 
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Local influence of rituximab and abatacept treatment on follicular helper T-lymphocytes in salivary glands of patients with primary Sjögren’s syndrome

(2016) Broekman, H.L.F.

The aim of this project was to investigate whether follicular helper T cells are present in the major salivary glands of primary Sjögren’s syndrome patients and to determine the effect of treatment with rituximab or abatacept on these cells. Furthermore, we analyzed local levels of IL21, a signature cytokine produced by Tfh-cells, before and after treatment. Tfh-cells defined by their expression of ICOS and CXCR5 were found in some, but not all patients analyzed. Also high numbers of IL21-positive cells were found in the parotid glands of all patients, and a decrease was seen in some patients after treatment with both rituximab and abatacept. Decreased expression of IL21 and CXCL13 was also seen at the mRNA level, suggesting a possible reduction in Tfh-cell activity and attraction of CXCR5+ cells into the salivary gland. Because of the small number of patients analyzed in this study, no statistically significant changes were yet detected. However, the results described here do suggest a possible local effect on Tfh-cells and other IL21-producing cells of both rituximab and abatacept in primary Sjögren’s syndrome. The presence of Tfh-cells and the high number of IL21-positive cells in the parotid glands also suggests that Tfh-cells are involved in the inflammatory process seen in pSS.





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