In primary Sjögren's syndrome high absolute numbers and proportions of B cells in parotid glands predict responsiveness to rituximab as defined by ESSDAI, but not by SSRI
In primary Sjögren's syndrome high absolute numbers and proportions of B cells in parotid glands predict responsiveness to rituximab as defined by ESSDAI, but not by SSRI
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在原发性干燥综合征中，腮腺中 B 细胞的绝对数量和比例较高可预测对利妥昔单抗的反应（如 ESSDAI 所定义，但 SSRI 未定义）
DOI：
10.1136/annrheumdis-2016-209317
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发表时间：
2016
影响因子：
27.4
通讯作者：
F. Spijkervet
中科院分区：
文献类型：
--
作者：
K. Delli;E. Haacke;F. Kroese;R. Pollard;S. Ihrler;B. van der Vegt;A. Vissink;H. Bootsma;F. Spijkervet
我们怀着极大的兴趣阅读了Cornec等人写给编辑的关于我们的论文“原发性干燥综合征（pSS）的个性化治疗：基线腮腺组织病理学预测对利妥昔单抗治疗的反应性”的信实质上，我们在论文中表明，腮腺组织实质CD20+细胞的绝对数量/mm2可预测pSS患者对利妥昔单抗（RTX）治疗的反应性。Cornec等人认为，他们的研究和我们的研究结果存在差异，1因为他们观察到，小唾液腺B细胞的高比例预测rtx缺乏临床反应。3正如我们将在这里展示和解释的那样，两项研究之间没有不一致之处，大多数明显的差异可能是组织分析方式和疾病活动建立方式的差异的结果。
With great interest we have read the letter to the editor by Cornec et al 1 regarding our paper ‘Towards personalised treatment in primary Sjogren's syndrome (pSS): baseline parotid histopathology predicts responsiveness to rituximab treatment’.2 In essence, we showed in our paper that absolute numbers of CD20+ cells/mm2 of parenchyma of parotid gland tissue are predictive for the responsiveness of patients with pSS to rituximab (RTX) treatment. Cornec et al argue that there is a discrepancy in outcomes presented in their study and our study,1 as they observed that a high proportion of minor salivary gland B cells predict the absence of a clinical response to RTX.3 As we will show and explain here, there is no inconsistency between the two studies and most of the apparent discrepancy is likely the result of differences in how the tissues are analysed and how the disease activity is established.
A major difference in the two studies is how B cells are assessed in tissue sections of salivary gland biopsies of patients with pSS before (and after) RTX treatment. We measured absolute numbers of CD20+ B cells/mm2 of parenchyma, while Cornec et al assessed the proportion of B cells.1 ,3 Obviously, even when there is a change in absolute numbers of B cells in the tissue, the B/T cell ratio still can remain the same. Thus, although higher numbers of B cells, do not need to be reflected per se in higher proportions of B cells, we also found in our study that patients with higher absolute numbers of B cells in the glandular tissue, had a higher B/B+T cell ratio. Furthermore, responders to RTX, as defined by a decrease in European League Against …