tailieunhanh - Báo cáo y học: " What have we learned from clinical trials in primary Sjögren’s syndrome about pathogenesis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: What have we learned from clinical trials in primary Sjögren’s syndrome about pathogenesis? | Kallenberg et al. Arthritis Research Therapy 2011 13 205 http content 13 1 205 REVIEW What have we learned from clinical trials in primary Sjogren s syndrome about pathogenesis Cees GM Kallenberg1 Arjan Vissink2 Frans GM Kroese1 Wayel H Abdulahad1 and Hendrika Bootsma1 Abstract In vitro and in vivo experimental data have pointed to new immunopathogenic mechanisms in primary Sjogren s syndrome pSS . The availability of targeted treatment modalities has opened new ways to selectively target these mechanistic pathways in vivo. This has taught us that the role of proinflammatory cytokines in particular TNFa is not crucial in the immunopathogenesis of pSS. B cells appear to play a major role as depletion of B cells leads to restoration of salivary flow and is efficacious for treatment of extraglandular manifestations and mucosa-associated lymphoid tissue lymphoma. B cells also orchestrate T-cell infiltration and ductal epithelial dearrangement in the salivary glands. Gene profiling of salivary gland tissue in relation to B-cell depletion confirms that the axis of IFNa B-cell activating factor B-cell activation proliferation and survival constitutes a major pathogenic route in pSS. Introduction Primary Sjogren s syndrome pSS is a systemic autoimmune disease primarily characterized by chronic inflammation of the exocrine glands in particular the salivary and lacrimal glands. Extraglandular manifestations occur in many patients and may involve almost any organ. B-lymphocyte hyperactivity in pSS is manifested by the presence of anti-SS-A and anti-SS-B antibodies rheumatoid factor type 2 cryoglobulins and hypergammaglobulinemia. Prolonged B-cell survival and excessive B-cell activity probably related to increased production of B-cell activating factor BAFF 1 may even lead to mucosa-associated lymphoid tissue lymphomas occurring in 5 of Sjogren s syndrome SS patients 2 3 . Correspondence Department of Rheumatology and .