Abstract

Sjögren’s syndrome (SS) is a female dominated autoimmune disease characterized by lymphocytic infiltration into salivary and lacrimal glands and subsequent exocrine glandular dysfunction. SS also may exhibit a broad array of extraglandular manifestations including an elevated incidence of non-Hodgkin’s B cell lymphoma. The etiology of SS remains poorly understood, yet progress has been made in identifying progressive stages of disease using preclinical mouse models. The roles played by immune cell subtypes within these stages of disease are becoming increasingly well understood, though significant gaps in knowledge still remain. There is evidence for distinct involvement from both innate and adaptive immune cells, where cells of the innate immune system establish a proinflammatory environment characterized by a type I interferon (IFN) signature that facilitates propagation of the disease by further activating T and B cell subsets to generate autoantibodies and participate in glandular destruction. This review will discuss the evidence for participation in disease pathogenesis by various classes of immune cells and glandular epithelial cells based upon data from both preclinical mouse models and human patients. Further examination of the contributions of glandular and immune cell subtypes to SS will be necessary to identify additional therapeutic targets that may lead to better management of the disease.

Highlights

  • Sjögren’s syndrome (SS) is the second most common autoimmune disorder after rheumatoid arthritis (RA) [1]

  • We aim to present the current state of knowledge on how the common cell types of the innate and adaptive immune systems contribute to SS as revealed by studies of human patients and animal models

  • Similar observation was seen in the salivary glands (SG) of C57BL/6.non-obese diabetic (NOD)-Aec1Aec2 mice at similar age [28]. Together these findings offer insights as to how the aberrant activity of both innate and adaptive immune cells mediate the pathogenesis of SS

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Summary

Introduction

Sjögren’s syndrome (SS) is the second most common autoimmune disorder after rheumatoid arthritis (RA) [1]. The lymphocytes that infiltrate into the exocrine glands can organize into focal structures in which germinal center-like formation is present in approximately 25% of primary SS patients [4], establishing a structure for local production of autoantibodies [4,5]. While the adaptive immune cells like B and T cells have traditionally attracted the most interest due to their predominant presence in the exocrine glands and the immunological importance autoantibodies, increasing evidence shows that immune system dysfunction in SS incorporates cells of the innate immune system as well [7,8,9,10,11,12]. We aim to present the current state of knowledge on how the common cell types of the innate and adaptive immune systems contribute to SS as revealed by studies of human patients and animal models

Disease Development
Dendritic Cells
Macrophages
Th1 Cells
Th2 Cells
Th17 Cells
Marginal Zone B Cells
Memory B Cells and Plasma B Cells
Findings
Conclusions

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