Abstract

BackgroundTreatment of patients with Sjögren’s syndrome (SjS) is a clinical challenge with high unmet needs. Gene expression profiling and integrative network-based approaches to complex disease can offer an insight on molecular characteristics in the context of clinical setting.MethodsAn integrated dataset was created from salivary gland samples of 30 SjS patients. Pathway-driven enrichment profiles made by gene set enrichment analysis were categorized using hierarchical clustering. Differentially expressed genes (DEGs) were subjected to functional network analysis, where the elements of the core subnetwork were used for key driver analysis.ResultsWe identified 310 upregulated DEGs, including nine known genetic risk factors and two potential biomarkers. The core subnetwork was enriched with the processes associated with B cell hyperactivity. Pathway-based subgrouping revealed two clusters with distinct molecular signatures for the relevant pathways and cell subsets. Cluster 2, with low-grade inflammation, showed a better response to rituximab therapy than cluster 1, with high-grade inflammation. Fourteen key driver genes appeared to be essential signaling mediators downstream of the B cell receptor (BCR) signaling pathway and to have a positive relationship with histopathology scores.ConclusionIntegrative network-based approaches provide deep insights into the modules and pathways causally related to SjS and allow identification of key targets for disease. Intervention adjusted to the molecular traits of the disease would allow the achievement of better outcomes, and the BCR signaling pathway and its leading players are promising therapeutic targets.

Highlights

  • Treatment of patients with Sjögren’s syndrome (SjS) is a clinical challenge with high unmet needs

  • A list of Differentially expressed genes (DEGs) was attained by the comparison of gene expression profiles of the salivary gland from SjS patients with those from normal healthy controls (NCs)

  • We identified that the B cell receptor (BCR) signaling pathway and B cell activation were the main processes of the core subnetwork, the largest connect component (LCC), in SjS (Fig. 2a)

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Summary

Introduction

Treatment of patients with Sjögren’s syndrome (SjS) is a clinical challenge with high unmet needs. Sjögren’s syndrome (SjS) is a systemic autoimmune disease with a specific predisposition for causing inflammation of the exocrine glands, predominantly the salivary and lacrimal glands [1, 2]. This exocrinopathy usually results in dryness of the mouth and eyes, fatigue, and joint pain, and has a negative effect on quality of life [1, 2]. Despite decades of intensive research, current management is limited to the treatment of sicca symptoms and no effective drug has yet been shown to modify the underlying etiopathogenesis [1, 2]

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