Circulating CCR7loPD-1hi Follicular Helper T Cells Indicate Disease Activity and Glandular Inflammation in Patients with Primary Sjögren’s Syndrome

Ji-Won Kim¹, Jaeseon Lee ², Ui Hong Jung ¹, Sung-Hoon Park ¹, Jennifer Lee ³, Seung-Ki Kwok ³ and Sung-Hwan Park ³, ¹Catholic University of Daegu School of Medicine, Daegu, Republic of Korea, ²Catholic University of Korea, College of Medicine, Seoul, Republic of Korea, ³Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: B cells, Disease Activity and T-Regulatory Cells, Sjogren's syndrome, T cells

Session Information

Date: Tuesday, November 12, 2019

Session Title: Sjögrenʼs Syndrome – Basic & Clinical Science Poster I

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Since primary Sjögren’s syndrome (pSS) is an autoummune disease of B cell hyperactivity and pathologic autoantibody response, follicular helper T (Tfh) cells and follicular regulatory T (Tfr) cells are suggested to be key players in pSS. We examined subsets of Tfh and Tfr cells from the blood in pSS patients, and whether these subsets represent disease activity, glandular inflammation, or autoantibody responses in pSS.

Methods: Circulating Tfh and Tfr cells, along with their specific subsets, were identified from the peripheral blood of 18 pSS patients and 14 age- and sex-matched healthy controls using flow cytometry analysis. Patients with pSS fulfilled the 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for pSS. Serum interleukin (IL)-21 was measured using the enzyme-linked immunosorbent assay. We examined the correlation of blood Tfh and Tfr cells and their subsets with disease activity, blood B-cell subsets, serum autoantibody titers, serum immunoglobulin G (IgG) levels, and serum IL-21 levels in pSS.

Results: Blood Tfr and Tfh cell ratios were increased in pSS patients compared with healthy controls. The CCR7^loPD-1^hi subset of circulating Tfh cells was increased in pSS patients with high degree of focal lymphocytic sialadenitis; whereas circulating Tfh cells did not differ between pSS patients and healthy controls. The frequency of CCR7^loPD-1^hi Tfh cells was significantly correlated with disease activity scores (Spearman’s rho = 0.552, p = 0.018) and differentiated B cells. PD-1 expression on blood Tfh and Tfr cells showed positive correlations with IL-21 in pSS. Increasing trend of blood Tfr cells was observed in primary pSS patients, and blood Tfr cells (particularly Th1 and Th17 subsets) represented hypergammaglobulinemia in pSS.

Conclusion: Circulating CCR7^loPD-1^hi Tfh cells indicated disease activity and glandular inflammation in pSS. Circulating Tfr cells, shifted toward Th1 and Th17 subsets, indicated ongoing IgG production in pSS. Subsets of circulating Tfh or Tfr cells could be biomarkers for disease monitoring and patient stratification in pSS.

Disclosure: J. Kim, None; J. Lee, None; U. Jung, None; S. Park, None; J. Lee, None; S. Kwok, None; S. Park, None.

To cite this abstract in AMA style:

Kim J, Lee J, Jung U, Park S, Lee J, Kwok S, Park S. Circulating CCR7loPD-1hi Follicular Helper T Cells Indicate Disease Activity and Glandular Inflammation in Patients with Primary Sjögren’s Syndrome [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/circulating-ccr7lopd-1hi-follicular-helper-t-cells-indicate-disease-activity-and-glandular-inflammation-in-patients-with-primary-sjogrens-syndrome/. Accessed November 20, 2019.

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