Session Type: Abstract Submissions (ACR)
To prospectively evaluate histopathologic, blood and clinical responses to abatacept treatment in patients with primary Sjögren’s syndrome (pSS).
Blood, saliva and minor salivary gland biopsies were obtained prior to and after the last of 8 doses of abatacept in 11 pSS patients. Histology evaluated the number of lymphocytic foci and of B- and T-cell subtypes (CD20+, CD3+, CD4+, CD8+). The numbers of FoxP3+ regulatory T-cells and the FoxP3 /CD 3 ratio was calculated. The histologic data were compared with results from peripheral blood and with changes in saliva secretion.
The numbers of lymphocytic foci decreased (p=0.09) with a corresponding reduction of CD20+, CD3+, CD4+ and CD8+ T-cells. Numbers of local FoxP3+ T-cells decreased in 9 of 10 samples (p=0.022). In peripheral blood CD3+ cells did not change in numbers while CD20+ B cells increased (p=0.038). This increase was due to an expansion of the naïve B cell pool (p=0.012). The slight decrease in gamma globulins and IgG did not reach significance (P=0.09 and 0.169, respectively). Overall, saliva secretion did not change, however 7 of 11 patients showed an increase in saliva secretion (p=0.018 for the 7 responders).
Inhibition of T cell co-stimulation using CTLA4-Ig leads to a reduced inflammation in glandular tissue with a 50% decrease in FoxP3+ cells, to an expansion of peripheral naïve B cells and to an increase in saliva secretion in 70% of pSS patients. In conclusion, abatacept bears the potential of a disease-modifying biologic agent in pSS.
M. D. Caversaccio,
P. M. Villiger,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/histological-serological-and-clinical-changes-in-response-to-abatacept-treatment-of-sjogrens-syndrome/