Follicular helper T cells may play an important role in the severity of primary Sjogren's syndrome

The aim of this study was to investigate the possible role of follicular helper T (T-FH) cells in the pathogenesis of primary Sjogren's syndrome (pSS) by analyzing immune-competent cells and serological markers with special emphasis on clinical symptoms. We enrolled 50 pSS patients and 16 healthy individuals in the study. Patients had elevated ratio of peripheral T-FH cells, however, when dividing patients into two groups defined by the presence of extraglandular manifestations (EGMs), only patients with EGMs differed from controls significantly. Moreover, T-FH cell percentages correlated positively with both activated T cell and Tr1 cell values. On the contrary, T-FH cell percentages showed negative correlation with both IgM and IgG memory B cell proportions. Elevated T-FH percentages were observed in the anti-SSA/SSB positive patients, and also in patients with higher IL-12, IL-21 levels and focus score values. Increased T-FH cell proportions seem to have an important role in disease development. (C) 2013 Elsevier Inc. All rights reserved.