The B-lymphocyte stimulator connection in Sjogren's syndrome

Abstract

Is there a place for using BLyS as a potential therapeutic target?This editorial refers to BLyS upregulation in Sjögren's syndrome associated with lymphoproliferative disorders, higher ESSDAI score and B-cell clonal expansion in the salivary glands by L Quartuccio, S Salvin, M Fabris et al. Rheumatology 2012;51: doi:10.1093/rheumatology/kes180, on pages 276–281.B cells are central to the pathogenesis of primary SS (pSS). The disease is characterized by marked polyclonal B-cell hyperactivity, which may switch on monoclonal B-cell expansion that may result in B-cell lymphoma, the worst complication of pSS, in some patients. In this issue of Rheumatology, Quartuccio et al. [1] report the results of an analysis of serum levels of B-lymphocyte stimulator (BLyS) (also known as BAFF) and the clinical, histopathological and immunological expression of pSS. The study is retrospective and includes a limited number of pSS patients, and the generalizability of the results may be restricted by the possible variation in the measurement of BLyS levels. However, the close association reported between BLyS levels and the main immunological markers, disease activity, histopathological B-cell clonality and B-cell lymphoma supports a crucial role of BLyS in the pathogenesis of pSS.