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Stereotypic Rheumatoid Factors That Are Frequently Expressed in Mucosa‐Associated Lymphoid Tissue–Type Lymphomas Are Rare in the Labial Salivary Glands of Patients With Sjögren's Syndrome
Author(s) -
Bende Richard J.,
Slot Linda M.,
Hoogeboom Robbert,
Wormhoudt Thera A. M.,
Adeoye Akanbi O.,
Guikema Jeroen E. J.,
Noesel Carel J. M.
Publication year - 2015
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.39002
Subject(s) - lymphoma , salivary gland , clone (java method) , pathology , b cell , malt lymphoma , rheumatoid factor , biology , lymphatic system , antibody , medicine , immunology , gene , biochemistry
Objective Among autoimmune diseases, Sjögren's syndrome (SS) is most strongly associated with the development of malignant B cell lymphoma, in particular mucosa‐associated lymphoid tissue (MALT)–type lymphoma. Previously, we have shown that in ∼40% of cases of salivary gland MALT lymphoma, high‐affinity stereotypic rheumatoid factor (RF) B cell receptors, specific for IgG‐Fc, are expressed. This study was undertaken to investigate whether in the inflamed salivary glands of patients with SS, a similar RF‐biased Ig repertoire is present. Methods Extensive analyses of the B cell Ig V H region repertoire were performed on microdissected tissue samples from the labial salivary glands of 4 patients with SS. Results All SS labial salivary glands harbored expanded B cell clones, of which 1 or 2 were highly expanded and detected in >50% of the microdissected samples. However, among the identified 464 distinct Ig clonotypes, only 3 stereotypic RF–expressing clones were detected. In 2 patients with SS, an RF‐expressing clone was detected at low frequency in 1 of the microdissected samples, whereas 1 patient with SS harbored a highly expanded RF‐expressing clone that was detected in all microdissected samples and also detected in the peripheral blood. Two years after analysis of this sample, the latter patient developed a diffuse large B cell lymphoma originating from the same RF clone. Conclusion Inflamed labial salivary glands in patients with SS generally harbor 1 or 2 highly expanded B cell clones. The repertoire strongly biased toward stereotypic RFs in salivary gland MALT lymphomas is not a reflection of a similar repertoire in the inflamed salivary glands of patients with SS; rather, in the latter, the repertoire is based on a strong selection advantage of incidental stereotypic RF–expressing B cells.