Advances in understanding the pathogenesis of primary Sjogren's syndrome

被引:313
作者
Nocturne, Gaetane [1 ]
Mariette, Xavier [1 ]
机构
[1] Univ Paris 11, INSERM U1012, Hop Bicetre, AP HP,Serv Rhumatol, F-94275 Le Kremlin Bicetre, France
关键词
GLAND EPITHELIAL-CELLS; LABIAL SALIVARY-GLANDS; INCREASED SERUM-LEVELS; NON-HODGKINS-LYMPHOMA; NATURAL-KILLER-CELLS; ACTIVATING FACTOR; T-CELLS; MALIGNANT-LYMPHOMA; PERIPHERAL-BLOOD; RISK-FACTOR;
D O I
10.1038/nrrheum.2013.110
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Primary Sjogren's syndrome (pSS) is a prototypic autoimmune disorder, management of which has long suffered from a lack of knowledge of the underlying pathophysiological mechanisms; however, over the past decade major advances have been made in understanding the pathogenesis of pSS. The innate immune system has been demonstrated to have an important role at the early stage of the disease, notably through activation of the type I interferon (IFN) system. In addition, mechanisms of B-cell activation in pSS have become clearer, particularly owing to recognition of the involvement of the TNF family cytokine B-cell-activating factor, production of which is highly dependent on expression of type I and type II IFNs. Moreover, key inroads have been made in understanding lymphomagenesis, the most severe complication of pSS. IL-12 production and subsequent T-cell activation, mainly IFN-gamma-secreting type 1 T-helper cells, have also been implicated in disease pathogenesis. Furthermore, evidence implicates neuroendocrine system dysfunction in pSS pathogenesis. These pathophysiological advances open new avenues of investigation. Indeed, the increased understanding of pSS pathogenesis has already led to the development of promising novel therapeutic strategies. This article summarizes recent findings regarding the pathogenic mechanisms involved in pSS and their implications.
引用
收藏
页码:544 / 556
页数:13
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