ArticleThe open rheumatology journal2008
Resistance to rituximab therapy and local BAFF overexpression in Sjögren's syndrome-related myoepithelial sialadenitis and low-grade parotid B-cell lymphoma.
Article in The open rheumatology journal, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 64 citations in OpenAlex.
- Identification and validation of biomarkers associated with acute and chronic graft versus host disease.Bone marrow transplantation · 2015Trial
- Role of Fibroblast-Immune Crosstalk in Kidney, Lung, and Skin Tertiary Lymphoid Structures.Immunological reviews · 2025Review
- B-Cell Receptor Signaling Is Thought to Be a Bridge between Primary Sjogren Syndrome and Diffuse Large B-Cell Lymphoma.International journal of molecular sciences · 2023Article
- Disparity in peripheral and renal B-cell depletion with rituximab in systemic lupus erythematosus: an opportunity for obinutuzumab?Rheumatology (Oxford, England) · 2022Article
- Role of tertiary lymphoid organs in the regulation of immune responses in the periphery.Cellular and molecular life sciences : CMLS · 2022Review
- Review
- Immunofibroblasts are pivotal drivers of tertiary lymphoid structure formation and local pathology.Proceedings of the National Academy of Sciences of the United States of America · 2019Article
- Phosphatidylinositol 3-kinase delta pathway: a novel therapeutic target for Sjögren's syndrome.Annals of the rheumatic diseases · 2019Article
- Tertiary Lymphoid Structures: Autoimmunity Goes Local.Frontiers in immunology · 2018Review
- Ectopic lymphoid neogenesis in rheumatic autoimmune diseases.Nature reviews. Rheumatology · 2017Review
- Transcriptional profiling of PBMCs unravels B cell mediated immunopathogenic imprints of HCV vasculitis.PloS one · 2017Article
- B-cell subpopulations in humans and their differential susceptibility to depletion with anti-CD20 monoclonal antibodies.Arthritis research & therapy · 2013Review
- A p53 axis regulates B cell receptor-triggered, innate immune system-driven B cell clonal expansion.Journal of immunology (Baltimore, Md. : 1950) · 2012Article
- Controversies on rituximab therapy in sjögren syndrome-associated lymphoproliferation.International journal of rheumatology · 2009Article
- Diagnostic Abilities for Determining the Level of Blood Cryoglobulins in the Choice of Tactics for Operations on the Small Intestine.Journal of medicine and lifeArticle
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveB-cell expansion is a key feature of Sjögren's syndrome (SS). Accordingly, several studies have reported the benefits of B-cell depletion with anti-CD20 monoclonal antibody (Rituximab) in the treatment of glandular and extraglandular manifestations of SS. Patients with SS are at increased risk of lymphoma development. B-lymphocyte stimulator (BAFF) is an essential cytokine for the control of B-cell maturation and survival, and high levels of BAFF were described in the serum and salivary glands of SS patients, strongly suggesting a crucial role in the proliferation of B cells in SS. PATIENT AND
methodsWe describe the treatments employed, with particular regards to rituximab therapy, and the histopathologic and biologic studies, in particular BAFF levels in serum and in pathologic tissues before and after B-cell depletion therapy, and the characterization of the cultured epithelial cells obtained by the parotid gland MALT-lymphoma, in a case of a 51-year old woman with primary SS and mixed cryoglobulinaemia type II with features of systemic vasculitis, who developed a bilateral parotid MALT-type lymphoma. Rheumatoid factor (RF), cryoglobulins, BAFF levels were assessed monthly up to month +6, then at the end of follow-up (month +12), as well as peripheral blood CD19-positive B-cell level
resultsA significant systemic effect of rituximab on B-cell biomarkers was documented, however, the cryoglobulinemic syndrome did not improve and the parotid enlargement did not decrease confirming the failure of B-cell depletion to affect the parotid lymphoma. BAFF levels decreased only under B-cell depletion associated with high-dose steroids. Tissue studies further documented the persistent overexpression of BAFF in the salivary gland pathologic tissue during the disease course.
conclusionTissue and systemic overexpression of BAFF may have contributed to resistance to rituximab therapy, in MALT lymphoproliferation associated with SS. Thus, alternative treatment strategies should be then considered, possibly including BAFF-targeted approaches.
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Registered trials
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