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Low levels of natural killer cells linked to response to Benlysta in patients with Sjögren’s syndrome
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Recently published data show patients with primary Sjögren’s syndrome who responded to treatment with Benlysta had lower levels of natural killer cells in both blood and saliva.
Researchers studied 15 patients enrolled in the Efficacy and Safety of Belimumab in Subjects with Primary Sjögren’s Syndrome (BELISS) trial at two centers in Paris and Udine, Italy. Patients had a median age of 44 years with a median disease duration of 1 year. Blood and saliva were analyzed and minor labial salivary gland (LSG) biopsies were performed at week 0 and week 28.
All patients were women and met the American-European Consensus Group criteria for primary Sjögren’s syndrome (pSS), were positive for anti-Sjögren’s syndrome antigen A (SSa) or anti–Sjögren’s syndrome antigen B (SSb) antibodies and had either systemic complications or persistent salivary gland enlargement, less than 5 years since disease onset, the presence of at least one biomarker of B-cell activation. Salivary gland swelling was present in eight of the patients and 11 patients had other systemic involvement.
Patients were treated with Benlysta (belimumab, GlaxoSmithKline) at 10 mg/kg every 4 weeks to week 24.
Following treatment, the median total lymphocyte count did not significantly change while an increase in the number of natural killer cells was observed, regardless of the presence of glandular or systemic involvement. A decrease in B lymphocytes, primarily CD27immunoglobulin D+ (IgD+) naïve B cells, was observed as early as week 4 and the reduction persisted through week 28. The total number of CD27+ memory B cells and CD27+ IgD+ unswitched memory B cells remained mostly unchanged.
At baseline, the lymphocytic sialadenitis with a focus score greater than 1 was detected in 12 salivary biopsies, and the median focus score decreased from 1.6 to 0.5 following treatment with belimumab. B-cell activating factor (BAFF) staining was present in 11 of 14 patients at baseline and in seven patients at week 28. A decrease from 27.5% in the median percentage of BAFF-positive cells in foci to 5% following treatment was observed. Natural killer cell infiltration did not change following treatment. – by Shirley Pulawski
Disclosure: Seror reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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