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Nocturne G, Virone A, Ng WF, Le Guern V, Hachulla E, Cornec D, Daien C, Vittecoq O, Bienvenu B, Marcelli C, Wendling D, Amoura Z, Dhote R, Lavigne C, Fior R, Gottenberg JE, Seror R, Mariette X. Rheumatoid Factor and Disease Activity Are Independent Predictors of Lymphoma in Primary Sjögren's Syndrome. Arthritis Rheumatol 2016; 68:977-85. [DOI: 10.1002/art.39518] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/17/2015] [Indexed: 12/11/2022]
Affiliation(s)
- G. Nocturne
- Université Paris-Sud, INSERM U1184; Le Kremlin-Bicêtre France
| | - A. Virone
- AP-HP, Hôpitaux Universitaires Paris-Sud; Le Kremlin-Bicêtre France
| | - Wan-Fai Ng
- Newcastle University; Newcastle-upon-Tyne UK
| | - V. Le Guern
- Université Paris Descartes and AP-HP, Hôpital Cochin; Paris France
| | | | - D. Cornec
- Centre Hospitalier Régional Universitaire (CHRU) de Brest, Hôpital de la Cavale Blanche and EA 2216, INSERM ESPRI, ERI29, Université de Brest; Brest France
| | - C. Daien
- Centre Hospitalier Universitaire (CHU) de Montpellier and URM5535 CNRS; Montpellier France
| | - O. Vittecoq
- CHU de Rouen, INSERM U905, and Université de Rouen; Rouen France
| | - B. Bienvenu
- CHU de Caen, Hôpital de la Côte de Nacre; Caen France
| | - C. Marcelli
- CHU de Caen, Hôpital de la Côte de Nacre; Caen France
| | - D. Wendling
- CHRU Besançon, and EA 4266, Université de Franche-Comté; Besançon France
| | - Z. Amoura
- Université Pierre et Marie Curie and AP-HP, Hôpital Pitié-Salpêtrière; Paris France
| | | | | | - R. Fior
- AP-HP, Hôpital Béclère; Clamart France
| | - J. E. Gottenberg
- INSERM UMR-S 1109, CHRU Strasbourg, and Université de Strasbourg; Strasbourg France
| | - R. Seror
- Université Paris-Sud, INSERM U1184, and AP-HP, Hôpitaux Universitaires Paris-Sud; Le Kremlin-Bicêtre France
| | - X. Mariette
- Université Paris-Sud, INSERM U1184, and AP-HP, Hôpitaux Universitaires Paris-Sud; Le Kremlin-Bicêtre France
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Nocturne G, Seror R, Fogel O, Belkhir R, Boudaoud S, Saraux A, Larroche C, Le Guern V, Gottenberg JE, Mariette X. CXCL13 and CCL11 Serum Levels and Lymphoma and Disease Activity in Primary Sjögren's Syndrome. Arthritis Rheumatol 2016; 67:3226-33. [PMID: 26359802 DOI: 10.1002/art.39315] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/30/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Non-Hodgkin's lymphoma (NHL) is a severe complication of primary Sjögren's syndrome (SS). Ectopic germinal centers (GCs) in the salivary glands are predictors of the occurrence of NHL. Given the association between CCL11 and CXCL13 and ectopic GCs, we assessed the link between these chemokines and NHL, as well as the association between these chemokines and disease activity, in patients with primary SS. METHODS Serum levels of CCL11 and CXCL13 were evaluated by multiplex assay in 385 patients included in the Assessment of Systemic Signs and Evolution of Sjögren's Syndrome (ASSESS) cohort. The association between chemokine levels, B cell biomarkers, and patient subsets was assessed using Spearman's test for continuous data and the nonparametric Mann-Whitney U test for categorical data. Multivariate analyses were performed to identify parameters associated with lymphoma and disease activity. RESULTS Seventeen patients had a history of lymphoma, and 5 of them had developed NHL during followup. The median serum levels of CCL11 and CXCL13 in the total cohort were 106.48 pg/ml (interquartile range 69.33-149.85) and 108.31 pg/ml (interquartile range 58.88-200.13), respectively. Patients with lymphoma had higher levels of CXCL13 than did patients without lymphoma (P = 0.006) and a trend toward a higher level of CCL11 (P = 0.056). Low C4 and high BAFF levels were associated with NHL on multivariate analysis (P = 0.01 and P = 0.0002, respectively). CCL11 and CXCL13 levels correlated positively with the rheumatoid factor titer, the κ-to-λ free light chain ratio, and the β2 -microglubulin level. CXCL13 was the only parameter associated with disease activity on multivariate analysis. CONCLUSION These findings demonstrate a link between CXCL13 and CCL11 and disease activity and lymphoma. This highlights the continuum between chronic B cell activation, disease activity, and lymphomagenesis in patients with primary SS.
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Affiliation(s)
- G Nocturne
- Université Paris-Sud, INSERM UMR1184, Le Kremlin-Bicêtre, France
| | - R Seror
- Université Paris-Sud, INSERM UMR1184, and Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
| | - O Fogel
- Université Paris-Sud, INSERM UMR1184, Le Kremlin-Bicêtre, France
| | - R Belkhir
- Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - S Boudaoud
- Université Paris-Sud, INSERM UMR1184, Le Kremlin-Bicêtre, France
| | - A Saraux
- Centre Hospitalier Universitaire (CHU) de Brest, Brest, France
| | | | | | - J E Gottenberg
- Hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, France
| | - X Mariette
- Université Paris-Sud, INSERM UMR1184, and Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
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Nocturne G, Tarn J, Boudaoud S, Locke J, Miceli-Richard C, Hachulla E, Dubost JJ, Bowman S, Gottenberg JE, Criswell LA, Lessard CJ, Sivils KL, Carapito R, Bahram S, Seror R, Ng WF, Mariette X. Germline variation of TNFAIP3 in primary Sjögren's syndrome-associated lymphoma. Ann Rheum Dis 2015; 75:780-3. [PMID: 26338037 DOI: 10.1136/annrheumdis-2015-207731] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 08/12/2015] [Indexed: 11/04/2022]
Abstract
Background and objectiveA germline and coding polymorphism (rs2230926) of TNFAIP3 (A20), a central gatekeeper of nuclear factor-kappa B (NF-kB) activation, was recently found associated with primary Sjögren's syndrome (pSS)-associated lymphoma in a French cohort. We aimed to replicate this association.Patients and methodsThe rs2230926 polymorphism was genotyped in cases and controls of European ancestry from two independent cohorts from UK and France. Case control association tests were performed (Fisher's test) in the two cohorts, followed by a meta-analysis of the two cohorts.ResultsThe UK cohort included 308 controls and 590 patients with pSS including 31 with a history of lymphoma. The French cohort consisted of 448 controls and 589 patients with pSS including 47 with lymphoma. In both cohorts, the rs2230926 missense polymorphism was not associated with pSS. However, in the UK cohort, the rs2230926G variant was significantly associated with pSS-associated lymphoma (OR=2.74, 95% CI (1.07 to 7.03), p=0.0423, compared with patients with pSS without lymphoma, and OR=3.12, 95% CI (1.16 to 8.41), p=0.0314, compared with healthy controls) as observed in the French cohort. The meta-analysis of the two cohorts confirmed these results (OR=2.48, 95% CI (1.87 to 3.28) p=0.0037 and OR=2.60, 95% CI (1.91 to 3.53) p=0.0031, respectively).ConclusionsThis study confirms the role of A20 impairment in pSS-associated lymphoma. Subtle germline abnormalities of genes leading to impaired control of NF-kB activation in B cells continuously stimulated by autoimmunity enhance the risk of lymphoma.
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Affiliation(s)
- Gaetane Nocturne
- INSERM UMR1184, CEA-iMETI/Division of Immuno-Virology, Université Paris Sud, Le Kremlin-Bicêtree, France
| | - Jessica Tarn
- Institute of Cellular Medicine and NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle, UK
| | - Saida Boudaoud
- INSERM UMR1184, CEA-iMETI/Division of Immuno-Virology, Université Paris Sud, Le Kremlin-Bicêtree, France
| | - James Locke
- Institute of Cellular Medicine and NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle, UK
| | - Corinne Miceli-Richard
- INSERM UMR1184, CEA-iMETI/Division of Immuno-Virology, Université Paris Sud, Le Kremlin-Bicêtree, France Department of Rhumatologie, Hopital Bicetre, Le Kremlin Bicêtre, France
| | | | | | - Simon Bowman
- Department of Rheumatology, University Hospitals Birmingham, Birmingham, UK
| | | | - Lindsey A Criswell
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Christopher J Lessard
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Kathy L Sivils
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Raphael Carapito
- U1109, INSERM and University of Strasbourg, Strasbourg, France Immunorhumatologie moléculaire, INSERM UMR S_1109, Centre de Recherche en Immunologie et Hématologie, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France and Service de Rhumatologie, Centre National de Référence pour les Maladies Systémiques Autoimmunes Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Siamak Bahram
- Immunorhumatologie moléculaire, INSERM UMR S_1109, Centre de Recherche en Immunologie et Hématologie, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France and Service de Rhumatologie, Centre National de Référence pour les Maladies Systémiques Autoimmunes Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Raphaèle Seror
- INSERM UMR1184, CEA-iMETI/Division of Immuno-Virology, Université Paris Sud, Le Kremlin-Bicêtree, France
| | - Wan-Fai Ng
- Institute of Cellular Medicine and NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle, UK
| | - Xavier Mariette
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin-Bicêtre, France
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