Lymphoma-associated mutations in autoreactive memory B cells of patients with Sjögren's syndrome.

We recently demonstrated that normal memory B lymphocytes carry a substantial number of de novo mutations in the genome. Here, we performed exome-wide somatic mutation analyses of bona fide autoreactive rheumatoid factor (RF)-expressing memory B cells retrieved from patients with SjÓ§gren's syndrome (SS). The amount and repertoire of the de novo exome mutations of RF B cells were found to be essentially different from those detected in healthy donor memory B cells. In contrast to the mutation spectra of normal B cells, which appeared random and non-selected, the mutations of the RF B cells were greater in number and enriched for mutations in genes also found mutated in B-cell non-Hodgkin lymphomas. During the study, one of the SS patients developed a diffuse large B-cell lymphoma (DLBCL) out of an RF clone that was identified 2 years earlier in an inflamed salivary gland biopsy. The successive oncogenic events in the RF precursor clone and the DLBCL were assessed. In conclusion, our findings of enhanced and selected genomic damage in growth-regulating genes in RF memory B cells of SS patients together with the documented transformation of an RF-precursor clone into DLBCL provide unique novel insight into the earliest stages of B-cell derailment and lymphomagenesis. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Dental Implants in Patients with Sjögren's Syndrome.

BACKGROUND: Limited evidence is available for applying dental implants in Sjögren's syndrome (SS) patients. PURPOSE: This study aims to retrospectively assess clinical outcome of implant therapy in a cohort of well-classified patients with SS. MATERIALS AND METHODS: All SS patients attending the University Medical Center Groningen for follow-up (n = 406) were asked whether they had implants. In SS patients with implants peri-implant health and implant survival was recorded and compared with data from matched healthy controls. Patients' symptoms, health-related quality of life, oral functioning, and satisfaction were assessed using validated questionnaires. RESULTS: Of the responding SS patients (n = 335), 21% was provided with implants. Of these 69 SS patients, 50 SS patients were willing to join our study. In SS patients, peri-implant health was reasonably good with minor marginal bone loss and a peri-implantitis prevalence of 14%, comparable with healthy controls. Implant survival was 97% (median follow-up 46 months) [IQR 26;73], and overall patients' satisfaction was high. Oral functioning correlated negatively with dryness, patients' satisfaction, and chewing ability in SS patients. CONCLUSIONS: Implant therapy is common in our cohort of SS patients. In spite of shortcomings of our retrospective analysis, implants in SS patients seem to perform comparable with implants in healthy patients.