{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:46:03Z","timestamp":1785735963838,"version":"3.56.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004001","name":"Guizhou Provincial Science and Technology Department","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010828","name":"Department of Education of Guizhou Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010828","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The coexistence of primary Sj\u00f6gren\u2019s disease (pSS) and rheumatoid arthritis (RA) is not uncommon, but its immunological characteristics and treatment patterns remain poorly defined. This study aimed to compare the immune profiles and therapeutic strategies between pSS patients with and without RA overlap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 148 patients with pSS were retrospectively enrolled, including 89 without RA and 59 with concomitant RA. Demographic characteristics, inflammatory markers, cytokines, lymphocyte subsets, autoantibodies, and treatment regimens were analysed. Logistic regression and ROC analyses were performed to identify markers associated with pSS+RA overlap group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the non-RA group, patients in the overlap group had longer disease duration and higher ESR levels. IL-6, IL-17, and IL-8 levels were significantly elevated, accompanied by increased CD4\n                      <jats:sup>+<\/jats:sup>\n                      T-cell percentage and CD4\/CD8 ratio, but decreased CD19\n                      <jats:sup>+<\/jats:sup>\n                      B-cell percentage. Anti-CCP and RF levels were markedly increased in the RA group. Biologic agents were used more frequently, whereas csDMARDs were used less frequently in the overlap group patients. Multivariable analyses identified IL-6, IgM, and CD19\n                      <jats:sup>+<\/jats:sup>\n                      B-cell percentage as independently associated with the overlap group. ROC analysis showed that anti-CCP had the highest discriminative ability (AUC\u00a0=\u00a00.873), while IL-6 demonstrated moderate diagnostic value (AUC\u00a0=\u00a00.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with pSS and concomitant RA exhibit an immune profile characterized by IL-6 pathway activation, T-cell predominance, and altered B-cell responses, closely resembling RA immunopathology. These findings provide insights into autoimmune overlap syndromes and support IL-6 as a potential therapeutic target in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1891805","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:31:07Z","timestamp":1785735067000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Immunological profiling and treatment patterns of primary Sj\u00f6gren\u2019s disease patients with concomitant rheumatoid arthritis: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yushan","family":"Tu","sequence":"first","affiliation":[{"name":"Graduate School of Guizhou University of Traditional Chinese Medicine","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Hou","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Medical Clinical Laboratory Center","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Medical Clinical Laboratory Center","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Medical Clinical Laboratory Center","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Yang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Medical Clinical Laboratory Center","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wukai","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s42358-024-00391-x","article-title":"Recommendations on cutaneous and hematological manifestations of Sj\u00f6gren's disease by the Brazilian Society of Rheumatology","volume":"64","author":"Pugliesi","year":"2024","journal-title":"Adv Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-023-01057-6","article-title":"Epidemiology of sj\u00f6gren syndrome","volume":"20","author":"Beydon","year":"2024","journal-title":"Nat Rev Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"152537","DOI":"10.2139\/ssrn.4835966","article-title":"Clinical stratification of 1318 primary Sj\u00f6gren's syndrome patients","volume":"68","author":"Fang","year":"2024","journal-title":"Semin Arthritis Rheum"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.31138\/mjr.270224.tcs","article-title":"Sj\u00f6gren's syndrome is rare in psoriasis, but common in psoriatic arthritis: Two sides of a coin - a single centre retrospective study","volume":"36","author":"Abacar","year":"2025","journal-title":"Mediterr J Rheumatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.684999","article-title":"The multiple roles of B cells in the pathogenesis of Sj\u00f6gren's syndrome","volume":"12","author":"Du","year":"2021","journal-title":"Front Immunol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00793-5","article-title":"Mechanisms of joint destruction in rheumatoid arthritis -immune cell-fibroblast-bone interactions","volume":"18","author":"Komatsu","year":"2022","journal-title":"Nat Rev Rheumatol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-224103","article-title":"Immune response to post-translationally modified proteins in rheumatoid arthritis: What makes it special","volume":"83","author":"van der Woude","year":"2024","journal-title":"Ann Rheum Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01154-0","article-title":"Distinct mucosal endotypes as initiators and drivers of rheumatoid arthritis","volume":"20","author":"Holers","year":"2024","journal-title":"Nat Rev Rheumatol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/jleuko\/qiae247","article-title":"How to focus on autoantigen-specific lymphocytes: A review on diagnosis and treatment of Sjogren's syndrome","volume":"117","author":"Ming","year":"2025","journal-title":"J Leukoc Biol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/j.ard.2026.01.023","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update","volume":"85","author":"Smolen","year":"2026","journal-title":"Ann Rheum Dis"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2025.156307","article-title":"New frontiers in rheumatoid arthritis therapy: From classic DMARDs to biologics and beyond","volume":"277","author":"Vanshika","year":"2026","journal-title":"Pathol Res Pract"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14020568","article-title":"A review of the impact of Sj\u00f6gren's syndrome and\/or the presence of anti-Ro\/SS-A antibodies on therapeutic strategies for rheumatoid arthritis","volume":"14","author":"Horai","year":"2025","journal-title":"J Clin Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1002\/art.39859","article-title":"2016 American College of Rheumatology\/European League Against Rheumatism classification criteria for primary Sj\u00f6gren's syndrome: A consensus and data-driven methodology involving three international patient cohorts","volume":"69","author":"Shiboski","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.138461","article-title":"2010 rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"69","author":"Aletaha","year":"2010","journal-title":"Ann Rheum Dis"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1461756","article-title":"Overview of mechanisms and novel therapies on rheumatoid arthritis from a cellular perspective","volume":"15","author":"Han","year":"2024","journal-title":"Front Immunol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2147\/jir.s530754","article-title":"Role of interleukin-6 in rheumatoid arthritis-associated interstitial lung disease: Focus on the JAK\/STAT pathway and macrophage polarization","volume":"18","author":"Yu","year":"2025","journal-title":"J Inflammation Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14186409","article-title":"Pathogenic role of cytokines in rheumatoid arthritis","volume":"14","author":"Fujimoto","year":"2025","journal-title":"J Clin Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2024.116598","article-title":"Targeting IL-17 and its receptors: A feasible way for natural herbal medicines to modulate fibroblast-like synoviocytes in rheumatoid arthritis","volume":"230","author":"Liang","year":"2024","journal-title":"Biochem Pharmacol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2024.2318814","article-title":"Hydroxychloroquine is associated with lower seroconversion upon 17DD-Yellow fever primovaccination in patients with primary Sj\u00f6gren's syndrome","volume":"20","author":"Libardi Lira MaChado","year":"2024","journal-title":"Hum Vaccin Immunother"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1568514","article-title":"Targeting IL-6 receptor mediated metabolic pathways to control Th17 cell differentiation and inflammatory responses","volume":"16","author":"Alwarawrah","year":"2025","journal-title":"Front Immunol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s13075-019-1955-2","article-title":"Differential effects of specific cathepsin S inhibition in biocompartments from patients with primary Sj\u00f6gren syndrome","volume":"21","author":"Hargreaves","year":"2019","journal-title":"Arthritis Res Ther"},{"key":"B22","doi-asserted-by":"publisher","first-page":"7319","DOI":"10.1038\/s41598-019-43714-5","article-title":"Elevated cytokine levels in tears and saliva of patients with primary Sj\u00f6gren's syndrome correlate with clinical ocular and oral manifestations","volume":"9","author":"Chen","year":"2019","journal-title":"Sci Rep"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(08)60453-5","article-title":"Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): A double-blind, placebo-controlled, randomised trial","volume":"371","author":"Smolen","year":"2008","journal-title":"Lancet"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201601","article-title":"Efficacy and safety of secukinumab in patients with rheumatoid arthritis: A phase II, dose-finding, double-blind, randomised, placebo controlled study","volume":"72","author":"Genovese","year":"2013","journal-title":"Ann Rheum Dis"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201040391","article-title":"IL-6: regulator of treg\/th17 balance","volume":"40","author":"Kimura","year":"2010","journal-title":"Eur J Immunol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/art.43404","article-title":"Sj\u00f6gren disease-B cells at the brink: From autoimmunity to lymphomagenesis and the rise of novel B cell-targeted therapies","volume":"78","author":"Gordon","year":"2026","journal-title":"Arthritis Rheumatol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/5xq3fb","article-title":"Clinical manifestations, imaging and treatment of Sj\u00f6gren's disease: One year in review 2024","volume":"42","author":"Tromby","year":"2024","journal-title":"Clin Exp Rheumatol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/s2665-9913(24)00338-2","article-title":"Evolution and trajectory of B-cell targeted therapies in rheumatic diseases","volume":"7","author":"Carter","year":"2025","journal-title":"Lancet Rheumatol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s13075-024-03283-z","article-title":"B cell receptor repertoire analysis in primary Sjogren's syndrome salivary glands identifies repertoire features associated with clinical activity","volume":"26","author":"Chang","year":"2024","journal-title":"Arthritis Res Ther"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.167.7.3610","article-title":"Bm1-Bm5 classification of peripheral blood B cells reveals circulating germinal center founder cells in healthy individuals and disturbance in the B cell subpopulations in patients with primary Sj\u00f6gren's syndrome","volume":"167","author":"Bohnhorst","year":"2001","journal-title":"J Immunol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.5021\/ad.23.126","article-title":"CD4\/CD8 ratio: An independent predictor of herpes zoster in patients with autoimmune inflammatory rheumatic diseases","volume":"36","author":"Liu","year":"2024","journal-title":"Ann Dermatol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2015-000066","article-title":"ACPA-positive primary Sj\u00f6gren's syndrome: True primary or rheumatoid arthritis-associated Sj\u00f6gren's syndrome","volume":"1","author":"Payet","year":"2015","journal-title":"RMD Open"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1080\/03009742.2018.1469164","article-title":"Anti-citrullinated protein antibodies and arthritis in Sj\u00f6gren's syndrome: A systematic review and meta-analysis","volume":"48","author":"Molano-Gonz\u00e1lez","year":"2019","journal-title":"Scand J Rheumatol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/0znf7e","article-title":"Potential efficacy of T and B lymphocyte-targeted therapies on articular involvement of patients with rheumatoid arthritis and systemic sclerosis overlap syndrome. Results from a 2-centre series of 19 cases","volume":"42","author":"Lebel","year":"2024","journal-title":"Clin Exp Rheumatol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271921","article-title":"Effects of anti-SSA antibodies on the response to methotrexate in rheumatoid arthritis: A retrospective multicenter observational study","volume":"17","author":"Waki","year":"2022","journal-title":"PloS One"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.7274","article-title":"A novel overlap syndrome: Rheumatoid arthritis, Sjogren's syndrome, antiphospholipid syndrome, and dermatomyositis","volume":"11","author":"Mohammed","year":"2023","journal-title":"Clin Case Rep"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1891805\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:31:08Z","timestamp":1785735068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1891805\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":36,"alternative-id":["10.3389\/fimmu.2026.1891805"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1891805","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"article-number":"1891805"}}