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Towards standardisation of histopathological assessments of germinal centres and lymphoid structures in primary Sjögren's syndrome
  1. Maarten R Hillen1,2,
  2. Francesca Barone2,
  3. Timothy RDJ Radstake1,
  4. Joel AG van Roon1
  1. 1Rheumatology & Clinical Immunology/Laboratory of Translational Immunology, UMC Utrecht, Utrecht, the Netherlands
  2. 2School of Immunity and Infection, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Joel A van Roon, Rheumatology & Clinical Immunology/Lab Translational Immunology, UMC Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands; j.vanroon{at}

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We read with great interest the study by Delli et al,1 indicating the potential value of baseline salivary gland histopathology to predict response to rituximab (RTX) therapy. In their study, the authors report that RTX treatment significantly affects local inflammation at different levels, including a decrease in numbers of lymphoepithelial lesions, area of focal infiltrates, numbers of B cells and germinal centres (GCs). Interestingly, the presence of a high number of CD20-expressing B cells in parotid gland biopsy at baseline predicted response to RTX treatment. We agree that these observations may facilitate personalised medicine in patients with primary Sjögren's syndrome (pSS). Importantly, the results from …

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