Mononuclear cell phenotypes and immunoglobulin gene rearrangements in lacrimal gland biopsies from patients with Sjögren's syndrome.

Immunocytochemical studies of lacrimal gland biopsies obtained from eight patients with Sjögren's syndrome revealed the major component of the mononuclear cell infiltrates to be comprised of B cells and Leu-3+ T-helper cells, which were present well in excess of control glands. Three of seven cases that were tested harbored cells that stained with monoclonal antibodies against different components of Epstein-Barr virus (EBV); one of the biopsies also contained cells that bore cytomegalovirus antigens. Immunoglobulin-gene rearrangements, but not T-cell receptor rearrangements, were demonstrated in one of two Sjögren's lacrimal gland biopsies tested. The authors conclude that the destruction of the tubuloacinar architecture of lacrimal gland tissue in Sjögren's syndrome appears secondary to lymphoproliferation of B cells and T-helper cells, probably derived from primary lymphoid follicles. Productive infection of lacrimal gland tissue with EBV may play a role in the pathogenesis of the syndrome in selective cases.