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. 2023 Jul 6;24(13):11179. doi: 10.3390/ijms241311179

Figure 4.

Figure 4

Proposed model of epitope spreading in lymph nodes and salivary glands eGCs. As described in Figure 2, autoantibodies against an autoantigen that shares a common epitope with a specific viral antigen are produced. B cells incorporate autoantigen A through BCR and present the second epitope of autoantigen A to Tfh. If there is a Tfh cell that recognizes this epitope, B cells differentiate into plasma cells and produce an antibody against autoantigen B with the second epitope. This epitope spreading process targeting additional autoepitopes will lead to the development of autoimmune diseases. The autoantigens reported to date in SS patients are shown on the right side of the figure. LN, lymph node; eGC, ectopic germinal center; PC, plasma cell; BCR, B cell receptor; TCR, T cell receptor; AQP5, aquaporin-5; CA6, carbonic anhydrase 6; CENP, centromere protein; NA14, nuclear autoantigen 14 kDa; MDM2, mouse double minute 2; M3R, muscarinic acetylcholine receptor 3; PSP, parotid secretory protein; SP-1, salivary protein-1; SSA/Ro, Sjögren’s syndrome-related antigen A/Ro; SSB/La, Sjögren’s syndrome-related antigen B/La; TRIM38, tripartite motif-containing protein 38.