Catalpol ameliorates Sjögren’s Syndrome by modulating interplay of T and B cells

Catalpol is an active ingredient of Rehmanniae Radix, a medical herb used frequently in treating primary Sjogren's Syndrome (pSS). However, no study has assessed the therapeutic effects of catalpol in treating Sjogren's Syndrome. This study aimed to investigate the therapeutic effects of catalpol for pSS by evaluating the water consumption, stimulated salivary flow rates, sialadenitis, T cell subsets and related cytokine levels. Catalpol treated mice had improved stimulated salivary flow rates and water consumption compared to mice from the control group. Catalpol also reduced the lymphocytic infiltration and prevented the formation of ectopic germinal centers. These effects, especially in the catalpol high dose group, were associated with elevated CD4⁺ CXC-R5⁺ PD-1⁺ Foxp3⁺ T follicular regulatory (Tfr) cells (1.572 % vs 1.118 %, P = 0.0005) and a higher ratio of Tfr cells to T follicular helper (Tfh) cells (2.137 vs 1.541, P = 0.0007). Downregulated levels of IFN-γ and BAFF in serum and submandibular glands were also noted in catalpol treated groups. Our work indicated that catalpol might be a potential drug for treating pSS by regulating the interplay between T and B cells.