Frequency of cTfh cells in pSS patients is almost reduced by 50% after B cell depletion therapy and reach levels comparable to controls, in association with a significant lowering of serum levels of IL-21, with a decrease in anti-SSA/Ro and antiSSB/La antibodies and with the improvement of the disease activity measured by ESSDAI (147). This evidence concerns the gene CALR and peeling skin syndrome.