Investigation of Lysosome-Associated Membrane Protein 3 Highlighting the Role of Lysosome in Pathophysiology and Treatment of Sjögren Disease.

Lysosome-associated membrane protein 3 (LAMP3) is a unique lysosomal membrane protein specifically expressed in mature dendritic cells and type II pneumocytes. Its ectopic expression in salivary gland epithelial cells (SGECs) is induced by type I interferon (IFN) signaling and is further amplified through Toll-like receptor 7 (TLR7) activation, which is implicated in the pathogenesis of Sjögren disease (SjD). This aberrant up-regulation disrupts glandular function by promoting endolysosomal degradation of aquaporin 5 (AQP5) and sodium-potassium-chloride cotransporter 1, leading to impaired fluid secretion and associated clinical sequelae (eg, dry mouth). Additionally, LAMP3-mediated lysosomal exocytosis of DAMPs enhances monocytic bone morphogenetic protein 6 (BMP6) production, which in turn suppresses AQP5 transcription. Moreover, LAMP3 drives the extracellular vesicle-mediated release of autoantigens, which further amplifies autoimmunity, and lysosome-dependent cell death in SGECs contributes to tissue damage. These findings establish LAMP3 as a pivotal regulatory hinge in SjD pathogenesis, linking IFN/TLR7 signaling, lysosomal dysfunction, and glandular hypofunction. Its central role makes it a compelling therapeutic target, with strategies including IFN and TLR7 pathway inhibitors to limit its induction, restoration of lysosomal function, BMP6 inhibition to preserve AQP5 expression, and AQP gene therapy to improve fluid secretion.