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Clinical and Developmental Immunology
Volume 2012, Article ID 827480, 7 pages
Clinical Study

Increased Frequency of Circulating Follicular Helper T Cells in Patients with Rheumatoid Arthritis

1Department of Laboratory Medicine, The Affiliated People’s Hospital, and School of Medical Science and Laboratory Medicine, Jiangsu University, Zhenjiang 212013, China
2Department of Nuclear Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, China
3Department of Pathology and Center of Infection and Immunology, The University of Hong Kong, Hong Kong
4Zhenjiang Key Laboratory of Medical Immunology, Affiliated Hospital of Jiangsu University, Zhenjiang, China

Received 16 October 2011; Revised 24 January 2012; Accepted 31 January 2012

Academic Editor: E. Shevach

Copyright © 2012 Jie Ma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Follicular helper T (Tfh) cells are recognized as a distinct CD4+ helper T-cell subset, which provides for B-cell activation and production of specific antibody responses, and play a critical role in the development of autoimmune disease. So far, only one study investigated the circulating Tfh cells increased in a subset of SLE patients. Since relatively little is known about the Tfh cells in rheumatoid arthritis (RA) patients, in this study, Tfh-cell frequency, related cytokine IL-21, and transcription factor Bcl-6 were investigated in 53 patients with RA and 31 health controls. Firstly, we found that the frequency of CD4+CXCR5+ICOShigh Tfh cells was increased significantly in the peripheral blood of RA patients, compared with that in healthy controls. It is known that Tfh cells are critical for directing the development of an antibody response by germinal centers B cells; secondly, we observed that the Tfh-cell frequency is accompanied by the level of anti-CCP antibody in RA patients. Furthermore, expression of Bcl-6 mRNA and plasma IL-21 concentrations in RA patients was increased. Taken together, these findings have shown that the increased frequency of circulating Tfh cells is correlated with elevated levels of anti-CCP antibody, indicating the possible involvement of Tfh cells in the disease progression of RA.