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Clinical and Developmental Immunology
Volume 2012 (2012), Article ID 948218, 10 pages
Clinical Study

The Phenotype of Circulating Follicular-Helper T Cells in Patients with Rheumatoid Arthritis Defines CD200 as a Potential Therapeutic Target

1School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, The University of Western Australia, 4th Floor G Block, Hospital Avenue, Nedlands, Perth, WA 6009, Australia
2Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Henry Wellcome Building for Molecular Physiology, Oxford OX3 7BN, UK
3Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Science, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7HE, UK

Received 6 June 2012; Accepted 26 August 2012

Academic Editor: G. Opdenakker

Copyright © 2012 Aron Chakera 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.


Rheumatoid arthritis (RA) is a systemic autoimmune disease primarily affecting synovial joints in which the development of autoantibodies represents a failure of normal tolerance mechanisms, suggesting a role for follicular helper T cells ( ) in the genesis of autoimmunity. To determine whether quantitative or qualitative abnormalities in the circulating cell population exist, we analysed by flow cytometry the number and profile of these cells in 35 patients with RA and 15 matched controls. Results were correlated with patient characteristics, including the presence of autoantibodies, disease activity, and treatment with biologic agents. Circulating cells from patients with RA show significantly increased expression of the immunoglobulin superfamily receptor CD200, with highest levels seen in seropositive patients ( ) and patients treated with anti-TNFα agents ( ). This occurs in the absence of any change in numbers or overt bias towards Th1, Th2, or Th17 phenotypes. CD200 levels did not correlate with DAS28 scores ( ). Although the number of circulating cells is not altered in the blood of patients with RA, the cells have a distinct phenotype. These differences associate cells with the pathogenesis of RA and support the relevance of the CD200/CD200R signalling pathway as a potential therapeutic target.