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TfH cells that co-express Th17 markers (CXCR5<jats:sup>+<\/jats:sup>Th17) encompass both of these pathogenic functions, and are increased in some human autoimmune settings including juvenile dermatomyositis. We investigated CXCR5<jats:sup>+<\/jats:sup>Th17 cells in RA subjects with stable or active disease and before and after TNF inhibitor therapy. CXCR5<jats:sup>+<\/jats:sup>Th17 cell frequency was increased in RA compared to healthy controls, but other helper T cell subsets were not different. CXCR5<jats:sup>+<\/jats:sup>Th17 cells correlated with disease activity in subjects with active RA prior to initiation of TNF inhibitor therapy. Baseline CXCR5<jats:sup>+<\/jats:sup>Th17 cells also correlated with numbers of swollen joints as late as one year post-therapy. CXCR5<jats:sup>+<\/jats:sup>Th17 cell frequencies were unaltered by TNF blockade and in fact remained remarkably stable within individuals. We conclude that CXCR5<jats:sup>+<\/jats:sup>Th17 cells are not a direct target of TNF blockade and therefore cannot serve as a biomarker of current disease activity. However, basal CXCR5<jats:sup>+<\/jats:sup>Th17 cell frequency may indicate underlying differences in disease phenotype between patients and predict ultimate success of TNF inhibitor therapy.<\/jats:p>","DOI":"10.1038\/srep39474","type":"journal-article","created":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T11:33:21Z","timestamp":1482406401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Analysis of CXCR5+Th17 cells in relation to disease activity and TNF inhibitor therapy in Rheumatoid Arthritis"],"prefix":"10.1038","volume":"6","author":[{"given":"Deepika","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Henkel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Sendon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"June","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Fabio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Metes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry W.","family":"Moreland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandy J.","family":"McGeachy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2016,12,22]]},"reference":[{"key":"BFsrep39474_CR1","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1016\/S0140-6736(10)60826-4","volume":"376","author":"DL Scott","year":"2010","unstructured":"Scott, D. 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