Pathologically expanded peripheral T helper cell subset drives B cells in rheumatoid arthritis

Deepak A. Rao, Michael F. Gurish, Jennifer L. Marshall, Kamil Slowikowski, Chamith Y. Fonseka, Yanyan Liu, Laura T. Donlin, Lauren A. Henderson, Kevin Wei, Fumitaka Mizoguchi, Nikola C. Teslovich, Michael E. Weinblatt, Elena M. Massarotti, Jonathan S. Coblyn, Simon M. Helfgott, Yvonne C. Lee, Derrick J. Todd, Vivian P. Bykerk, Susan M. Goodman, Alessandra B. PernisLionel B. Ivashkiv, Elizabeth W. Karlson, Peter A. Nigrovic, Andrew Filer, Christopher D. Buckley, James A. Lederer, Soumya Raychaudhuri, Michael B. Brenner*

*Corresponding author for this work

Research output: Contribution to journalArticle

227 Scopus citations


CD4 + T cells are central mediators of autoimmune pathology; however, defining their key effector functions in specific autoimmune diseases remains challenging. Pathogenic CD4 + T cells within affected tissues may be identified by expression of markers of recent activation. Here we use mass cytometry to analyse activated T cells in joint tissue from patients with rheumatoid arthritis, a chronic immune-mediated arthritis that affects up to 1% of the population. This approach revealed a markedly expanded population of PD-1 hi CXCR5- CD4+ T cells in synovium of patients with rheumatoid arthritis. However, these cells are not exhausted, despite high PD-1 expression. Rather, using multidimensional cytometry, transcriptomics, and functional assays, we define a population of PD-1hi CXCR5- peripheral helper' T (T PH) cells that express factors enabling B-cell help, including IL-21, CXCL13, ICOS, and MAF. Like PD-1 hi CXCR5+ T follicular helper cells, T PH cells induce plasma cell differentiation in vitro through IL-21 secretion and SLAMF5 interaction (refs 3, 4). However, global transcriptomics highlight differences between T PH cells and T follicular helper cells, including altered expression of BCL6 and BLIMP1 and unique expression of chemokine receptors that direct migration to inflamed sites, such as CCR2, CX3CR1, and CCR5, in T PH cells. T PH cells appear to be uniquely poised to promote B-cell responses and antibody production within pathologically inflamed non-lymphoid tissues.

Original languageEnglish (US)
Pages (from-to)110-114
Number of pages5
Issue number7639
StatePublished - Feb 1 2017

ASJC Scopus subject areas

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    Rao, D. A., Gurish, M. F., Marshall, J. L., Slowikowski, K., Fonseka, C. Y., Liu, Y., Donlin, L. T., Henderson, L. A., Wei, K., Mizoguchi, F., Teslovich, N. C., Weinblatt, M. E., Massarotti, E. M., Coblyn, J. S., Helfgott, S. M., Lee, Y. C., Todd, D. J., Bykerk, V. P., Goodman, S. M., ... Brenner, M. B. (2017). Pathologically expanded peripheral T helper cell subset drives B cells in rheumatoid arthritis. Nature, 542(7639), 110-114.