title: New insights into the immunopathogenesis of systemic lupus erythematosus: the role of T follicular helper cells.
abstract: OBJECTIVE
  To review the development of T follicular helper (TFH) cells and their role in systemic lupus erythematosus (SLE) pathogenesis, the effect of dendritic cells (DCs) on TFH cells in SLE, as well as the potential use of TFH cells as a new therapeutic target in clinical practice.
  
  
  METHODS
  The data used in this review were retrieved mainly from the PubMed database (1989-2013). The terms used in the literature search were "T follicular helper cells," "systemic lupus erythematosus," and "dendritic cells."
  
  
  METHODS
  Relevant publications about the TFH cells development, the interaction between the TFH cells and the DCs, and the clinical applications of TFH cells were identified, retrieved, and reviewed.
  
  
  RESULTS
  TFH cells, a novel distinct CD4+ T cell subset, are specialized in providing help to B cells in the formation of germinal centers (GCs) and long-term protective humoral immune responses. The development of TFH cells from naïve CD4+ T cell is a multistep process. As the pivot of immunoregulation, DCs are indispensable for TFH cells generation. In addition to receptor-ligand interactions between TFH cells and DCs, the cytokines secreted by DCs are also necessary for TFH cell generation. TFH cell dysregulation has been implicated in the development of SLE. More evidence from animal models of SLE and SLE patients suggests that TFH cells are necessary for pathogenic autoantibody production. Therefore, therapeutically targeting TFH cells can be a promising approach to treat antibody-mediated autoimmune diseases including SLE.
  
  
  CONCLUSIONS
  TFH cells play a critical role in the pathogenesis of SLE, making them attractive therapeutic targets in clinical practice.
authors.affiliation: Department of Hematology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Ma
authors.affiliation: Department of Hematology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Suigui
authors.initials: S
authors.lastname: Wan
authors.affiliation: Department of Hematology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. Email: cqx65@yahoo.com.
authors.forename: Changqing
authors.initials: C
authors.lastname: Xia
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D003713:Dendritic Cells / Q000276:immunology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*
chemical_list: D001323:Autoantibodies