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Correspondence
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Volume 355:2046-2048 November 9, 2006 Number 19
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Tumor Necrosis Factor Inhibitors for Rheumatoid Arthritis

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by Scott, D.L.
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To the Editor: In reviewing the pathophysiological process of rheumatoid arthritis, Scott and Kingsley (Aug. 17 issue)1 focus almost exclusively on dendritic cells and T cells. However, in mice, the maintenance of T-cell activation and tumor necrosis factor (TNF) production has been shown to be critically dependent on B cells.2 Indeed, B cells appear to be pivotal in the pathogenesis of rheumatoid arthritis: they can be 10,000 times as potent as dendritic cells in presenting antigen,3 they form germinal centers in synovium, and they produce injurious autoantibodies.

The appropriateness of this recent shift in focus from T cells to B . . . [Full Text of this Article]



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