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Summary: It is well established that the generation of a high-affinity long-lived antibody response requires the presence of T cells, specifically CD4 T cells. These CD4 T cells support the generation of a germinal centre (GC) response where somatic hypermutation and affinity maturation take place leading to the generation of memory B cells and plasma cells, which provide long-lasting protection. Greater insight into the nature of the CD4 T cells involved in this process was provided by two studies in 2000 that described CD4 T cells residing in the B cell follicle that expressed CXCR5. As a result these cells were named follicular B helper T cells, now more commonly known as T follicular helper (Tfh) cells. Since then there has been enormous growth in our understanding of these cells, now considered a distinct T helper (Th) cell lineage that can arise from naive CD4 T cells following activation. This review summarizes some of the most recent work that has characterized Tfh cells and the pathways that lead to their generation.

(C) 2011 Muntaz B. Habal, MD