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Citrulline‐Specific Th1 Cells Are Increased in Rheumatoid Arthritis and Their Frequency Is Influenced by Disease Duration and Therapy

Rheumatoid arthritis (RA) is thought to be a T cell–mediated disease, based on its strong association with HLA class II alleles, clinical responsiveness to T cell–directed therapies, and the presence of CD4+ T cells in rheumatoid joints. The presence of anti–citrullinated protein antibodies (ACPAs) in RA serum and the association of these antibodies with HLA–DR4 alleles implicate citrulline‐specific autoreactive T cells in the development and progression of RA. The goal of this study was to determine the characteristics and specificity of autoreactive T cell responses in RA.