TLR9 and rheumatoid arthritis: Moreover, TNF-α secretion was also found to be induced by DNA stimulation in the RA context, as CpG-rich DNA from blood plasma isolated from an RA patient was shown to stimulate the TLR9-MyD88-NF-kB signaling pathway when added to the culture medium of PBMCs (peripheral blood mononuclear cells) from healthy donors, resulting in a significant increase in the IL-6 and TNF-α secretion [33].