The results of the study by Zhang and co-workers [58] corroborated with a previous study used exosome-derived synovial fibroblasts of RA patient which found that exosome from RA synovial fibroblast of patient (RASF) has a membrane bound form of TNF-a, which leads to apoptotic resistance of T-cells in RA because the lack of apoptotic machinery for T-cells progresses RA [113]. Here, TNF is linked to rheumatoid arthritis.