Moreover, it has been described that in patients with rheumatoid arthritis Tph lymphocytes are able to release, in addition to IL-21, Th1-type pro-inflammatory cytokines (such as interferon-γ, tumor necrosis factor-α and granulocyte/monocyte colony stimulating factor) [18, 20, 26, 27]. Here, TNF is linked to rheumatoid arthritis.