Summary
Follicular B helper T (Tfh) cells support high affinity and long-term antibody responses. Here we found that within circulating CXCR5
+ CD4
+ T cells in humans and mice, the CCR7
loPD-1
hi subset has a partial Tfh effector phenotype, whereas CCR7
hiPD-1
lo cells have a resting phenotype. The circulating CCR7
loPD-1
hi subset was indicative of active Tfh differentiation in lymphoid organs and correlated with clinical indices in autoimmune diseases. Thus the CCR7
loPD-1
hi subset provides a biomarker to monitor protective antibody responses during infection or vaccination and pathogenic antibody responses in autoimmune diseases. Differentiation of both CCR7
hiPD-1
lo and CCR7
loPD-1
hi subsets required ICOS and BCL6, but not SAP, suggesting that circulating CXCR5
+ helper T cells are primarily generated before germinal centers. Upon antigen reencounter, CCR7
loPD-1
hi CXCR5
+ precursors rapidly differentiate into mature Tfh cells to promote antibody responses. Therefore, circulating CCR7
loPD-1
hi CXCR5
+ CD4
+ T cells are generated during active Tfh differentiation and represent a new mechanism of immunological early memory.