Contents Chapter 1 General introduction and outline 9 Part I Adaptive immune responses at sites of inflammation 21 Chapter 2 In rheumatoid arthritis, synovitis at different inflammatory sites is dominated by shared but patient-specific T cell clones 23 Chapter 3 In rheumatoid arthritis inflamed joints share dominant patient-specific B-cell clones 41 Part II Treatment options in early stages of rheumatoid arthritis 57 Chapter 4 Prevention of rheumatoid arthritis: A systematic literature review of preventive strategies in at-risk individuals 59 Part III Dynamics in the of B-cell repertoire after B-cell depletion in different phases of RA 93 Chapter 5 Sensitive B-cell receptor repertoire analysis shows repopulation correlates with clinical response to rituximab in rheumatoid arthritis 95 Chapter 6 Dynamics of the B cell receptor repertoire during the preclinical phase of rheumatoid arthritis: Longitudinal studies in untreated RA-risk individuals (DOMINO study) and the effects of rituximab treatment (PRAIRI study) 117 Chapter 7 General discussion and future perspectives 141 Appendices English summary 162 Nederlandse samenvatting 166 PhD portfolio 170 List of publications 174 Contributing authors 178 About the author 183 Dankwoord (acknowledgements) 184
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