Gene expression analysis of cTfh population shows upregulation of activation, effector, and exhaustion markers in patients with pES. (A) Heat map showing differentially expressed genes in patients with pES (n = 4) compared with HCs (n = 4). (B) Volcano plot showing few upregulated and downregulated genes with fold change either >2 or <0.5 and P < .05 in patients with pES. (C) Heatmaps showing gene expression changes categorized based on gene annotation categories of T cells in patients with pES compared with control samples. (D) Bar plots showing plasma concentration of sCD40L, IL-21, IFN-γ, CXCL9, CXCL10, IL-12p40, IL-10, IL-18, IL-2, and IL-7 in healthy (n = 20) and pES (n = 22) samples. Data represent mean ± SEM values for each group. Mann-Whitney test for nonparametric samples and Student t test for parametric samples were performed for significance. *P < .05; **P < .01; ns, not significant.