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The mechanism by which bacteria traverse the mucosal barrier remains unclear, with the most convincing studies suggesting that a specific transcytotic process involving specialized cells overlying the domes of intestinal lymphoid aggregates (Peyers patches) termed M-cells, which are characterized by a sparse glycocalyx, short and irregular microvilli and a microfold appearance [16, 17]

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Long-term drug-free remission can be currently achieved in only a minority of RA patients and in about 30% a reduced anti-TNF- dose can be maintained [146]