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T Follicular helper CD4 T cells (Tfh) are the specialized providers of B cell help and are essential for germinal centers and most antibody responses. Germinal centers are the engines of rapid B cell evolution and have exquisitely complex cellular dynamics. Tfh differentiation is a multistage, multifactorial process. Tfh have recently emerged as major players in protective immunity to pathogens, generation of high-affinity and long-term antibody responses to vaccines, autoimmune diseases, allergies and even cancer. However, there are major gaps in our understanding of Tfh differentiation, Tfh function, germinal center function and the biological selection of high-affinity antibody responses in vivo in a variety of relevant anti-pathogen and autoimmune contexts. This conference will bring together scientists and physicians from a range of disciplines and disease models to elaborate the complex biology of Tfh cells and germinal centers and discuss emerging avenues to manipulate them in clinical settings.