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New relationships for old autoantibodies in rheumatoid arthritis


Shelef MA1,2. Arthritis Rheumatol. 2019 Mar 12. doi: 10.1002/art.40879. [Epub ahead of print]

Author Information

1 Department of Medicine, University of Wisconsin-Madison, Madison, USA.

2 William S. Middleton Memorial Veterans Hospital, Madison, USA.


In rheumatoid arthritis, there are two dominant categories of autoantibodies: anti-citrullinated protein antibodies (ACPAs) and rheumatoid factor (RF). ACPAs target many different citrullinated proteins and underlie diagnostic anti-cyclic citrullinated peptide antibody (CCP) tests. RF, which is also used diagnostically, is an antibody of any isotype that binds to the Fc portion of IgG. Patients with rheumatoid arthritis also produce autoantibodies that bind to homocitrullinated (1), malondialdehyde-acetaldehyde adducted (2), and acetylated proteins (3), suggesting a propensity to generate antibodies against post-translationally modified proteins in general.