ArticlePloS one2017
Anti-citrullinated protein antibody positive rheumatoid arthritis is primarily determined by rheumatoid factor titre and the shared epitope rather than smoking per se.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Determining in which pre-arthritis stage HLA-shared epitope alleles and smoking exert their effect on the development of rheumatoid arthritis.Annals of the rheumatic diseases · 2022Pooled it
- A predominant involvement of the triple seropositive patients and others with rheumatoid factor in the association of smoking with rheumatoid arthritis.Scientific reports · 2020Pooled it
- Improved classification of rheumatoid arthritis with a score including anti-acetylated ornithine antibodies.Scientific reports · 2020Trial
- Mediterranean diet and remission in rheumatoid arthritis: findings from the EIRA study.EULAR rheumatology open · 2026Article
- Molecular basis of post-translational neoantigen generation in rheumatoid arthritis: breaking immunological tolerance and implications for targeted therapy.Frontiers in immunology · 2026Review
- Rutin-loaded chitosan nanoparticles alleviated Freund's adjuvant induced rheumatoid arthritis via modulating oxidative stress and inflammatory parameters in Wistar rats.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- An overview of multi-omics technologies in rheumatoid arthritis: applications in biomarker and pathway discovery.Frontiers in immunology · 2024Review
- Geo-epidemiology of autoantibodies in rheumatoid arthritis: comparison between four ethnically diverse populations.Arthritis research & therapy · 2023Article
- Target modulation and pharmacokinetics/pharmacodynamics translation of the BTK inhibitor poseltinib for model-informed phase II dose selection.Scientific reports · 2021Article
- Impact of the HLA-DRB1 shared epitope on responses to treatment with tofacitinib or abatacept in patients with rheumatoid arthritis.Arthritis research & therapy · 2021Article
- Presence of autoantibodies in "seronegative" rheumatoid arthritis associates with classical risk factors and high disease activity.Arthritis research & therapy · 2020Article
- Is the epidemiology of rheumatoid arthritis changing? Results from a population-based incidence study, 1985-2014.Annals of the rheumatic diseases · 2020Article
- Autoantibodies and B Cells: The ABC of rheumatoid arthritis pathophysiology.Immunological reviews · 2020Review
- Review
- A Cost per Responder Model for Abatacept versus Adalimumab Among Rheumatoid Arthritis Patients with Seropositivity.ClinicoEconomics and outcomes research : CEOR · 2020Article
- Complex Relationships of Smoking, HLA-DRB1 Genes, and Serologic Profiles in Patients With Early Rheumatoid Arthritis: Update From a Swedish Population-Based Case-Control Study.Arthritis & rheumatology (Hoboken, N.J.) · 2019Article
- HLA associations in inflammatory arthritis: emerging mechanisms and clinical implications.Nature reviews. Rheumatology · 2019Review
- Article
- Smoking is not linked to the development of anti-peptidylarginine deiminase 4 autoantibodies in rheumatoid arthritis.Arthritis research & therapy · 2018Article
- Mechanisms of vascular comorbidity in autoimmune diseases.Current opinion in rheumatology · 2018Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo analyse the relationship between rheumatoid factor (RF) titre, smoking and HLA-DRB1 alleles coding a "shared epitope" (SE) in relation to anti-citrullinated protein antibody (ACPA) positivity in rheumatoid arthritis (RA).
methodsRA patients (n = 658) attending rheumatology clinics in Cornwall, UK (cohort 1) were stratified according to RF and ACPA titre, and smoking pack years at diagnosis. A further 409 RA patients from North Staffordshire, UK (cohort 2) were studied to confirm the relationship between RF levels, smoking and ACPA positivity in relation to SE status.
resultsIn cohort 1 there was a trend (p<0.01) of increasing ACPA positivity rates with increasing levels of RF without statistically significant differences between patients who had never smoked and smokers (never smoked: 15/71 (21%) RF -ve, vs. 43/64 (67%) RF weak +ve, vs 88/100 (88%) RF strong +ve, ever smoked: 18/70 (26%) RF -ve vs. 66/83 (80%) RF weak +ve vs. 196/210 (93%) RF strong +ve). No significant gender difference was observed. No significant difference between smoking and ACPA positivity was seen in RF negative patients. Smoking >20 pack years conferred an increased risk of anti-CCP positive RA (158/200 (79%)), compared to having never smoked (146/235 (62%), p = <0.01), but this increased risk correlated with smokers' RF positivity as the principal determinant on subsequent regression analysis of cohort 2. In cohort 2, ACPA positivity rates significantly increased with RF positivity and carriage of 1 or 2 SE alleles (p<0.01). Little or no relationship was observed in patients lacking SE.
conclusionsACPA positivity in RA strongly associates with increasing RF titre independent of smoking. This relationship is dependent on carriage of SE alleles. There is no relationship between ACPA and smoking in RF negative patients.
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