The thesis concerns studies on several aspects of the ACPA response in UA and RA patients. One objective was to investigate the effect ACPA on the development of RA and how ACPA and other risk... Show moreThe thesis concerns studies on several aspects of the ACPA response in UA and RA patients. One objective was to investigate the effect ACPA on the development of RA and how ACPA and other risk factors could collectively contribute to the development of RA. The second aim was to increase knowledge on the development of the ACPA response itself Chapter 2 is a review on the percentage of patients with UA who develop RA Chapter 3 describes differences and similarities between ACPA-positive and ACPA-negative RA at first presentation to the rheumatologist and after follow-up. The strongest genetic risk factors, SE-alleles, were described to predispose only for ACPA-positive RA. In Chapter 4, it was investigated whether SE is a risk factor for ACPA-positive RA or for the development of ACPA. The contribution of HLA__DRB1 to the development of ACPA-negative RA was investigated in Chapter 5. In Chapter 6, it was determined whether SE-alleles interact with tobaccoexposure in the risk to develop ACPA-positive or ACPA-negative RA and whether different subtypes of SE interact differently with smoking. Chapter 7 evaluates whether tobaccoexposure also influences the isotype of ACPA. Chapters 8 and 9, describe different isotypes and the fine-specificity of the ACPA response. Finally, the results are summarized and discussed. Show less
