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Rheumatoid arthritis (RA) is characterised by frequent occurrence of autoantibodies. The anti-cyclic citrullinated peptide antibodies (anti-CCP) are now used routinely as they may antedate the development of seropositive RA, because their diagnostic sensitivity and specificity is better than rheumatoid factors (RFs), and because they may predict a more severe outcome.1,–,3 Previous studies have observed an increased prevalence of RF and anti-CCP in first-degree relatives of patients with RA.4 One study on RA discordant twin pairs provided evidence for genetic effects on IgM-RF and IgG-RF independent of HLA-DR.5 Anti-CCPs have been reported to be independently associated with the HLA-DRB1 shared epitope, PTPN22 and smoking, …
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