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The autoantibody repertoire in periodontitis: a role in the induction of autoimmunity to citrullinated proteins in rheumatoid arthritis? Antibodies against uncitrullinated peptides seem to occur prior to the antibodies to the corresponding citrullinated peptides
  1. Mikael Brink1,
  2. Monika Hansson2,
  3. Johan Rönnelid3,
  4. Lars Klareskog2,
  5. Solbritt Rantapää Dahlqvist1
  1. 1Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden
  2. 2Rheumatology Unit, Department of Medicine, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden
  3. 3Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
  1. Correspondence to Professor Solbritt Rantapää-Dahlqvist, Department of Public Health and Clinical Medicine/ Rheumatology, University Hospital, Umeå SE-901 85, Sweden; solbritt.rantapaa.dahlqvist{at}

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We have read the article by de Pablo et al1 with great interest. The authors reported higher frequencies of antibodies against the uncitrullinated form of fibrinogen and of the arginine containing α-enolase peptide-1 in patients with periodontitis compared with patients without periodontitis. As a consequence of their study the authors concluded that antibodies to uncitrullinated versions of rheumatoid arthritis (RA) associated autoantigens may occur before the development of anticitrullinated peptide/protein antibodies. This encouraged us to analyse the data for individuals identified in the Medical Biobank of Northern Sweden as having donated blood samples before the onset of the symptoms of RA with regard to the first time point when different autoantibody specificities were detectable.

Figure 1

Per cent of positivity of antibodies against the citrullinated and uncitrullinated peptides in individuals before …

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