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Nucleosome accumulation and reduction of C-reactive protein are associated with the generation of anti-nuclear antibodies in patients with rheumatoid arthritis treated with adalimumab, but not with etanercept
  1. R Priori1,
  2. C Alessandri1,
  3. L Magrini1,
  4. E A M Cassarà1,
  5. F Ceccarelli1,
  6. M Modesti1,
  7. C Croia1,
  8. M Bombardieri2,
  9. G Valesini1
  1. 1
    Dipartimento di Clinica e Terapia Medica, Reumatologia, “Sapienza” Università di Roma, Roma, Italy
  2. 2
    William Harvey Research Institute, Centre for Experimental Medicine and Rheumatology, London, UK
  1. Correspondence to Professor G Valesini, Dipartimento di Clinica e Terapia Medica, Reumatologia, “Sapienza” Università di Roma, Viale del Policlinico 155, 00161 Roma, Italy; guido.valesini{at}

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During the last decade, three tumour necrosis factor (TNF)α antagonists have been approved for the treatment of moderate to severe rheumatoid arthritis (RA).1 These new drugs, while extremely powerful, can induce puzzling biological phenomena such as the production of autoantibodies whose extent seems to vary accordingly to the drug used.2,3

A dysregulation of apoptosis with exposition of nuclear antigens and consequent rapid (within hours) accumulation of nucleosomes has been evoked to explain autoantibody occurrence in patients treated with infliximab.4 In addition (or in alternative) to an increased release of nuclear antigens, a defect in clearance mechanisms can play a role in the generation of autoantibodies.5

We studied autoantibody profiles (anti-nuclear antibody (ANA), anti-double stranded …

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  • Funding This work was supported by Fondazione Umberto di Mario ONLUS, MIUR-PRIN 2005.

  • Competing interests None declared.

  • Ethics approval This study was approved by the local ethics committee of Policlinico Umberto I- Sapienza University of Rome, Rome, Italy.

  • RP and CA contributed equally to this work.

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