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Antibodies to autoantigens modified by citrullination through deimination of arginine to citrulline are present in about two-thirds of all RA patients, but are rare (<2%) in healthy individuals and are relatively rare in other inflammatory conditions [ 81, 82].
Antibodies against epitopes modified by citrullination show the highest specificity for RA and can be detected very early in the disease course [ 2- 4].
As described later, self-proteins modified by citrullination in the periphery are important autoantigens presented by DC in RA, and in the murine collagen-induced arthritis model.
Recently, we identified a novel antigenic isoform of vimentin in patients with rheumatoid arthritis, which was modified by citrullination and mutation (MCV) [ 3].
Together, studies in humans suggest that PB T cells in HLA-DR SE+ individuals may be predisposed to autoreactivity towards self-antigens, including those modified by citrullination, potentially exposed during stress or proinflammatory settings, including joint trauma or smoking [ 3, 48].
Klareskog and colleagues in Sweden have found that cigarette smoking may trigger HLA-DR restricted immune reactions to autoantigens modified by citrullination, potentially explaining the interaction between HLA shared epitope and cigarette smoking that greatly increases the risk of anti-CCP-positive RA (L Klareskog, personal communication).
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In apoptotic cells many autoantigenic proteins or complexes can be modified by processes such as (de phosphorylation, citrullination, nucleolytic cleavage or proteolytic cleavage by caspases (reviewed in [ 3]).
The quality of the endogenous priming of the immune system is also likely to be different because neo-epitopes on CII in cartilage are formed by a changed glycosylation pattern [ 33, 34] but also by processes modified by the inflammatory process itself, such as citrullination and oxidation [ 3, 35, 36].
Peptides modified by a variety of post-translational modifications, including citrullination, transglutamination and oxidation, are implicated in a number of autoimmune diseases, including multiple sclerosis, type 1 diabetes and coeliac disease [ 23, 24].
Temperatures are often modified by sea winds.
(modified) by James W. Heisig.
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