
Mechanisms leading to anti‐citrullinated protein antibody (ACPA) generation in rheumatoid arthritis (RA) are hypothesized to originate in the lung. The objective of this study was to understand associations between neutrophil extracellular trap (NET) formation in the lung and local ACPA generation in subjects At‐Risk for RA. Induced sputum was collected in 49 subjects At‐Risk for RA, 12 with RA and 18 controls. Sputum neutrophils were tested for ex vivo NET formation and sputum‐induced NET formation of control neutrophils was measured using immunofluorescence imaging. Sputum macrophages were tested for ex vivo endocytosis of apoptotic and opsonized cells. Levels of ACPA, NET remnants and inflammatory proteins were quantified in sputum supernatant...
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