In addition to serving as antigen-presenting cells to T lymphocytes, B lymphocytes may produce proinflammatory cytokines and antibodies. ,9 Antibodies of significance in RA are rheumatoid factors (antibodies reactive with the Fc region of IgG) and antibodies against cyclic citrullinated peptide (CCP).5 Rheumatoid factors are not present in all patients with RA, but their presence is indicative of disease severity, likelihood of extra-articular manifestations, and increased mortality.10 CCPs are produced early in the course of disease. High levels of anti-CCP antibodies are indicative of aggressive disease and a greater likelihood of poor outcomes. Monitoring anti-CCP antibodies may be useful to predict the severity of disease and match aggressive treatment appropriately.

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