Autoantibodies and interstitial lung disease in rheumatoid arthritis: towards a 'mix-and-match' approach?

We read with interest the article by Castellanos-Moreira et al who identified for the first time an association between anticarbamylated protein antibodies and interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA).1 The reported prevalence of ILD in RA ranges from 4% to 70% according to different cohorts and inclusion criteria. The clinical spectrum is rather broad ranging from mild reversible lung inflammatory disease to rapidly progressing fibrotic conditions with poor prognosis and frequent cause of death. On this basis, clinicians should be alert and promptly identify, classify and manage ILD according to its features and severity. However, whether a patient with RA will develop or not ILD, depends on several genetic, demographic, environmental and immunological factors that interact with each other and reliable markers able to predict ILD development are currently lacking.2 The increasing …