While the primary manifestation of rheumatoid arthritis (RA) is articular disease, extra-articular disease may also occur, according to a recent review. In particular, pulmonary disease is a frequent extra-articular manifestation of seropositive RA and a leading cause of morbidity and mortality in this population. This review highlights studies published in the last several years and in particular, discussed the relationship of antibodies to citrullinated protein/peptide antigens (ACPA) and lung disease in patients with RA.

Researchers also review the data regarding the potential role of the lung and generation of RA-related autoantibodies in a period of disease development termed "preclinical RA." Finally, they discuss the role of ACPA and other Abs in non-RA pulmonary diseases and discuss a research agenda for next steps in the understanding and management of the lung in RA.