OBJECTIVES: Events in the lungs might contribute to generation of anticitrullinated protein antibodies ( @entity7134 ) in @entity309 ( @entity309 ). We investigated if signs of immune activation are present in bronchial biopsies and bronchoalveolar lavage (BAL) of @entity1 with early-untreated @entity309 without clinical signs of lung involvement. METHODS: Twenty-four @entity1 with @entity309 with symptom duration <1   year and na  ve to disease-modifying antirheumatic drugs were subjected to bronchoscopy where BAL and mucosal bronchial biopsies were retrieved. For comparison, 15 bronchial biopsies and 79 BAL samples from healthy volunteers were available. Histological examination was performed to evaluate lymphocyte infiltration, presence of immune cells (T and B cells, plasma cells, dendritic cells and macrophages) and immune activation markers. Cell composition of BAL samples was analysed by differential counting and T cell subsets by flow cytometry. RESULTS: Lymphocyte infiltration was more frequently found in @entity7134 -positive @entity1 (50%) as compared with @entity7134 -negative @entity1 (17%) and controls (13%). Germinal centres, B cells and plasma cells were only found in @entity7134 -positive @entity1 . The frequency of T cells in bronchial biopsies of @entity1 with @entity7134 -positive @entity309 was positively associated with expression of immune activation markers. BAL samples of @entity1 with @entity7134 -positive, but not @entity7134 -negative, @entity309 had significantly higher relative numbers of lymphocytes and expressed higher levels of activation markers compared with controls. CONCLUSIONS: Signs of immune cell accumulation and activation are present both in the bronchial tissue and in BAL of untreated @entity1 with @entity309 without concomitant @entity358 , strengthening the role of the lung compartment as an important player in @entity7134 -positive @entity309 .

Signs of immune activation and local inflammation are present in the bronchial tissue of @entity1 with untreated early XXXX .

@entity7134 :: ('5657', 'Gene') :: ['ACPA'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity358 :: ('MESH:D008171', 'Disease') :: ['lung disease'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis', 'RA', 'early RA']
@entity309 :: (MESH:D001172,Disease) :: ['rheumatoid arthritis']
