[From mechanisms to manifestations: Research advances in ACPA-related clinical presentations of rheumatoid arthritis].

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized primarily by joint destruction. Anti-citrullinated protein antibodies (ACPA) are not only key drivers and major risk factors for the onset and immune persistence of RA but also crucial biomarkers for its clinical diagnosis. Recent studies have demonstrated that ACPA can directly exacerbate the clinical symptoms of RA through various mechanisms, including promoting inflammatory responses, mediating bone erosion, and inducing pain. Therefore, ACPA holds significant value not only for the early diagnosis, prognosis assessment, and treatment monitoring of RA but is also regarded as a highly promising therapeutic target, offering new directions for developing precision treatment strategies for RA. This article reviews the latest research progress on the correlation between ACPA and the core clinical symptoms as well as common complications of RA, aiming to provide a theoretical basis for a deeper understanding of the pathogenesis and the development of personalized treatment plans for ACPA-positive RA patients.