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Clinical profiling included DAS28, CRP\/ESR, treatments, and comorbidities. PAD4-potentiating activity, ACE1 activities, and anti-gingipain antibodies were measured using standardized in-house assays. Associations with RA status, treatments, and outcomes were analysed using covariate-adjusted models; discrimination for selected comorbidities was explored with ROC analyses.\u00a0PAD4-potentiating activity, anti-Kgp\/anti-RgpB and ACE1 activities did not differ between RA and controls. In RA, anti-Kgp showed a weak correlation with DAS28 (Rs=0.17, p=0.033) and was lower with biologic disease-modifying antirheumatic drugs (DMARDs); ACE1 activity was lower among synthetic-DMARDs users across all three substrates (all p\u22480.01\u20130.04). None of the biomarkers showed independent associations with DAS28 in adjusted models. Overall discrimination for cardio-metabolic outcomes was limited; small, predefined strata showed exploratory signals, but low event counts and multiple comparisons constrain inference.\u00a0In this cohort, between-group differences were limited overall. However, two exploratory within-RA signals emerged: anti-Kgp levels were weakly associated with disease activity and therapy, and lower ACE1 activity was associated with synthetic DMARDs use. Together, anti-Kgp and ACE1 (N-domain) may reflect mucosal-immune and vascular-remodeling axes that could relate to comorbidity patterns and warrant prospective, pre-specified validation.\n                  <\/jats:p>","DOI":"10.1007\/s00296-026-06272-4","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:09:20Z","timestamp":1787641760000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-gingipain antibodies and ACE1 activity in rheumatoid arthritis: associations with disease activity and cardiovascular comorbidity in a cross-sectional study"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8299-7603","authenticated-orcid":false,"given":"Marta","family":"Kaminska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6030-9249","authenticated-orcid":false,"given":"Maja","family":"Chrobak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Sathler Alves","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2049-5368","authenticated-orcid":false,"given":"Yasmin Gurtler Pinheiro","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2631-6711","authenticated-orcid":false,"given":"Ewa","family":"Bielecka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur Dalmaso","family":"Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben Horst","family":"Duque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0987-368X","authenticated-orcid":false,"given":"Jose Geraldo","family":"Mill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-1308","authenticated-orcid":false,"given":"Valeria","family":"Valim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5072-9391","authenticated-orcid":false,"given":"Piotr","family":"Mydel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"6272_CR1","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1002\/art.27584","volume":"62","author":"D Aletaha","year":"2010","unstructured":"Aletaha D, Neogi T, Silman AJ et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative. 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