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Anti-cyclic citrullinated peptide antibodies (ACPAs) are RA-related autoantibodies that are associated with RA-ILD. ACPA production can be induced in the lungs of patients with IPF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty-four patients with IPF and 10 patients with RA-ILD underwent bronchoalveolar lavage fluid (BALF) collection. The concentrations of IgG ACPAs in the BALF were measured and corrected for total IgG levels. The relationships between corrected BALF ACPA levels and clinical features were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The proportion of ACPAs (ACPA-IgG level adjusted by total IgG level) in the BALF was significantly lower in patients with IPF than in those with RA-ILD (1222\u2009\u00b1\u20091424 U\/mg vs. 9058\u2009\u00b1\u200915159 U\/mg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Compared with the group with low ACPA proportions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929), the IPF group with high ACPA proportions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915) in the BALF was younger (65.2\u2009\u00b1\u20099.4 years vs. 70.9\u2009\u00b1\u20096.8 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and had more females (6 out of 15 (40%) vs. 2 out of 29 (7%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Additionally, the IPF patients with a high ACPA proportion in the BALF had significantly better outcomes than those with a low ACPA proportion did (median overall survival time: 92.4 months vs. 41.1 months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The corrected BALF ACPA level might be an important biomarker for identifying IPF phenotypes with favourable outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-025-04088-9","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:05:40Z","timestamp":1767859540000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anti-cyclic citrullinated peptide antibody in bronchoalveolar lavage fluid of patients with idiopathic pulmonary fibrosis"],"prefix":"10.1186","volume":"26","author":[{"given":"Ryobu","family":"Mori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Ikezoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Handa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiminobu","family":"Tanizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuko","family":"Uno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyohiro","family":"Hirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"4088_CR1","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1164\/rccm.201006-0894CI","volume":"183","author":"B Ley","year":"2011","unstructured":"Ley B, Collard HR, King TE Jr. Clinical course and prediction of survival in idiopathic pulmonary fibrosis. 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Written informed consent was obtained from all patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Ryobu Mori, Kohei Ikezoe, Tomohiro Handa, Kiminobu Tanizawa, and Toyohiro Hirai received a research grant from FUJIFILM Corporation; Tomohiro Handa is part of an endowed department sponsored by Teijin Pharma Ltd. Kazuko Uno has no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"54"}}