Fechtner S, Berens H, Bemis E, et al. - Findings from this study suggest that in individuals who eventually develop classified rheumatoid arthritis (RA), there are raised levels of EA-IgG antibody (an anti-EBV antibody) in the preclinical period, which indicates the presence of elevated EBV re-activation cycles in them. The development of RA may critically involve a combination of RF and EBV reactivation.

• Analysis was performed on sera from 83 individuals with RA and 83 matched controls retrieved during pre and post- RA diagnosis periods.

• Sera were examined for 5 anti-EBV antibodies (EBNA-1-IgG, VCA-IgG, EA-IgG, VCA-IgA, and EA-IgA), 7 RA-related autoantibodies (RF-neph, RF-IgA, RF-IgM, RF-IgG, CCP2, CCP3, CCP3.1), 22 cytokine/chemokine, 36 individual APCAs, and CMV-IgG antibodies.

• Presence of preclinical EBV antibodies differentiated RA individuals from controls.

• RA cases specifically had higher EA-IgG antibody levels when compared with controls.

• Significant correlation of elevations in EA-IgG levels was evident with increasing RF-IgM levels in future RA cases but not in controls.