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Methods: We performed high-throughput proteomic and metabolomic profiling on plasma from a well-characterized cohort comprising 40 patients with ACPA– RA, 40 patients with ACPA+ RA, and 40 healthy controls

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In the RA synovial microenvironment, activated immune cells, including macrophages and T cells, excessively produce and accumulate ROS, which contributes to oxidative stress and perpetuates inflammation (137,138)