PRTN3 and arthritic joint disease: The pulmonary mucosa as an autoimmune process origin is based on the following observations: ACPAs are presented in the sputum of ACPA-positive patients without arthritis; there are microscopic and macroscopic changes in the lungs with early rheumatoid arthritis and untreated ACPA-positive patients; pulmonary alterations have been demonstrated in high-resolution computed tomography in subjects without the disease but with ACPA-positive; pulmonary biopsy samples from patients with ACPA positive with established AR suggest that ACPAs are produced locally.