PPIA and Arthritis: These results are consistent with published data showing CyPA can promote inflammation in arthritis and pancreatic cancers through the NF-κB pathway and ERK1/2 and MAPK signaling pathways.51,52 High level of CyPA not only induces chemotaxis in numerous monocytes and neutrophils to the inflammatory site53 but also activates the MAPK signaling pathway to induce more cytokines and chemokines expression.