PRTN3 and Arthritis: Existing research has confirmed that smoking may increase the risk of arthritis, particularly among individuals positive for anti-citrullinated peptide antibodies (ACPA), where the risk is even more pronounced (29).Additionally, a study on U.S. adults found that current smokers had a significantly increased risk of developing arthritis, with a relative risk of 1.47 (95% CI 1.29–1.68) (30), suggesting that smoking may be an independent risk factor for arthritis.