LTF and systemic lupus erythematosus: The predominance of anti-lactoferrin specificity in our cohort may reflect both genetic background and regional environmental exposures—such as silica, infectious triggers, or pollutants—that have been implicated in ANCA induction (18) These findings support the hypothesis that population-specific factors influence the autoantibody repertoire in SLE and contribute to its clinical heterogeneity.