Recent data further indicate that anti-CarP responses extend beyond classical ACPA-related pathways: Dibrov et al., in a contemporary cohort, reported substantial anti-CarP positivity in both ACPA-positive and ACPA-negative RA, reinforcing the view that carbamylation-driven autoimmunity constitutes an additional layer of the humoral response. This evidence concerns the gene PRTN3 and Autoimmunity.