Response to: ‘Potential roles for tenascin in (very) early diagnosis and treatment of rheumatoid arthritis’ by Cutolo et al

We thank the authors for their commentary1 on our article which was recently published in the Annals of Rheumatic Diseases .2 Cutolo et al write an extended discussion of the study, in which we describe the development of therapeutic monoclonal antibodies that block the pro-inflammatory activity of the fibrinogen-like globe (FBG) domain of tenascin-C, and the efficacy of these antibodies in preventing disease progression in preclinical models of rheumatoid arthritis (RA). The commentary includes a detailed summary of the autoantibody response to a citrullinated epitope (cTNC5) within the FBG domain of tenascin-C which arises very early during the development of RA, and which can also be detected in around one in five people at risk of developing RA. As highlighted by the authors, the questions around how the response …