Fig. 5From: Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritisSchematic representation of causes and consequences of carbamylation. Inflammation, smoking and renal disease may shift the balance towards predominance of cyanate over urea, allowing carbamylation. As a consequence of excess carbamylation, protein and cellular dysfunction may occur, leading to systemic effects. In susceptible individuals, extensive carbamylation will provide the trigger for the development an autoimmune response directed against carbamylated proteinsBack to article page