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331, p = 0.004) but not with ACPA titer in RA patients with low titers of ACPA titers ( less then 200 U/ml). CONCLUSIONS Serum levels of Gal-9 were increased in RA patients and associated with RA disease activity in RA patients without high titers of ACPA. The levels of ACPA titers may influence the values of circulating Gal-9 in RA patients with various clinical phenotypes. These data suggest that Gal-9 possessed the properties of pro-inflammatory or arthropathic biomarker under the status of ACPA titers.Advances in human pluripotent stem cell (hPSC) biol