Objective Fibrinogen is a target of autoimmune reactions in rheumatoid arthritis (RA). Fibrin(ogen) derivatives are involved in infl ammatory processes and the generation of a stable fi brin network is necessary for suffi cient infl ammation control. As the density and stability of fi brin networks depend on complex interactions between factor XIIIA (F13A) and fi brinogen genotypes, the authors studied whether these genotypes were related to C-reactive protein (CRP) levels during acute-phase reactions. Methods Association between α-fi brinogen (FGA), β-fi brinogen (FGB) and F13A genotypes with CRP levels was tested in two cohorts with longitudinal CRP measurements. Discovery and replication cohorts consisted of 288 RA (913 observations) and 636 non-RA patients (2541 observations), respectively. Results Genotype FGB −455G>A (rs1800790) was associated with CRP elevations (≥10 mg/l) in both cohorts (RA, OR per allele 0.69, p=0.0007/P adj <0.015; non-RA, OR 0.70, p=0.0004/p adj <0.02; combined, OR 0.69, p<10 −5 /p adj =0.001). Genotype F13A 34VV (rs5985) was conditional for the association of FGB −455G>A with CRP as indicated by a clear restriction on F13A 34VV individuals and a highly signifi cant heterogeneity between F13A 34VV and F13A 34L genotypes (p<10 −5 , p adj =0.001). In both cohorts, mean CRP levels signifi cantly declined with ascending numbers of FGB −455A alleles. Genotype FGA T312A (rs6050) exhibited opposite effects on CRP compared with FGB −455G>A. Again, this relation was dependent on F13A V34L genotype. Conclusion Novel genetic determinants of CRP completely unrelated to previously known CRP regulators were identifi ed. Presumably, these haemostatic gene variants modulate infl ammation by infl uencing fi brin crosslinking. These fi ndings could give new perspectives on the genetic background of infl ammation control.Fibrin crosslinking by factor XIII is of crucial importance not only for haemostasis but also for infl ammation control. 1 Several aspects of infl ammatory processes including chemotaxis, 2 3 cell adhesion and migration [4][5][6][7] as well as the antimicrobial host defence 1 8-10 are dependent on or at least significantly infl uenced by fi brin(ogen) and its derivatives. In this context fi brin(ogen) functions as a modulator of different types of cell-cell interactions. 7 11 12 Finally, fi brinogen is involved in the pathogenesis of rheumatoid arthritis (RA), [13][14][15] and it is a target of anticitrullinated protein antibodies (ACPA), which characterise a clinically more severe subset of RA. 16 The architecture of the fi brin gel is a major determinant of clot rigidity and fi brinolysis resistance. 17 It depends on complex interactions between environmental and genetic factors. 18 There are two well-characterised determinants of the fi brin gel architecture. On the one hand, the fi brin gel structure is critically infl uenced by fi brinogen levels, which themselves exhibit a relevant genetic background. [17][18][19] Therefore, variants located in the fi brinogen gene loci, ...