Levels of Serum PAD4 in Patients with Polymyositis/Dermatomyositis and Its Correlation with NET
Objective To observe the level of serum peptidyl arginine deiminase 4(PAD4)in patients with polymyositis/dermato-myositis(PM/DM)and its correlation with serum neutrophil extracellular traps(NET)markers and other clinical indicators.Methods The peripheral blood of 60 patients with PM/DM(36 cases of DM,24 cases of PM)and 20healthy controls were collected.The levels of PAD4 and NET markers[citrullinated histone H3(CitH3)and cell free DNA(cfDNA)]in serum were detected,the correlation between them was analyzed,and their correlation with clinical data were also analyzed.Results Compared with healthy controls,the level of ser-um PAD4 in PM/DM patients was significantly increased(t=13.21,P<0.001).The level of serum NET markers in PM/DM patients was significantly higher than that in healthy controls(CitH3:t=9.518,P<0.001;cfDNA:t=2.984,P=0.0038).The correlation a-nalysis between serum PAD4 and NET marker levels in PM/DM patients showed that there was a positive correlation(PAD4 and CitH3:r=0.835,P<0.001;PAD4 and cfDNA:r=0.322,P=0.012).The correlation analysis of serum PAD4,CitH3 and cfDNA levels with clinical data showed that PAD4 levels were positively correlated with erythrocyte sedimentation rate(ESR)and procalcitonin(PCT),and negatively correlated with albumin(ALB)levels.There was a positive correlation between serum CitH3 level and alanine aminotrans-ferase(ALT).Serum cfDNA level was positively correlated with white blood cell(WBC),neutrophil(NE#),neutrophil ratio(NE%),C-reactive protein(CRP),interleukin-6(IL-6),ALT,aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydro-genase(LDH)and UREA,and negatively correlated with ALB level.Conclusion Serum PAD4 levels in PM/DM patients were signifi-cantly increased and correlated with abnormal increase of NET.Meanwhile,PAD4 and NET marker levels in serum were positively corre-lated with inflammatory markers of PM/DM patients,suggesting that abnormal increase of PAD4mediated excessive formation of NET may be involved in the pathogenesis of PM/DM.