Study of Peptidyl Arginine Deiminases 4 (PAD 4) Antibodies in Rheumatoid Arthritis Patients

El-Hallous, Darwish; Mohannad, Nevine; Kamel, Maher; Radwan, El-Sayed

doi:10.21608/ejrci.2015.4477

Study of Peptidyl Arginine Deiminases 4 (PAD 4) Antibodies in Rheumatoid Arthritis Patients

Document Type : Original Article

Authors

¹ Departments of Internal Medicine, Alexandria University

² Alexandria University Hospitals

³ Medical Biochemistry , Alexandria University; Alexandria; Egypt

⁴ Damanhour Teaching Hospital, Alexandria University; Alexandria; Egypt

10.21608/ejrci.2015.4477

Abstract

Rheumatoid arthritis (RA) is one of the most commonly occurring form of inflammatory polyarthritis. If untreated,
20%–30% of RA patients become debilitated within the first three years following initial diagnosis. The clinical examination
often fail to identify patients with early RA partly due to heterogeneity of disease presentation and course. To meet the need
for improved diagnostic and prognostic tests, various serum biomarkers are being assessed, including a wide range of
autoantibodies. Autoantibodies against peptidyl arginine deiminase type 4 (PAD-4) have recently been described as a specific
biomarker in subjects with clinically apparent RA. In this study, we tested the presence of anti-PAD4 antibodies in 40
Egyptian subjects with RA and their first degree relatives in order to determine whether these autoantibodies play a role in
early disease evolution. In addition, we aimed to describe the Anti-PAD4 relation to anti-CCP autoantibodies, and potential
associations with a more severe RA phenotype. The study was carried out on total of 100 subjects divided into; 40 RA
patients, 40 of first degree relatives (sister or brother) of RA patients and 20 matched controls. Results: The results
indicated that the serum level of Anti-PAD 4 is increased in Egyptian RA patients and their relatives and has a positive
association with disease activity. Also its level together with Anti-CCP provides a good diagnostic tool of RA. Conclusion:
The serum level of Anti-PAD4 may provide diagnostic information of RA and may be considered as an early marker of the
disease among the first degree relatives of RA patients. [Egypt J Rheumatology & Clinical Immunology, 2016; 4(1): 59-66]

Keywords