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This study was undertaken to study the prevalence and clinical significance of different isotypes and IgG subclasses of anti–peptidyl arginine deiminase 4 (anti‐PAD4) autoantibodies in individuals with rheumatoid arthritis (RA). Anti‐PAD4 IgG1, anti‐PAD4 IgG2, anti‐PAD4 IgG3, anti‐PAD4 IgG4, anti‐PAD4 IgA, and anti‐PAD4 IgE antibodies were more frequent in RA patients than healthy controls. Anti‐PAD4 IgG1, anti‐PAD4 IgG3, and anti‐PAD4 IgE antibodies identify discrete disease subsets in RA, suggesting that heavy chain usage drives distinct effector mechanisms of anti‐PAD4 antibodies in RA.
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