肽酰基精氨酸脫亞氨酶4（peptidylarginine deiminase 4，PAD4）依賴鈣離子催化精氨酸殘基向目標蛋白瓜氨酸殘基轉化的過程，是一種翻譯后修飾，被稱為瓜氨酸化。PAD4通過組蛋白瓜氨酸化調(diào)節(jié)基因轉錄活性誘導人類疾病的發(fā)生、發(fā)展。綜述了PAD4在自身免疫性疾病、腫瘤、急性冠狀動脈綜合征中的作用，總結了PAD4抑制劑介導蛋白質瓜氨酸化的生物學作用的可能機制，歸納了PAD4特異性抑制劑治療類風濕關節(jié)炎和其他疾病的臨床效用，討論了PAD4及其抑制劑對自身免疫性疾病和癌癥的潛在治療價值。

Peptidylarginine deiminase4 relies on calcium ions to catalyze the conversion of arginine residues to citrulline residues of the target protein. This is a post-translational modification called citrullination. PAD4 regulates gene transcription activity through histone citrullination to induce the occurrence and development of human diseases. In this review, we summarized the role of PAD4 in autoimmune diseases, tumors, and acute coronary syndromes, and the possible mechanisms of the biological effects of PAD4 inhibitors mediating protein citrullination. The clinical utility of PAD4 specific inhibitors in the treatment of rheumatoid arthritis and other diseases were discussed. In addition, we summarized and discussed the potential therapeutic value of PAD4 and its inhibitors for disease diagnosis and treatment of autoimmune diseases and cancers.

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