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Abstract Juvenile rheumatoid arthritis (JRA) is the most common rheumatological disease in children and is one of the most common chronic diseases of childhood. It represents a group of disorders that all share the clinical manifestation of chronic joint inflammation. The etiology is largely unknown, and the genetic component is complex, making clear distinctions between the various subtypes difficult. As a result, various classification criteria are recognized, with different benefits and limitations. In the last few years, there has been an explosion of research into anti-citrullinated protein/peptide antibodies, including antibodies to filaggrin, fibrin, and vimentin. Citrullination is a normal physiological process that occurs inside many dying cells of the body. It is, therefore, important to realize that the immune system normally does not encounter citrullinated proteins. Soon after the change in phenotype of the dying cell, it is ingested by macrophages and other cells active in the specific clearance of apoptotic cells. When the clearance system is inefficient or of inadequate capacity, such as when massive cell death occurs, pepdidylarginine deiminase (PAD) enzymes and citrullinated proteins can leak from the necrotizing cell and ’meet’ the immune system. |