Peptidylarginine deiminases (PADs) have an important role in the pathogenesis of generating citrullinated proteins which is one type of protein posttranslation modifications (PTMs). Additionally, peptidylarginine deiminases 4 (PAD4) is a component of neutrophil extracellular traps (NET) that leads to autoimmune disease during NETosis. Our aim was to check the PAD4 enzyme expression at level of gene and protein expression in streptozotocin (STZ) induced diabetic rat pancreas and checking the link between PAD4 and inflammatory cytokines. Wistar rats were divided into two groups: control group and diabetic STZ group. STZ was administered by intraperitoneally (60 mg/kg/ body weight). Rats were caged for six weeks and then terminated. Pancreatic tissue was harvested for measurement of PAD4 protein expression, PAD4 mRNA, citrulli-nated histone-3 protein (CITH3), cytokines and Ca2+ content. All measurements in diabetic rats were significantly in-creased compared to non-diabetic rats (p

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker, whereas methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing a diagnosis. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency and the treatment goals govern decisions regarding the route and dose of B12 therapy.