A recent review of NETs proposes a clear distinction between ROS and elastase-dependent NETs, which have antimicrobial activity, and a second ROS independent, PAD4-mediated mechanism of DNA release termed leukotoxic hypercitrullination, which is triggered by elevated intracellular calcium (which activates PAD4) and is associated with autoimmunity (38). This evidence concerns the gene PADI4 and Autoimmunity.