For example, USP4 has been shown to interact with and deubiquitinate RORγt, promoting its function and IL-17A transcription in rheumatic heart disease (Yang et al. 2015); similarly, USP7 has been found to promote lupus nephritis by regulating NF-κB p65 signaling via JMJD3 stabilization (Zhang et al. 2021). Here, USP4 is linked to rheumatic heart disease.