床边探讨:中性粒细胞胞外诱捕网(NETs)作为自身免疫性疾病生物标志物和治疗靶点
At the Bedside: Neutrophil extracellular traps (NETs) as targets for biomarkers and therapies in autoimmune diseases.
作者信息
Barnado April, Crofford Leslie J, Oates Jim C
机构信息
*Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; and Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
*Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; and Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
出版信息
J Leukoc Biol. 2016 Feb;99(2):265-78. doi: 10.1189/jlb.5BT0615-234R. Epub 2015 Dec 11.
Neutrophil extracellular traps are associated with a unique form of cell death distinct from apoptosis or necrosis, whereby invading microbes are trapped and killed. Neutrophil extracellular traps can contribute to autoimmunity by exposing autoantigens, inducing IFN-α production, and activating the complement system. The association of neutrophil extracellular traps with autoimmune diseases, particularly systemic lupus erythematosus, will be reviewed. Increased neutrophil extracellular trap formation is seen in psoriasis, antineutrophil cytoplasmic antibody-associated vasculitis, antiphospholipid antibody syndrome rheumatoid arthritis, and systemic lupus erythematosus. Neutrophil extracellular traps may promote thrombus formation in antineutrophil cytoplasmic antibody-associated vasculitis and antiphospholipid antibody syndrome. In systemic lupus erythematosus, increased neutrophil extracellular trap formation is associated with increased disease activity and renal disease, suggesting that neutrophil extracellular traps could be a disease activity marker. Neutrophil extracellular traps can damage and kill endothelial cells and promote inflammation in atherosclerotic plaques, which may contribute to accelerated atherosclerosis in systemic lupus erythematosus. As neutrophil extracellular traps induce IFN-α production, measuring neutrophil extracellular traps may estimate IFN-α levels and identify which systemic lupus erythematosus patients have elevated levels and may be more likely to respond to emerging anti-IFN-α therapies. In addition to anti-IFN-α therapies, other novel agents, such as N-acetyl-cysteine, DNase I, and peptidylarginine deiminase inhibitor 4, target neutrophil extracellular traps. Neutrophil extracellular traps offer insight into the pathogenesis of autoimmune diseases and provide promise in developing disease markers and novel therapeutic agents in systemic lupus erythematosus. Priority areas for basic research based on clinical research insights will be identified, specifically the potential role of neutrophil extracellular traps as a biomarker and therapeutic target in systemic lupus erythematosus.
中性粒细胞胞外诱捕网与一种不同于凋亡或坏死的独特细胞死亡形式相关,借此可捕获并杀死入侵的微生物。中性粒细胞胞外诱捕网可通过暴露自身抗原、诱导Ⅰ型干扰素(IFN-α)产生以及激活补体系统而导致自身免疫。本文将综述中性粒细胞胞外诱捕网与自身免疫性疾病,尤其是系统性红斑狼疮的关联。在银屑病、抗中性粒细胞胞浆抗体相关性血管炎、抗磷脂抗体综合征、类风湿关节炎及系统性红斑狼疮中均可见中性粒细胞胞外诱捕网形成增加。在抗中性粒细胞胞浆抗体相关性血管炎和抗磷脂抗体综合征中,中性粒细胞胞外诱捕网可能促进血栓形成。在系统性红斑狼疮中,中性粒细胞胞外诱捕网形成增加与疾病活动度增加及肾脏疾病相关,提示中性粒细胞胞外诱捕网可能是一种疾病活动度标志物。中性粒细胞胞外诱捕网可损伤并杀死内皮细胞,并促进动脉粥样硬化斑块中的炎症反应,这可能促使系统性红斑狼疮患者的动脉粥样硬化加速进展。由于中性粒细胞胞外诱捕网可诱导IFN-α产生,检测中性粒细胞胞外诱捕网可能有助于评估IFN-α水平,并识别哪些系统性红斑狼疮患者的IFN-α水平升高,且可能更有可能对新出现的抗IFN-α疗法产生反应。除抗IFN-α疗法外,其他新型药物,如N-乙酰半胱氨酸、脱氧核糖核酸酶Ⅰ及肽基精氨酸脱亚氨酶抑制剂4,也以中性粒细胞胞外诱捕网为靶点。中性粒细胞胞外诱捕网有助于深入了解自身免疫性疾病的发病机制,并为系统性红斑狼疮疾病标志物及新型治疗药物的研发带来希望。将根据临床研究见解确定基础研究的优先领域,特别是中性粒细胞胞外诱捕网作为系统性红斑狼疮生物标志物和治疗靶点的潜在作用。