Hu Jing, Kang Hongxin, Chen Huan, Yao Jiaqi, Yi Xiaolin, Tang Wenfu, Wan Meihua
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University, Guo Xue Rd, 37 Chengdu, Sichuan Province, 610041 PR China.
Therap Adv Gastroenterol. 2020 Nov 24;13:1756284820974913. doi: 10.1177/1756284820974913. eCollection 2020.
Severe acute pancreatitis (SAP) is a critical abdominal disease associated with high death rates. A systemic inflammatory response promotes disease progression, resulting in multiple organ dysfunction. The functions of neutrophils in the pathology of SAP have been presumed traditionally to be activation of chemokine and cytokine cascades accompanying the inflammatory process. Recently, since their discovery, a new type of antimicrobial mechanism, neutrophil extracellular traps (NETs), and their role in SAP, has attracted widespread attention from the scientific community. Significantly different from phagocytosis and degranulation, NETs kill extracellular microorganisms by releasing DNA fibers decorated with granular proteins. In addition to their strong antimicrobial functions, NETs participate in the pathophysiological process of many noninfectious diseases. In SAP, NETs injure normal tissues under inflammatory stress, which is associated with the activation of inflammatory cells, to cause an inflammatory cascade, and SAP products also trigger NET formation. Thus, due to the interaction between NET generation and SAP, a treatment targeting NETs might become a key point in SAP therapy. In this review, we summarize the mechanism of NETs in protecting the host from pathogen invasion, the stimulus that triggers NET formation, organ injury associated with SAP involving NETs, methods to interrupt the harmful effects of NETs, and different therapeutic strategies to preserve the organ function of patients with SAP by targeting NETs.
重症急性胰腺炎（SAP）是一种病死率较高的严重腹部疾病。全身炎症反应会促进疾病进展，导致多器官功能障碍。传统上认为中性粒细胞在SAP病理过程中的作用是伴随炎症过程激活趋化因子和细胞因子级联反应。最近，自中性粒细胞胞外诱捕网（NETs）被发现以来，这种新型抗菌机制及其在SAP中的作用引起了科学界的广泛关注。NETs与吞噬作用和脱颗粒作用显著不同，它通过释放装饰有颗粒蛋白的DNA纤维来杀死细胞外微生物。除了强大的抗菌功能外，NETs还参与许多非感染性疾病的病理生理过程。在SAP中，NETs在炎症应激下损伤正常组织，这与炎症细胞的激活有关，从而引发炎症级联反应，并且SAP产物也会触发NETs的形成。因此，由于NETs的产生与SAP之间的相互作用，针对NETs的治疗可能成为SAP治疗的关键。在本综述中，我们总结了NETs保护宿主免受病原体入侵的机制、触发NETs形成的刺激因素、与NETs相关的SAP所致器官损伤、中断NETs有害作用的方法，以及通过靶向NETs来保护SAP患者器官功能的不同治疗策略。
