Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Cells. 2021 Aug 26;10(9):2208. doi: 10.3390/cells10092208.
The enlightenment of the formation of neutrophil extracellular traps (NETs) as a part of the innate immune system shed new insights into the pathologies of various diseases. The initial idea that NETs are a pivotal defense structure was gradually amended due to several deleterious effects in consecutive investigations. NETs formation is now considered a double-edged sword. The harmful effects are not limited to the induction of inflammation by NETs remnants but also include occlusions caused by aggregated NETs (aggNETs). The latter carries the risk of occluding tubular structures like vessels or ducts and appear to be associated with the pathologies of various diseases. In addition to life-threatening vascular clogging, other occlusions include painful stone formation in the biliary system, the kidneys, the prostate, and the appendix. AggNETs are also prone to occlude the ductal system of exocrine glands, as seen in ocular glands, salivary glands, and others. Last, but not least, they also clog the pancreatic ducts in a murine model of neutrophilia. In this regard, elucidating the mechanism of NETs-dependent occlusions is of crucial importance for the development of new therapeutic approaches. Therefore, the purpose of this review is to address the putative mechanisms of NETs-associated occlusions in the pathogenesis of disease, as well as prospective treatment modalities.
中性粒细胞胞外诱捕网 (NETs) 的形成作为先天免疫系统的一部分,为各种疾病的发病机制提供了新的见解。最初认为 NETs 是一种关键的防御结构,但随着后续研究的深入,发现了其几个有害影响,这一观点逐渐得到修正。NETs 的形成现在被认为是一把双刃剑。其有害影响不仅限于 NETs 残片诱导炎症,还包括由聚集的 NETs (aggNETs) 引起的阻塞。后者有阻塞管状结构(如血管或导管)的风险,似乎与各种疾病的发病机制有关。除了危及生命的血管堵塞外,其他阻塞还包括胆道系统、肾脏、前列腺和阑尾中的疼痛性结石形成。aggNETs 也容易阻塞外分泌腺的导管系统,如眼腺、唾液腺等。最后但同样重要的是,它们还会在中性粒细胞增多的小鼠模型中阻塞胰腺导管。在这方面,阐明依赖 NETs 的阻塞的机制对于开发新的治疗方法至关重要。因此,本综述的目的是探讨 NETs 相关阻塞在疾病发病机制中的潜在机制,以及有前景的治疗方式。