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NETs 诱导的血栓形成对心血管和慢性肾脏病的影响。

NETs-Induced Thrombosis Impacts on Cardiovascular and Chronic Kidney Disease.

机构信息

Division of Angiology, Swiss Cardiovascular Center, Inselspital (M.T., S.M.B., M.S., Y.D.), Bern University Hospital, University of Bern, Switzerland.

Department for BioMedical Research (DBMR) (M.T., S.M.B., M.S., Y.D.), Bern University Hospital, University of Bern, Switzerland.

出版信息

Circ Res. 2023 Apr 14;132(8):933-949. doi: 10.1161/CIRCRESAHA.123.321750. Epub 2023 Apr 13.

Abstract

Arterial and venous thrombosis constitute a major source of morbidity and mortality worldwide. Association between thrombotic complications and cardiovascular and other chronic inflammatory diseases are well described. Inflammation and subsequent initiation of thrombotic events, termed immunothrombosis, also receive growing attention but are still incompletely understood. Nevertheless, the clinical relevance of aberrant immunothrombosis, referred to as thromboinflammation, is evident by an increased risk of thrombosis and cardiovascular events in patients with inflammatory or infectious diseases. Proinflammatory mediators released from platelets, complement activation, and the formation of NETs (neutrophil extracellular traps) initiate and foster immunothrombosis. In this review, we highlight and discuss prominent and emerging interrelationships and functions between NETs and other mediators in immunothrombosis in cardiovascular disease. Also, with patients with chronic kidney disease suffering from increased cardiovascular and thrombotic risk, we summarize current knowledge on neutrophil phenotype, function, and NET formation in chronic kidney disease. In addition, we elaborate on therapeutic targeting of NETs-induced immunothrombosis. A better understanding of the functional relevance of antithrombotic mediators which do not increase bleeding risk may provide opportunities for successful therapeutic interventions to reduce thrombotic risk beyond current treatment options.

摘要

动脉和静脉血栓形成是全世界发病率和死亡率的主要来源。血栓并发症与心血管和其他慢性炎症性疾病之间的关联已得到充分描述。炎症和随后引发的血栓事件,即免疫血栓形成,也受到越来越多的关注,但仍不完全了解。然而,异常免疫血栓形成(称为血栓炎症)的临床相关性明显,表现为炎症性或传染性疾病患者的血栓形成和心血管事件风险增加。血小板释放的促炎介质、补体激活和 NETs(中性粒细胞胞外陷阱)的形成会引发和促进免疫血栓形成。在这篇综述中,我们强调并讨论了 NETs 与心血管疾病中免疫血栓形成的其他介质之间的突出和新兴的相互关系和功能。此外,由于慢性肾脏病患者心血管和血栓形成风险增加,我们总结了目前关于慢性肾脏病中性粒细胞表型、功能和 NET 形成的知识。此外,我们详细阐述了针对 NET 诱导的免疫血栓形成的治疗靶向。更好地了解不会增加出血风险的抗血栓形成介质的功能相关性,可能为成功的治疗干预提供机会,以降低血栓形成风险,超越当前的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e73/10377271/4b70ee2008dd/res-132-933-g001.jpg

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