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Neutrophil Extracellular Traps and Their Implications in Cardiovascular and Inflammatory Disease
Authors:Johannes Klopf  Christine Brostjan  Wolf Eilenberg  Christoph Neumayer
Affiliation:Division of Vascular Surgery and Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, General Hospital of Vienna, 1090 Vienna, Austria; (J.K.); (C.B.); (W.E.)
Abstract:Neutrophils are primary effector cells of innate immunity and fight infection by phagocytosis and degranulation. Activated neutrophils also release neutrophil extracellular traps (NETs) in response to a variety of stimuli. These NETs are net-like complexes composed of cell-free DNA, histones and neutrophil granule proteins. Besides the evolutionarily conserved mechanism to capture and eliminate pathogens, NETs are also associated with pathophysiological processes of various diseases. Here, we elucidate the mechanisms of NET formation and their different implications in disease. We focused on autoinflammatory and cardiovascular disorders as the leading cause of death. Neutrophil extracellular traps are not only present in various cardiovascular diseases but play an essential role in atherosclerotic plaque formation, arterial and venous thrombosis, as well as in the development and progression of abdominal aortic aneurysms. Furthermore, NETosis can be considered as a source of autoantigens and maintains an inflammatory milieu promoting autoimmune diseases. Indeed, there is further need for research into the balance between NET induction, inhibition, and degradation in order to pharmacologically target NETs and their compounds without impairing the patient’s immune defense. This review may be of interest to both basic scientists and clinicians to stimulate translational research and innovative clinical approaches.
Keywords:neutrophil extracellular traps (NETs)  neutrophils  cardiovascular diseases  inflammation  autoimmunity  atherosclerosis  abdominal aortic aneurysm  diabetes mellitus  COVID-19  malignant neoplasia
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