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2017 ; 24
(1
): 66-71
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Consequences of extracellular trap formation in sepsis
#MMPMID27820735
O'Brien XM
; Biron BM
; Reichner JS
Curr Opin Hematol
2017[Jan]; 24
(1
): 66-71
PMID27820735
show ga
PURPOSE OF REVIEW: This review will focus on in-vivo findings derived from animal
models of sepsis regarding the trapping role of neutrophil extracellular traps
(NETs) which is difficult to assess ex vivo. The NETotic response of neutrophils
at sites of sterile injury or autoimmune disease is destructive as no
antimicrobial advantage to the host is realized and dampening NETosis is largely
beneficial. In early stages of local infection or in sepsis, the trapping
function of NETs may help abscess formation and limit microbial dissemination.
RECENT FINDINGS: The trapping function of NETs limits bacterial dissemination
keeping an abscess from becoming bacteremic or confining tissue infection to
local sites. Once containment is lost and disease has progressed, the best
therapeutic approach suggested by animal studies to date is to inhibit protein
arginine deiminase 4 and prevent NETosis rather than attempting to neutralize
caustic NET components. Prognostic value may best be realized by taking cell free
DNA, citrulllinated histones, neutrophil function and counts of immature
granulocytes into consideration rather than rely on any one measure alone.
SUMMARY: The trapping function of NETs may supercede the value of antimicrobial
function in the early phases of sepsis such that degradation of the DNA backbone
is contraindicated.
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