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2017 ; 69
(3
): 655-667
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In Vivo Role of Neutrophil Extracellular Traps in Antiphospholipid
Antibody-Mediated Venous Thrombosis
#MMPMID27696751
Meng H
; Yalavarthi S
; Kanthi Y
; Mazza LF
; Elfline MA
; Luke CE
; Pinsky DJ
; Henke PK
; Knight JS
Arthritis Rheumatol
2017[Mar]; 69
(3
): 655-667
PMID27696751
show ga
OBJECTIVE: Antiphospholipid syndrome (APS) is a leading acquired cause of
thrombotic events. Although antiphospholipid antibodies have been shown to
promote thrombosis in mice, the role of neutrophils has not been explicitly
studied. The aim of this study was to characterize neutrophils in the context of
a new model of antiphospholipid antibody-mediated venous thrombosis. METHODS:
Mice were administered fractions of IgG obtained from patients with APS. At the
same time, blood flow through the inferior vena cava was reduced by induction of
stenosis. Resulting thrombi were characterized for size and neutrophil content.
Circulating factors and the vessel wall were also assessed. RESULTS: As measured
by both thrombus weight and thrombosis frequency, mice treated with IgG from
patients with APS (APS IgG) demonstrated exaggerated thrombosis as compared with
control IgG-treated mice. Thrombi in mice treated with APS IgG were enriched for
citrullinated histone H3 (a marker of neutrophil extracellular traps [NETs]). APS
IgG-treated mice also demonstrated elevated levels of circulating cell-free DNA
and human IgG bound to the neutrophil surface. In contrast, circulating
neutrophil numbers and markers of vessel wall activation were not appreciably
different between APS IgG-treated mice and control mice. Treatment with either
DNase (which dissolves NETs) or a neutrophil-depleting antibody reduced
thrombosis in APS IgG-treated mice to the level in control mice. CONCLUSION:
These data support a mechanism whereby circulating neutrophils are primed by
antiphospholipid antibodies to accelerate thrombosis. This line of investigation
suggests new, immunomodulatory approaches for the treatment of APS.