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2017 ; 12
(ä): 885-896
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Evidence of eosinophil extracellular trap cell death in COPD: does it represent
the trigger that switches on the disease?
#MMPMID28352169
Uribe Echevarría L
; Leimgruber C
; García González J
; Nevado A
; Álvarez R
; García LN
; Quintar AA
; Maldonado CA
Int J Chron Obstruct Pulmon Dis
2017[]; 12
(ä): 885-896
PMID28352169
show ga
In spite of the numerous studies on chronic obstructive pulmonary disease (COPD),
the cellular and molecular basis of the disease's development remain unclear.
Neutrophils and eosinophils are known to be key players in COPD. Recently,
neutrophil extracellular trap cell death (NETosis), a mechanism due to
decondensation and extrusion of chromatin to form extracellular traps, has been
demonstrated in COPD. However, there is limited knowledge about eosinophil
extracellular trap cell death (EETosis) and its role in the pathogenesis of COPD.
The aim of this study was to evaluate EETosis in stable COPD. Induced sputum
obtained from healthy smokers and low exacerbation risk COPD A or B group
patients or high exacerbation risk COPD C or D group patients were included.
Samples were examined using electron microscopy and immunofluorescence. Healthy
smokers (n=10) and COPD A (n=19) group exhibited neutrophilic or
paucigranulocytic phenotypes, with NETosis being absent in these patients. In
contrast, COPD B (n=29), with eosinophilic or mixed phenotypes, showed EETosis
and incipient NETosis. COPD C (n=18) and COPD D groups (n=13) were differentiated
from low exacerbation rate-COPD group by the abundant cellular debris, with COPD
C group having an eosinophilic pattern and numerous cells undergoing EETosis. A
hallmark of this group was the abundant released membranes that often appeared
phagocytosed by neutrophils, which coincidentally exhibited early NETosis
changes. The COPD D group included patients with a neutrophilic or mixed pattern,
with abundant neutrophil extracellular trap-derived material. This study is the
first to demonstrate EETosis at different stages of stable COPD. The results
suggest a role for eosinophils in COPD pathophysiology, especially at the
beginning and during the persistence of the disease, regardless of whether the
patient quit smoking, with EETosis debris probably triggering uncontrolled
NETosis. The main target of these findings should be young smokers with the
potential to develop COPD.