AUTHOR=Bruschi Maurizio , Moroni Gabriella , Sinico Renato Alberto , Franceschini Franco , Fredi Micaela , Vaglio Augusto , Cavagna Lorenzo , Petretto Andrea , Pratesi Federico , Migliorini Paola , Manfredi Angelo , Ramirez Giuseppe A. , Esposito Pasquale , Negrini Simone , Trezzi Barbara , Emmi Giacomo , Santoro Domenico , Scolari Francesco , Volpi Stefano , Mosca Marta , Tincani Angela , Candiano Giovanni , Prunotto Marco , Verrina Enrico , Angeletti Andrea , Ravelli Angelo , Ghiggeri Gian Marco TITLE=Neutrophil Extracellular Traps in the Autoimmunity Context JOURNAL=Frontiers in Medicine VOLUME=8 YEAR=2021 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.614829 DOI=10.3389/fmed.2021.614829 ISSN=2296-858X ABSTRACT=
The formation of neutrophil extracellular traps (NETs) is a strategy utilized by neutrophils for capturing infective agents. Extracellular traps consist in a physical net made of DNA and intracellular proteins externalized from neutrophils, where bacteria and viruses are entrapped and killed by proteolysis. A complex series of events contributes to achieving NET formation: signaling from infectious triggers comes first, followed by decondensation of chromatin and extrusion of the nucleosome components (DNA, histones) from the nucleus and, after cell membrane breakdown, outside the cell. NETs are composed of either DNA or nucleosome proteins and hundreds of cytoplasm proteins, a part of which undergo post-translational modification during the steps leading to NETs. There is a thin balance between the production and the removal of circulating NETs from blood where digestion of DNA by circulating DNases 1 and IL3 has a critical role. A delay in NET removal may have consequences for autoimmunity. Recent studies have shown that circulating NET levels are increased in systemic lupus erythematosus (SLE) for a functional block of NET removal mediated by anti-DNase antibodies or, in rare cases, by DNase IL3 mutations. In SLE, the persistence in circulation of NETs signifies elevated concentrations of either free DNA/nucleosome components and oxidized proteins that, in some cases, are recognized as non-self and presented to B-cells by Toll-like receptor 9 (TLR9). In this way, it is activated as an immunologic response, leading to the formation of IgG2 auto-antibody. Monitoring serum NET levels represents a potential new way to herald the development of renal lesions and has clinical implications. Modulating the balance between NET formation and removal is one of the objectives of basic research that are aimed to design new drugs for SLE.