NETs in APS: current knowledge and future perspectives

A Tambralli, K Gockman, JS Knight - Current Rheumatology Reports, 2020 - Springer
Current Rheumatology Reports, 2020Springer
Abstract Purpose of Review Antiphospholipid syndrome (APS) is a thrombo-inflammatory
disease that is primarily treated with anticoagulation. Better understanding the inflammatory
aspects of APS could lead to safer, more effective, and more personalized therapeutic
options. To this end, we sought to understand recent literature related to the role of
neutrophils and, in particular, neutrophil extracellular traps (NETs) in APS. Recent Findings
Expression of genes associated with type I interferons, endothelial adhesion, and pregnancy …
Purpose of Review
Antiphospholipid syndrome (APS) is a thrombo-inflammatory disease that is primarily treated with anticoagulation. Better understanding the inflammatory aspects of APS could lead to safer, more effective, and more personalized therapeutic options. To this end, we sought to understand recent literature related to the role of neutrophils and, in particular, neutrophil extracellular traps (NETs) in APS.
Recent Findings
Expression of genes associated with type I interferons, endothelial adhesion, and pregnancy regulation are increased in APS neutrophils. APS neutrophils have a reduced threshold for NET release, which likely potentiates thrombotic events and perhaps especially large-vein thrombosis. Neutrophil-derived reactive oxygen species also appear to play a role in APS pathogenesis. There are new approaches for preventing and disrupting NETs that could potentially be leveraged to reduce the risk of APS-associated thrombosis.
Summary
Neutrophils and NETs contribute to APS pathophysiology. More precisely understanding their roles at a mechanistic level should help identify new therapeutic targets for inhibiting NET formation, enhancing NET dissolution, and altering neutrophil adhesion. Such approaches may ultimately lead to better clinical management of APS patients and thereby reduce the chronic burden of this disease.
Springer