Neutrophil extracellular traps and thrombosis in COVID-19

Journal of Thrombosis and Thrombolysis - Tập 51 - Trang 446-453 - 2020
Yu Zuo1, Melanie Zuo2, Srilakshmi Yalavarthi1, Kelsey Gockman1, Jacqueline A. Madison1, Hui Shi1,3, Wrenn Woodard4, Sean P. Lezak4, Njira L. Lugogo5, Jason S. Knight1, Yogendra Kanthi6,7
1Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, USA
2Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, USA
3Division of Rheumatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
4Michigan Clinical Research Unit, University of Michigan, Ann Arbor, USA
5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, USA
6Laboratory of Vascular Thrombosis and Inflammation, National Heart, Lung, and Blood Institute, NIH, Bethesda, USA
7Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, USA

Tóm tắt

Studies of patients with COVID-19 have demonstrated markedly dysregulated coagulation and a high risk of morbid arterial and venous thrombotic events. Elevated levels of blood neutrophils and neutrophil extracellular traps (NETs) have recently been described in patients with COVID-19. However, their potential role in COVID-19-associated thrombosis remains incompletely understood. In order to elucidate the potential role of hyperactive neutrophils and NET release in COVID-19-associated thrombosis, we conducted a case–control study of patients hospitalized with COVID-19 who developed thrombosis, as compared with gender- and age-matched COVID-19 patients without clinical thrombosis. We found that remnants of NETs (cell-free DNA, myeloperoxidase-DNA complexes, and citrullinated histone H3) and neutrophil-derived S100A8/A9 (calprotectin) in patient sera were associated with higher risk of morbid thrombotic events in spite of prophylactic anticoagulation. These observations underscore the need for urgent investigation into the potential relationship between NETs and unrelenting thrombosis in COVID-19, as well as novel approaches for thrombosis prevention.

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