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Hernández González LL, Pérez-Campos Mayoral L, Hernández-Huerta MT, Mayoral Andrade G, Martínez Cruz M, Ramos-Martínez E, Pérez-Campos Mayoral E, Cruz Hernández V, Antonio García I, Matias-Cervantes CA, Avendaño Villegas ME, Lastre Domínguez CM, Romero Díaz C, Ruiz-Rosado JDD, Pérez-Campos E. Targeting Neutrophil Extracellular Trap Formation: Exploring Promising Pharmacological Strategies for the Treatment of Preeclampsia. Pharmaceuticals (Basel) 2024; 17:605. [PMID: 38794175 PMCID: PMC11123764 DOI: 10.3390/ph17050605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
Neutrophils, which constitute the most abundant leukocytes in human blood, emerge as crucial players in the induction of endothelial cell death and the modulation of endothelial cell responses under both physiological and pathological conditions. The hallmark of preeclampsia is endothelial dysfunction induced by systemic inflammation, in which neutrophils, particularly through the formation of neutrophil extracellular traps (NETs), play a pivotal role in the development and perpetuation of endothelial dysfunction and the hypertensive state. Considering the potential of numerous pharmaceutical agents to attenuate NET formation (NETosis) in preeclampsia, a comprehensive assessment of the extensively studied candidates becomes imperative. This review aims to identify mechanisms associated with the induction and negative regulation of NETs in the context of preeclampsia. We discuss potential drugs to modulate NETosis, such as NF-κβ inhibitors, vitamin D, and aspirin, and their association with mutagenicity and genotoxicity. Strong evidence supports the notion that molecules involved in the activation of NETs could serve as promising targets for the treatment of preeclampsia.
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Affiliation(s)
- Leticia Lorena Hernández González
- National Technology of Mexico/IT Oaxaca, Oaxaca de Juárez, Oaxaca 68030, Mexico; (L.L.H.G.); (M.M.C.); (C.M.L.D.); (C.R.D.)
- Faculty of Biological Systems and Technological Innovation, Autonomous University “Benito Juárez” of Oaxaca, Oaxaca 68125, Mexico
| | - Laura Pérez-Campos Mayoral
- Research Center, Faculty of Medicine UNAM-UABJO, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico; (L.P.-C.M.); (G.M.A.); (E.P.-C.M.)
| | - María Teresa Hernández-Huerta
- CONAHCyT, Faculty of Medicine and Surgery, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico; (M.T.H.-H.); (C.A.M.-C.)
| | - Gabriel Mayoral Andrade
- Research Center, Faculty of Medicine UNAM-UABJO, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico; (L.P.-C.M.); (G.M.A.); (E.P.-C.M.)
| | - Margarito Martínez Cruz
- National Technology of Mexico/IT Oaxaca, Oaxaca de Juárez, Oaxaca 68030, Mexico; (L.L.H.G.); (M.M.C.); (C.M.L.D.); (C.R.D.)
| | - Edgar Ramos-Martínez
- School of Sciences, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico;
| | - Eduardo Pérez-Campos Mayoral
- Research Center, Faculty of Medicine UNAM-UABJO, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico; (L.P.-C.M.); (G.M.A.); (E.P.-C.M.)
| | | | | | - Carlos Alberto Matias-Cervantes
- CONAHCyT, Faculty of Medicine and Surgery, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico; (M.T.H.-H.); (C.A.M.-C.)
| | - Miriam Emily Avendaño Villegas
- National Technology of Mexico/IT Oaxaca, Oaxaca de Juárez, Oaxaca 68030, Mexico; (L.L.H.G.); (M.M.C.); (C.M.L.D.); (C.R.D.)
| | | | - Carlos Romero Díaz
- National Technology of Mexico/IT Oaxaca, Oaxaca de Juárez, Oaxaca 68030, Mexico; (L.L.H.G.); (M.M.C.); (C.M.L.D.); (C.R.D.)
- Research Center, Faculty of Medicine UNAM-UABJO, Autonomous University “Benito Juárez” of Oaxaca (UABJO), Oaxaca 68020, Mexico; (L.P.-C.M.); (G.M.A.); (E.P.-C.M.)
| | - Juan de Dios Ruiz-Rosado
- Kidney and Urinary Tract Research Center, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA
- Division of Nephrology and Hypertension, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Eduardo Pérez-Campos
- National Technology of Mexico/IT Oaxaca, Oaxaca de Juárez, Oaxaca 68030, Mexico; (L.L.H.G.); (M.M.C.); (C.M.L.D.); (C.R.D.)
- Clinical Pathology Laboratory, “Eduardo Pérez Ortega”, Oaxaca 68000, Mexico
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Li X, Xiao S, Filipczak N, Yalamarty SSK, Shang H, Zhang J, Zheng Q. Role and Therapeutic Targeting Strategies of Neutrophil Extracellular Traps in Inflammation. Int J Nanomedicine 2023; 18:5265-5287. [PMID: 37746050 PMCID: PMC10516212 DOI: 10.2147/ijn.s418259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Neutrophil extracellular traps (NETs) are large DNA reticular structures secreted by neutrophils and decorated with histones and antimicrobial proteins. As a key mechanism for neutrophils to resist microbial invasion, NETs play an important role in the killing of microorganisms (bacteria, fungi, and viruses). Although NETs are mostly known for mediating microbial killing, increasing evidence suggests that excessive NETs induced by stimulation of physical and chemical components, microorganisms, and pathological factors can exacerbate inflammation and organ damage. This review summarizes the induction and role of NETs in inflammation and focuses on the strategies of inhibiting NETosis and the mechanisms involved in pathogen evasion of NETs. Furthermore, herbal medicine inhibitors and nanodelivery strategies improve the efficiency of inhibition of excessive levels of NETs.
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Affiliation(s)
- Xiang Li
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, People’s Republic of China
| | - Shanghua Xiao
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, People’s Republic of China
| | - Nina Filipczak
- Center for Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston, MA, USA
| | | | - Hongming Shang
- Department of Biochemistry & Chemical Biology, Vanderbilt University, Nashville, TN, USA
| | - Jing Zhang
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, People’s Republic of China
| | - Qin Zheng
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, People’s Republic of China
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Le Joncour A, Régnier P, Maciejewski-Duval A, Charles E, Barete S, Fouret P, Rosenzwajg M, Klatzmann D, Cacoub P, Saadoun D. Reduction of Neutrophil Activation by Phosphodiesterase 4 Blockade in Behçet's Disease. Arthritis Rheumatol 2023; 75:1628-1637. [PMID: 36862398 DOI: 10.1002/art.42486] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/17/2023] [Accepted: 02/15/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Behçet's disease (BD) is a systemic vasculitis with inflammatory lesions mediated by cytotoxic T cells and neutrophils. Apremilast, an orally available small-molecule drug that selectively inhibits phosphodiesterase 4 (PDE4), has been recently approved for the treatment of BD. We aimed to investigate the effect of PDE4 inhibition on neutrophil activation in BD. METHODS We studied surface markers and reactive oxygen species (ROS) production by flow cytometry, and neutrophil extracellular traps (NETs) production and molecular signature of neutrophils by transcriptome analysis before and after PDE4 inhibition. RESULTS Activation surface markers (CD64, CD66b, CD11b, and CD11c), ROS production, and NETosis were up-regulated in BD patient neutrophils compared to healthy donor neutrophils. Transcriptome analysis revealed 1,021 significantly dysregulated neutrophil genes between BD patients and healthy donors. Among dysregulated genes, we found a substantial enrichment for pathways linked to innate immunity, intracellular signaling, and chemotaxis in BD. Skin lesions of BD patients showed increased infiltration of neutrophils that colocalized with PDE4. Inhibition of PDE4 by apremilast strongly inhibited neutrophil surface activation markers as well as ROS production, NETosis, and genes and pathways related to innate immunity, intracellular signaling, and chemotaxis. CONCLUSION We highlight key biologic effects of apremilast on neutrophils in BD.
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Affiliation(s)
- Alexandre Le Joncour
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France
| | - Paul Régnier
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Anna Maciejewski-Duval
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Erwan Charles
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphane Barete
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Unit of Dermatology, Paris, France
| | - Pierre Fouret
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Anatomopathology, Paris, France
| | - Michelle Rosenzwajg
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - David Klatzmann
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Patrice Cacoub
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France
| | - David Saadoun
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France
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Stolfa I, Page C. Phosphodiesterase inhibitors and lung diseases. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2023; 98:55-81. [PMID: 37524492 DOI: 10.1016/bs.apha.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Phosphodiesterase enzymes (PDE) have long been known as regulators of cAMP and cGMP, second messengers involved in various signaling pathways and expressed in a variety of cell types implicated in respiratory diseases such as airway smooth muscle and inflammatory cells making them a key target for the treatment of lung diseases as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, and pulmonary hypertension (PH). The first reported PDE inhibitor was the xanthine, theophylline, described as a non-specific PDE inhibitor and whilst this drug is effective, it also has a range of unwanted side effects. In an attempt to improve the therapeutic window of xanthines, a number of selective PDE inhibitors have been developed for the treatment of respiratory diseases with only the selective PDE 4 inhibitor, roflumilast, being approved for the treatment of severe COPD. However, roflumilast also has a very narrow therapeutic window due to a number of important doses limiting side effects, particularly in the gastrointestinal tract. However, there continues to be research carried out in this field to identify improved selective PDE inhibitors, both by targeting other PDE subtypes (e.g., PDE 7 found in a number of inflammatory and immune cells) and through development of selective PDE inhibitors for pulmonary administration to reduce systemic exposure and improve the side effect profile. This approach has been exemplified by the development of ensifentrine, a dual PDE 3-PDE 4 inhibitor, an inhaled drug that has recently completed two successful Phase III clinical trials in patients with COPD.
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Affiliation(s)
- Ivana Stolfa
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College, London, United Kingdom
| | - Clive Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College, London, United Kingdom.
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Goonathilake MR, Waqar S, George S, Jean-Baptiste W, Yusuf Ali A, Inyang B, Koshy FS, George K, Poudel P, Chalasani R, Mohammed L. Can Phosphodiesterase 4 Inhibitor Therapy Be Used in Respiratory Diseases Other Than Chronic Obstructive Pulmonary Disease? Cureus 2022; 14:e27132. [PMID: 36017299 PMCID: PMC9392891 DOI: 10.7759/cureus.27132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/20/2022] [Indexed: 11/05/2022] Open
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The PDE4 Inhibitor Tanimilast Restrains the Tissue-Damaging Properties of Human Neutrophils. Int J Mol Sci 2022; 23:ijms23094982. [PMID: 35563373 PMCID: PMC9104715 DOI: 10.3390/ijms23094982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Neutrophils, the most abundant subset of leukocytes in the blood, play a pivotal role in host response against invading pathogens. However, in respiratory diseases, excessive infiltration and activation of neutrophils can lead to tissue damage. Tanimilast-international non-proprietary name of CHF6001—is a novel inhaled phosphodiesterase 4 (PDE4) inhibitor in advanced clinical development for the treatment of chronic obstructive pulmonary disease (COPD), a chronic inflammatory lung disease where neutrophilic inflammation plays a key pathological role. Human neutrophils from healthy donors were exposed to pro-inflammatory stimuli in the presence or absence of tanimilast and budesonide—a typical inhaled corticosteroid drug-to investigate the modulation of effector functions including adherence to endothelial cells, granule protein exocytosis, release of extracellular DNA traps, cytokine secretion, and cell survival. Tanimilast significantly decreased neutrophil-endothelium adhesion, degranulation, extracellular DNA traps casting, and cytokine secretion. In contrast, it promoted neutrophil survival by decreasing both spontaneous apoptosis and cell death in the presence of pro-survival factors. The present work suggests that tanimilast can alleviate the severe tissue damage caused by massive recruitment and activation of neutrophils in inflammatory diseases such as COPD.
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Zhang Q, Ling S, Hu K, Liu J, Xu JW. Role of the renin-angiotensin system in NETosis in the coronavirus disease 2019 (COVID-19). Pharmacotherapy 2022; 148:112718. [PMID: 35176710 PMCID: PMC8841219 DOI: 10.1016/j.biopha.2022.112718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/20/2022]
Abstract
Myocardial infarction and stroke are the leading causes of death in the world. Numerous evidence has confirmed that hypertension promotes thrombosis and induces myocardial infarction and stroke. Recent findings reveal that neutrophil extracellular traps (NETs) are involved in the induction of myocardial infarction and stroke. Meanwhile, patients with severe COVID-19 suffer from complications such as myocardial infarction and stroke with pathological signs of NETs. Due to the extremely low amount of virus detected in the blood and remote organs (e.g., heart, brain and kidney) in a few cases, it is difficult to explain the mechanism by which the virus triggers NETosis, and there may be a different mechanism than in the lung. A large number of studies have found that the renin-angiotensin system regulates the NETosis at multiple levels in patients with COVID-19, such as endocytosis of SARS-COV-2, abnormal angiotensin II levels, neutrophil activation and procoagulant function at multiple levels, which may contribute to the formation of reticular structure and thrombosis. The treatment of angiotensin-converting enzyme inhibitors (ACEI), angiotensin II type 1 receptor blockers (ARBs) and neutrophil recruitment and active antagonists helps to regulate blood pressure and reduce the risk of net and thrombosis. The review will explore the possible role of the angiotensin system in the formation of NETs in severe COVID-19.
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DI Stefano A, Gnemmi I, Dossena F, Ricciardolo FL, Maniscalco M, Lo Bello F, Balbi B. Pathogenesis of COPD at the cellular and molecular level. Minerva Med 2022; 113:405-423. [PMID: 35138077 DOI: 10.23736/s0026-4806.22.07927-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic inflammatory responses in the lung of patients with stable mild-to severe forms of COPD play a central role in the definition, comprehension and monitoring of the disease state. A better understanding of the COPD pathogenesis can't avoid a detailed knowledge of these inflammatory changes altering the functional health of the lung during the disease progression. We here summarize and discuss the role and principal functions of the inflammatory cells populating the large, small airways and lung parenchyma of patients with COPD of increasing severity in comparison with healthy control subjects: T and B lymphocytes, NK and Innate Lymphoid cells, macrophages, and neutrophils. The differential inflammatory distribution in large and small airways of patients is also discussed. Furthermore, relevant cellular mechanisms controlling the homeostasis and the "normal" balance of these inflammatory cells and of structural cells in the lung, such as autophagy, apoptosis, necroptosis and pyroptosis are as well presented and discussed in the context of the COPD severity.
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Affiliation(s)
- Antonino DI Stefano
- Divisione di Pneumologia e Laboratorio di Citoimmunopatologia dell'Apparato Cardio Respiratorio, Istituti Clinici Scientifici Maugeri, SpA, Società Benefit, IRCCS, Veruno, Novara, Italy -
| | - Isabella Gnemmi
- Divisione di Pneumologia e Laboratorio di Citoimmunopatologia dell'Apparato Cardio Respiratorio, Istituti Clinici Scientifici Maugeri, SpA, Società Benefit, IRCCS, Veruno, Novara, Italy
| | - Francesca Dossena
- Divisione di Pneumologia e Laboratorio di Citoimmunopatologia dell'Apparato Cardio Respiratorio, Istituti Clinici Scientifici Maugeri, SpA, Società Benefit, IRCCS, Veruno, Novara, Italy
| | - Fabio L Ricciardolo
- Rare Lung Disease Unit and Severe Asthma Centre, Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital Orbassano, University of Turin, Turin, Italy
| | - Mauro Maniscalco
- Divisione di Pneumologia, Istituti Clinici Scientifici Maugeri, SpA, Società Benefit, IRCCS, Telese, Benevento, Italy
| | - Federica Lo Bello
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Bruno Balbi
- Divisione di Pneumologia e Laboratorio di Citoimmunopatologia dell'Apparato Cardio Respiratorio, Istituti Clinici Scientifici Maugeri, SpA, Società Benefit, IRCCS, Veruno, Novara, Italy
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9
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Neutrophil Extracellular Traps in Skin Diseases. Biomedicines 2021; 9:biomedicines9121888. [PMID: 34944704 PMCID: PMC8698493 DOI: 10.3390/biomedicines9121888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 12/22/2022] Open
Abstract
Neutrophils are the primary innate immune cells, and serve as sentinels for invading pathogens. To this end, neutrophils exert their effector functions via phagocytosis, degranulation, reactive oxygen species generation, and neutrophil extracellular trap (NET) release. Pathogens and pathogen-derived components trigger NET formation, leading to the clearance of pathogens. However, NET formation is also induced by non-related pathogen proteins, such as cytokines and immune complexes. In this regard, NET formation can be induced under both non-sterile and sterile conditions. NETs are enriched by components with potent cytotoxic and inflammatory properties, thereby occasionally damaging tissues and cells and dysregulating immune homeostasis. Research has uncovered the involvement of NETs in the pathogenesis of several connective tissue diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and ANCA-associated vasculitis. In dermatology, several skin diseases clinically develop local or systemic sterile pustules and abscesses. The involvement of neutrophils and subsequent NET formation has recently been elucidated in these skin diseases. Therefore, this review highlights the NETs in these neutrophil-associated diseases.
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Caseley EA, Lara-Reyna S, Poulter JA, Topping J, Carter C, Nadat F, Spickett GP, Savic S, McDermott MF. An Atypical Autoinflammatory Disease Due to an LRR Domain NLRP3 Mutation Enhancing Binding to NEK7. J Clin Immunol 2021; 42:158-170. [PMID: 34671876 PMCID: PMC8528658 DOI: 10.1007/s10875-021-01161-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022]
Abstract
The NLRP3 inflammasome is a vital mediator of innate immune responses. There are numerous NLRP3 mutations that cause NLRP3-associated autoinflammatory diseases (NLRP3-AIDs), mostly in or around the NACHT domain. Here, we present a patient with a rare leucine-rich repeat (LRR) domain mutation, p.Arg920Gln (p.R920Q), associated with an atypical NLRP3-AID with recurrent episodes of sore throat and extensive oropharyngeal ulceration. Unlike previously reported patients, who responded well to anakinra, her oral ulcers did not significantly improve until the PDE4 inhibitor, apremilast, was added to her treatment regimen. Here, we show that this mutation enhances interactions between NLRP3 and its endogenous inhibitor, NIMA-related kinase 7 (NEK7), by affecting charge complementarity between the two proteins. We also demonstrate that additional inflammatory mediators, including the NF-кB and IL-17 signalling pathways and IL-8 chemokine, are upregulated in the patient’s macrophages and may be directly involved in disease pathogenesis. These results highlight the role of the NLRP3 LRR domain in NLRP3-AIDs and demonstrate that the p.R920Q mutation can cause diverse phenotypes between families.
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Affiliation(s)
- Emily A Caseley
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, Leeds, UK
| | - Samuel Lara-Reyna
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - James A Poulter
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, Leeds, UK
| | - Joanne Topping
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, Leeds, UK
| | - Clive Carter
- Transplant and Cellular Immunology, St James's University Hospital, Leeds, UK
| | - Fatima Nadat
- Transplant and Cellular Immunology, St James's University Hospital, Leeds, UK
| | - Gavin P Spickett
- Regional Department of Immunology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
| | - Sinisa Savic
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, Leeds, UK.,Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK.,National Institute for Health Research-Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK
| | - Michael F McDermott
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, Leeds, UK.
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