Levels of Neutrophil Extracellular Traps Can Identify Increased Risk of Disease Activity, Nephritis and Cardiovascular Disease in People with Lupus
Researchers found that levels of neutrophil extracellular traps (NETs) are elevated in the plasma of people with lupus. NET levels also indicated persons at risk of active disease activity and/or severe disease, including nephritis and cardiovascular disease. Inside the body, NETs are composed of DNA and have a central role in immune defense, protecting against infection and supporting immune-modulatory functions.
The NET levels of U.S. and Swedish people, with lupus and healthy, were analyzed and cross-checked in four different groups. Those with lupus had elevated levels of NETs compared to healthy individuals. NET levels were increased in people with low to modest disease activity. Additionally, people with lupus who exhibited higher NET levels developed higher disease activity within three months, as well as higher than average disease activity over the following year.
Investigators also found that people with lupus with low disease activity and a history of nephritis had higher levels of NETs. Lupus patients with elevated levels of NETs had increased presence of endothelial microparticles demonstrating a link between endothelial damage and NETs, which can indicate the development of cardiovascular disease (atherosclerosis and arterial thrombosis).
Dr. Lood, one of the study's investigators, explains the relevance of this study for people with lupus stating, “neutrophils are our main white blood cells defending us against harmful pathogens. However, in patients with SLE, neutrophils are activated, exploding in the blood stream, releasing toxic components causing inflammation and damage to the surrounding tissue. In the current study, we made the novel discovery that remnants of exploding neutrophils, so called neutrophil extracellular traps, NETs, were found in the circulation of SLE patients. Levels of NETs identified patients with a very severe form of SLE, including nephritis and cardiovascular disease, the two main causes of premature death in SLE patients. Further, levels of NETs could predict the future, including whether the patients would flare within three months. These observations are very important as they can help the clinician identify patients with severe subclinical disease, allowing for close monitoring as well as early preventive treatment.”
The ability to gauge an individual’s current or future disease activity is important for early interventions and better outcomes. More study is needed on NETs as a marker of disease activity. Learn about how lupus affects white blood cells.