Internal medicine

Pathology

Disease

Neutrophil extracellular traps

Innate immune system

Antibody

Autoantibody

Immunology

Rheumatoid arthritis

Vasculitis

Inflammation

Arthritis

Gout

Medicine

Immune system

Nature Reviews Rheumatology

Rheumatic diseases are a collection of disorders defined by the presence of inflammation and destruction of joints and internal organs. A common feature of these diseases is the presence of autoantibodies targeting molecules commonly expressed in neutrophils. These preformed mediators are released by neutrophils but not by other immune cells such as macrophages. Neutrophils, major players in the host innate immune response, initiate a cell death mechanism termed neutrophil extracellular trap (NET) formation as a way to ensnare pathogens. NETs are also a source of released self-molecules found in rheumatic diseases. Subsequently, research on the role of NETs in the onset, progression and resolution of inflammation in rheumatic diseases has intensified. This Review has two aims. First, it aims to highlight the mechanisms required for the generation of NETs, the research landscape of which is rapidly changing. Second, it aims to discuss the role of neutrophils and NETs in systemic lupus erythematosus, vasculitis (specifically anti-neutrophil cytoplasmic autoantibody-associated vasculitis), rheumatoid arthritis and gout. Our goal is to clarify the field of NET research in rheumatic diseases in the hope of improving the therapeutic approaches utilized for these diseases. A growing body of evidence indicates that neutrophils and neutrophil extracellular traps (NETs) are involved in the progression of rheumatic diseases. This Review focuses on the role of NETs in systemic lupus erythematosus, vasculitis, rheumatoid arthritis and gout.

The role of neutrophil extracellular traps in rheumatic diseases