Title:Neutrophil Extracellular Traps in Cerebral Ischemia/Reperfusion Injury:
Friend and Foe
Volume: 21
Issue: 10
Author(s): Haoyue Luo, Hanjing Guo, Yue Zhou, Rui Fang, Wenli Zhang*Zhigang Mei*
Affiliation:
- School of Pharmacy, Hunan University of
Chinese Medicine, Changsha, Hunan, 410208, China
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and
Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine,
Hunan University of Chinese Medicine, Changsha, Hunan, 410208, China
- Third-Grade Pharmacological Laboratory on Chinese Medicine
Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University,
Yichang, Hubei, 443002, China
Keywords:
Ischemic stroke, Alzheimer’s disease, cerebral ischemia, cerebral ischemia-reperfusion, neutrophil extracellular traps, CNS diseases.
Abstract: Cerebral ischemic injury, one of the leading causes of morbidity and mortality worldwide,
triggers various central nervous system (CNS) diseases, including acute ischemic stroke (AIS) and
chronic ischemia-induced Alzheimer's disease (AD). Currently, targeted therapies are urgently needed
to address neurological disorders caused by cerebral ischemia/reperfusion injury (CI/RI), and the
emergence of neutrophil extracellular traps (NETs) may be able to relieve the pressure. Neutrophils
are precursors to brain injury following ischemic stroke and exert complicated functions. NETs extracellularly
release reticular complexes of neutrophils, i.e., double-stranded DNA (dsDNA), histones,
and granulins. Paradoxically, NETs play a dual role, friend and foe, under different conditions, for example,
physiological circumstances, infection, neurodegeneration, and ischemia/reperfusion. Increasing
evidence indicates that NETs exert anti-inflammatory effects by degrading cytokines and chemokines
through protease at a relatively stable and moderate level under physiological conditions, while
excessive amounts of NETs release (NETosis) irritated by CI/RI exacerbate the inflammatory response
and aggravate thrombosis, disrupt the blood-brain barrier (BBB), and initiates sequential neuron injury
and tissue damage. This review provides a comprehensive overview of the machinery of NETs formation
and the role of an abnormal cascade of NETs in CI/RI, as well as other ischemia-induced neurological
diseases. Herein, we highlight the potential of NETs as a therapeutic target against ischemic
stroke that may inspire translational research and innovative clinical approaches.