Introduction
General characteristics of NETosis
Morphological and molecular features of NETosis
Cell death type | Main characteristics | ||
---|---|---|---|
Regulated necroptosis [22] | Apoptosis | Rounding-up of the cell Nuclear fragmentation DNA fragmentation Plasma membrane blebbing and rupture Activation of caspases Apoptotic bodies formation Minor modification of cytoplasmic organelles ROS overgeneration Engulfment by resident phagocytes in vivo | |
Autophagy | Lack of chromatin condensation Digestion of cellular organelles—accumulation of autophagic vacuoles Massive vacuolization of the cytoplasm | ||
Necrosis | Regulated necrosis = necroptosis (including NETosis) | Cytoplasmic swelling (oncosis) Rupture of plasma membrane and spilling of intracellular content ROS overgeneration | |
Accidental necrosis | Caused by external factors |
Activation of NETosis
Molecular events associated with NETosis
NET clearance
NETosis and dialysis
NETosis and hemodialysis
NETosis and peritoneal dialysis
NETosis and frequent comorbidities in hemodialyzed patients
Cardiovascular diseases
Diabetes
Autoimmune diseases
Oncologic diseases
Future perspectives of NETosis exploration in dialyzed patients
Conclusion
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Elevated plasma levels of cell-free DNA after a hemodialysis procedure may be activated by NETosis which occurs as a consequence of activation of neutrophils during the process of hemodialysis.
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NETs play crucial roles in pathogenesis of numerous comorbidities of HD patients, such as diabetes, cardiovascular and autoimmune diseases.
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Better understanding of NETs formation, clearance, and inter-individual differences in this processes is needed for the development of proper diagnostic and therapeutic approaches.
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The study of plasma cell-free DNA levels together with markers of NETosis could also contribute to evaluation of the influence of hemodialysis on patient’s immune system and to the prediction and management of clinical outcomes with regard to patient’s comorbidities.