Circulatory Neutrophils Exhibit Enhanced Neutrophil Extracellular Trap Formation in Early Puerperium: NETs at the Nexus of Thrombosis and Immunity.

Abstract

Pregnancy is associated with elevated maternal levels of cell-free DNA of neutrophil extracellular trap (NET) origin, as circulatory neutrophils exhibit increased spontaneous NET formation, mainly driven by G-CSF and finely modulated by sex hormones. The postpartum period, on the other hand, involves physiological alterations consistent with the need for protection against infections and fatal haemorrhage. Our findings indicate that all relevant serum markers of neutrophil degranulation and NET release are substantially augmented postpartum. Neutrophil pro-NETotic activity in vitro is also upregulated particularly in post-delivery neutrophils. Moreover, maternal puerperal neutrophils exhibit a strong pro-NETotic phenotype, associated with increased levels of all key players in the generation of NETs, namely citH3, MPO, NE, and ROS, compared to non-pregnant and pregnant controls. Intriguingly, post-delivery NET formation is independent of G-CSF in contrast to late gestation and complemented by the presence of TF on the NETs, alterations in the platelet activity status, and activation of the coagulation cascade, triggered by circulating microparticles. Taken together, our results reveal the highly pro-NETotic and potentially procoagulant nature of postpartum neutrophils, bridging an overt immune activation with possible harmful thrombotic incidence.

• Authors: Stavros Giaglis, Chanchal Sur Chowdhury, Shane Vontelin van Breda, Maria Stoikou, André N Tiaden, Douglas Daoudlarian, Guenther Schaefer, Andreas Buser, Ulrich A Walker, Olav Lapaire, Irene Hoesli, Paul Hasler, Sinuhe Hahn
• Journal: International journal of molecular sciences (Int J Mol Sci) Vol. 22 Issue 24 (Dec 20 2021) ISSN: 1422-0067 [Electronic] Switzerland
• PMID: 34948443 (Publication Type: Journal Article)

Chemical References

• Cell-Free Nucleic Acids
• Reactive Oxygen Species
• Granulocyte Colony-Stimulating Factor
• MPO protein, human
• Peroxidase

Topics

• Adult
• Case-Control Studies
• Cell-Free Nucleic Acids (blood)
• Extracellular Traps (genetics, metabolism)
• Female
• Granulocyte Colony-Stimulating Factor (genetics)
• Humans
• Maternal Age
• Neutrophil Activation
• Neutrophils (immunology)
• Peroxidase
• Postpartum Period (blood, genetics, metabolism)
• Pregnancy
• Reactive Oxygen Species (metabolism)