Neutrophil extracellular traps in patients with sepsis

Masamitsu Hashiba, Aminul Huq, Atsutoshi Tomino, Akihiko Hirakawa, Tomonori Hattori, Hiromichi Miyabe, Masanobu Tsuda, Naoshi Takeyama

Research output: Contribution to journalArticlepeer-review

50 Citations (Scopus)


Background Release of neutrophil extracellular traps (NETs) has been identified as an important aspect of innate immunity. We examined whether sepsis had any influence on ex vivo generation of NETs by neutrophils. Materials and methods We isolated neutrophils from consecutive patients with sepsis (n = 17) and without sepsis (n = 18) admitted to the intensive care unit. Neutrophils were activated by incubation with phorbol-12-myristate-13-acetate (PMA) to induce release of NETs, and NET formation was assessed by measuring the extracellular DNA level. Immunolabeling and fluorescence imaging were also performed. Extracellular killing of bacteria by NETs was studied by co-culture of Escherichia coli and neutrophils in the presence of a phagocytosis inhibitor. To assess in vivo NET formation, plasma levels of cell-free DNA and histones were measured. Results After stimulation with PMA, neutrophils isolated from septic patients released 4.08 ± 1.02% of their total DNA, whereas neutrophils from nonseptic patients released 29.06 ± 2.94% (P = <0.0001). Immunofluorescent staining of released DNA, elastase, and myeloperoxidase also revealed similar results. Neutrophils from nonseptic patients showed effective extracellular killing of E coli through NETs, whereas neutrophils from septic patients did not (P < 0.001). Plasma levels of cell-free DNA and histones were higher in septic patients than nonseptic patients (P < 0.001). Conclusions The ex vivo generation of NETs is downregulated in neutrophils isolated from patients with sepsis. However, it is unclear whether in vivo NET formation is also impaired during sepsis, so further investigation is necessary.

Original languageEnglish
Pages (from-to)248-254
Number of pages7
JournalJournal of Surgical Research
Issue number1
Publication statusPublished - 01-03-2015

All Science Journal Classification (ASJC) codes

  • Surgery


Dive into the research topics of 'Neutrophil extracellular traps in patients with sepsis'. Together they form a unique fingerprint.

Cite this