2018
DOI: 10.1136/annrheumdis-2018-213746
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Dysregulated neutrophil responses and neutrophil extracellular trap formation and degradation in PAPA syndrome

Abstract: PAPA syndrome is characterised by an imbalance of NET formation and degradation that may enhance the half-life of these structures in vivo, promoting inflammation. Anakinra ameliorates NET formation in PAPA and this finding supports a role for IL-1 signalling in exacerbated neutrophil responses in this disease. The study also highlights other inflammatory pathways potentially pathogenic in PAPA, including IL-17 and IL-6, and these results may help guide new therapeutic approaches in this severe and often treat… Show more

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Cited by 78 publications
(85 citation statements)
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References 49 publications
(107 reference statements)
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“…Humans Most of our knowledge of neutrophil heterogeneity in chronic inflammation derives from studies performed in autoimmune diseases [54,96]. In these studies, the presence of LDNs has been consistently reported in patients with systemic lupus erythematosus (SLE), psoriasis, chronic granulomatous disease, ANCA-associated systemic vasculitis, rheumatoid arthritis (RA), juvenile idiopathic arthritis, and pyogenic arthritis-pyoderma gangrenosum-acne syndrome [54,[96][97][98][99][100]. As opposed to immunosuppressive LDNs/PMN-MDSCs, LDNs from autoimmune patients have been defined as low-density granulocytes (LDGs) (Box 1 and Figure 3) based on their proinflammatory properties [4,7,54,96], including the promotion of Th17 cell differentiation and proliferation [101].…”
Section: Neutrophil Diversity and Heterogeneity In Chronic Inflammationmentioning
confidence: 99%
See 1 more Smart Citation
“…Humans Most of our knowledge of neutrophil heterogeneity in chronic inflammation derives from studies performed in autoimmune diseases [54,96]. In these studies, the presence of LDNs has been consistently reported in patients with systemic lupus erythematosus (SLE), psoriasis, chronic granulomatous disease, ANCA-associated systemic vasculitis, rheumatoid arthritis (RA), juvenile idiopathic arthritis, and pyogenic arthritis-pyoderma gangrenosum-acne syndrome [54,[96][97][98][99][100]. As opposed to immunosuppressive LDNs/PMN-MDSCs, LDNs from autoimmune patients have been defined as low-density granulocytes (LDGs) (Box 1 and Figure 3) based on their proinflammatory properties [4,7,54,96], including the promotion of Th17 cell differentiation and proliferation [101].…”
Section: Neutrophil Diversity and Heterogeneity In Chronic Inflammationmentioning
confidence: 99%
“…As opposed to immunosuppressive LDNs/PMN-MDSCs, LDNs from autoimmune patients have been defined as low-density granulocytes (LDGs) (Box 1 and Figure 3) based on their proinflammatory properties [4,7,54,96], including the promotion of Th17 cell differentiation and proliferation [101]. It is important to note that the distinction between LDNs/LDGs and LDNs/PMN-MDSCs is based only on functional assays performed on isolated cells because no validated markers have been identified that can discriminate between suppressive and proinflam- or 'low-density granulocytes' (LDGs) (Box 1) have been found in patients with autoimmune diseases, including systemic lupus erythematosus (SLE), psoriasis, chronic granulomatous disease, anti-neutrophil cytoplasmic autoantibody (ANCA)associated vasculitis, rheumatoid arthritis (RA), juvenile idiopathic arthritis, and pyogenic arthritis-pyoderma gangrenosumacne syndrome [96][97][98][99][100]. However, not all studies tested/reported the proinflammatory properties of LDNs from autoimmune patients.…”
Section: Neutrophil Diversity and Heterogeneity In Chronic Inflammationmentioning
confidence: 99%
“…The results showed that only at the concentration of 1.6 µM, BPA modulated neutrophil functions related to absorption. These observations appear to be particularly concerning in the case of people who are professionally exposed to BPA, considering the fact that the phagocytic activity is the rst line of defense against many pathogens [9][10][11][12][13].…”
Section: Discussionmentioning
confidence: 99%
“…One of the strategies used by neutrophils to kill pathogens is phagocytosis, which involves the stages such as "recognition" and "absorption" of the pathogen and formation of a phagolysosome. Inside the phagolysosome, the absorbed pathogen is killed by any of the two mechanisms: aerobic (associated with the production of reactive oxygen species (ROS) and reactive nitrogen species) and anaerobic (associated with the presence of proteins contained in the granules) [7,[9][10][11][12][13].…”
Section: Introductionmentioning
confidence: 99%
“…Flares of sterile arthritis with neutrophil infiltrate and the overproduction of IL-1β are the main features of pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome. NETs have been identified in the skin lesions of a patient with active PAPA syndrome in a milieu characterized by IL-1β, IL-8, and IL-17A expression, but not in skin samples from a patient with no active skin lesions 96 . In vitro, serum of PAPA patients induced NET formation by neutrophils from healthy donors that could be blocked by the IL-1 receptor antagonist anakinra, suggesting that IL-1β contributes to the enhanced NET formation in PAPA 96 .…”
Section: Nets In Autoinflammatory Diseasesmentioning
confidence: 94%