Cardiovascular disease is the leading cause of mortality worldwide. Atherosclerosis constitutes most cardiovascular disease etiologies. Atherosclerosis is a chronic inflammatory and lipid-driven disease affecting the intima of blood vessels, resulting in an increase in its thickness and, therefore, narrowing of the arterial lumen. Many blood and immune cells have been shown to be implicated in atherosclerosis pathophysiology. Neutrophils are among those cells with their novel function of forming neutrophil extracellular traps. Neutrophil extracellular traps are mesh-like structures formed and released on activation of neutrophils. These structures consist of decondensed chromatin, histones, and other components, including nuclear and cellular proteins, cytoskeleton, proteases, and azurophilic granules. Neutrophil extracellular traps contain these elements and hold other circulating elements in the blood, such as tissue factor, fibrin, and other coagulation factors. Neutrophil extracellular traps are also implicated in the pathogenesis of atherothrombosis, which evolves as a consequence of atherosclerosis. In this review, we aim to demonstrate the process of neutrophil extracellular traps formation, release, and interaction with other blood cells, meaning it could be possible to use neutrophil extracellular traps as a therapeutic target in deceleration of atherosclerosis progression.
Impact statement
Fatal consequences of atherosclerosis and atherothrombosis give research in this field great importance. This review provides recent information about the implications of neutrophils in the pathophysiology of atherosclerosis and atherothrombosis via formation and release of neutrophil extracellular traps (NETs), thereby enhancing our understanding on how the process of atherosclerosis develops and how its consequences occur. Information provided in this review suggests NETs as a new therapeutic target and a rich point for research. This review gives answers to questions about the mechanisms of atherosclerosis and atherothrombosis progression through studying the implications of NETs in these processes.
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