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Updated: Mar 15, 2026
Morphological and Compositional Analysis of Neutrophil Extracellular Traps Induced by Microbial and Chemical Stimuli
Published on: November 4, 2022
Neutrophil extracellular traps involvement in corneal fungal infection
Xiuming Jin1, Yingying Zhao1, Fan Zhang2
1Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Purpose:
Neutrophils release neutrophil extracellular traps (NETs) when defending against invading microorganisms. We investigated the existence of NETs in fungal keratitis.
Methods:
Fourteen patients with unilateral fungal keratitis were included. Detailed information about each patient was recorded, including (1) patient history (onset of symptoms and previous therapy), (2) ocular examination findings by slit-lamp biomicroscopy, (3) laboratory findings from direct smear examination and culture of corneal scrapings, (4) NET formation, and (5) treatment strategy and prognosis. Immunofluorescence staining was used to evaluate the existence of NETs on corneal scrapings. The relationship between the quantification of NETs and the clinical character of the fungal keratitis was identified.
Results:
NETs were identified in all 14 patients. Patients with a higher grade of NET formation and fewer fungal hyphae always showed a good treatment response and a short course of infection. NETs were consistently found mixed with fungal hyphae in the corneal scrapings from infected patients. No statistical significance was found between the grade of NETs formed and the course of infection before presentation, and no relationship between the quantification of NETs and the size of the ulcer was found.
Conclusions:
The results suggest that NETs are involved in fungal keratitis. The number of NETs in infected corneas may provide a tool for evaluating the prognosis for fungal keratitis.
Insights
Neutrophil extracellular traps (NETs) were found in all fungal keratitis patients. Higher NET levels correlated with better treatment outcomes, suggesting NETs may predict fungal keratitis prognosis.
Area of Science:
- Ophthalmology
- Immunology
- Microbiology
Background:
- Neutrophils defend against pathogens by releasing neutrophil extracellular traps (NETs).
- Fungal keratitis is an infection of the cornea caused by fungi.
Purpose of the Study:
- To investigate the presence and role of NETs in fungal keratitis.
- To determine if NETs can serve as a prognostic marker for fungal keratitis.
Main Methods:
- Studied 14 patients with unilateral fungal keratitis.
- Collected clinical data, performed direct smear and culture of corneal scrapings.
- Utilized immunofluorescence staining to detect and quantify NETs in corneal samples.
Main Results:
- NETs were detected in all 14 patients, often mixed with fungal hyphae.
- Higher NET grades correlated with a better treatment response and shorter infection duration.
- No significant relationship was found between NET grade and pre-presentation infection course or ulcer size.
Conclusions:
- NETs are implicated in the host response to fungal keratitis.
- Quantification of NETs in infected corneas may offer a prognostic tool for fungal keratitis.
