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Neutrophil extracellular traps (NETs) are elevated in tuberculosis (TB) patients, especially those with severe disease or relapse. Monitoring NETs may help predict TB relapse risk and disease progression.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Pathology

Background:

  • Tuberculosis (TB) is a leading global cause of death.
  • Neutrophils and their role in TB pathogenesis are not fully understood.
  • Neutrophil extracellular traps (NETs) are increasingly recognized in inflammatory conditions.

Purpose of the Study:

  • To investigate neutrophil activation and NET formation in various TB types.
  • To correlate NET parameters with disease severity, relapse, and tissue damage in TB.
  • To examine NET presence in granulomas and pulmonary vasculature in TB patients.

Main Methods:

  • Analysis of serum NET markers (NE-DNA, MPO-DNA, cfDNA, elastase activity) in TB patients and healthy controls.
  • Histological examination of lung and lymph node granulomas from TB patients and controls (sarcoidosis, apical periodontitis).
  • Imaging of pulmonary vessels in TB patients to detect vascular occlusions and neutrophil aggregates.

Main Results:

  • NET parameters were significantly increased in TB patients' sera compared to controls.
  • Elevated NET formation and neutrophil elastase (NE) activity were observed in TB patients with extensive tissue damage and those experiencing relapse.
  • NETs were identified in caseating granulomas, and vascular occlusions with neutrophil aggregates were found in pulmonary vessels of TB patients.

Conclusions:

  • NET formation is heightened in TB and correlates with disease severity and relapse.
  • Circulating NET parameters could serve as biomarkers for monitoring TB relapse risk.
  • Neutrophils play a dual role in TB, contributing to both host defense and tissue damage, including vascular complications.