Neutrophil Extracellular Traps in the Prognosis of Sepsis: A Current Update

Sepsis is a dysregulated host response to an infection characterized by the presence of coagulopathy and endothelial dysfunction. Neutrophil extracellular traps (NETs) are networks of extracellular fibers, primarily composed of DNA from neutrophils that bind invasive pathogens. These extracellular traps are involved in the activation and dysfunction of several pathways during the process of sepsis syndrome, including the immune response to injury, inflammation, and coagulation. Those formations consist of many molecules that have been studied as biomarkers for multiple sepsis pathophysiological pathways that reflect various complications. The best-studied segments of such formations, circulating free DNA, citrullinated histone 3 and myeloperoxidase, are considered to contribute to upscaling specificity. Plenty of NET end-products have been recently studied as indirect biomarkers for NET-related sepsis complications. Several studies have examined the relationship between NET end-products and established sepsis severity scores, such as Acute Physiology and Chronic Health Evaluation II (APACHE 2) and Multiple Organ Dysfunction Score (MODS). These studies also explore how these end-products contribute to the prognosis of acute respiratory distress syndrome (ARDS), mortality, and their efficacy in evaluating disseminating intravascular coagulation (DIC). This is a short review of the current literature regarding the evaluation of neutrophil extracellular trap levels in the prognosis of sepsis patients.