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Updated: May 22, 2026

Rapid Magnetic-microbead Method for Efficient Purification of Low-density Neutrophils
Published on: November 11, 2025
Low-density granulocyte-driven NET formation is associated with poor prognosis in IgA nephropathy with thrombotic
Qianqian Li1,2, Junpeng You1,2, Jieru Fan1,2
1Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Introduction:
Thrombotic microangiopathy (TMA) is a common pathological phenotype of immunoglobulin A nephropathy (IgAN). Low-density granulocytes (LDGs) exhibit potent pro-inflammatory properties and promote neutrophil extracellular trap (NET) formation, playing a pivotal role in thrombus development. This study aims to investigate the long-term prognosis of IgAN-TMA and explore the role of LDGs in its pathogenesis.
Methods:
Sixty patients with IgAN-TMA and 249 high-risk IgAN controls were included. LDGs (CD14lowCD15high) were quantified via flow cytometry among 15 IgAN-TMA patients, 20 IgAN patients, and 15 healthy controls. Serum dsDNA and MPO-DNA complex levels were quantified via PicoGreen and ELISA, respectively. Serum-induced NET formation was assessed with fluorescence microscopy.
Results:
Compared with controls, IgAN-TMA patients showed more adverse clinico-pathological profiles. TMA was identified as independently associated with adverse renal outcomes and poor renal prognosis in IgAN. Additionally, IgAN-TMA patients had a significantly higher proportion of circulating LDGs, correlating with disease severity. Furthermore, IgAN-TMA patients exhibited increased levels of circulating dsDNA and MPO-DNA complexes, serum from these patients significantly induced NET formation.
Conclusions:
IgAN-TMA prognosis is worse than that of high-risk IgAN. LDGs are significantly elevated and correlate with the severity of the pathogenic process in IgAN-TMA, warranting further extensive investigation.
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