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Expression and significance of neutrophil extracellular network in nephridial tissues of severe Henoch-Schonlein purpura nephritis patients

Xiao-Ya Du, Xiao-Dan Huang, Yin Pang, Peng Cheng, Jiu-Xu Zhao, Mao Qing Gong

The expression and significance of the neutrophil extracellular network (NET) in nephridial tissues of severe Henoch–Schonlein purpura nephritis (HSPN) patients were analyzed in this study. Citrullinated histone H3 as a marker and an immunologicalmethod were used to detectNET expression in 25 cases of HSPN patients, 15 cases of small lesions (MCD) patients, and 7 cases of healthy nephridial tissues. Analysis of patients with renal histological activity index and chronic index as well as detection of the infiltration of the corresponding part of the CDl9 as a marker of B lymphocytes along with their relationships with NET were performed simultaneously. Results showed that NET expression was significantly higher in the glomeruli of the patients with severe HSPN than those of the healthy control group and the MCD group (1.146 ± 0.903, 0 ± 0, 0 ± 0, P<0.01).NET expression increased significantly inmoderate and exuberant mesangial cells, cellular crescents, and renal tubular interstitiuminfiltrated with inflammatorycells.Meanwhile, glomerularNET expression inmoderate and exuberant mesangial cells was significantly higher than that in other types, and the differences were statistically significant (P<0.01). We also found that, on the average, the number of NET-positive cells in moderate and exuberant mesangial cells and severe HSPN renal tubules were positively correlated (r=0.558, P=0.011).The number ofNET-positive renal interstitial cells was also positively correlated with the chronic index of purpura nephritis pathology (r=0.645, P=0.002). Therefore,NET iswidely expressed in the renal tissues of severe HSPN patients. The infiltrated NET possibly caused renal injury in the patients with severe HSPN