Crossroads: Pathogenic role and therapeutic targets of neutrophil extracellular traps in rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is a prevalent autoimmune disease whose main features include chronic synovial inflammation, bone destruction, and joint degeneration. Neutrophils are often considered to be the first responders to inflammation and are a key presence in the inflammatory milieu of RA. Neutrophil extracellular traps (NETs), a meshwork of DNA-histone complexes and proteins released by activated neutrophils, are widely involved in the pathophysiology of autoimmune diseases, especially RA, in addition to playing a key role in the neutrophil innate immune response. NETs have been found to be an important source of citrullinated autoantigen antibodies and inflammatory factor release, which can activate RA synovial fibroblasts (FLS) and cause joint damage. This article reviews the role of NETs in the pathophysiology of RA, demonstrating the application of multiple molecules with various therapies, with a view to informing the discovery and development of novel biomarkers and therapeutic targets for RA.