Antibodies to Neutrophil Extracellular Traps: Novel Markers for the Antiphospholipid Syndrome

Abstract

In this issue of Arthritis & Rheumatology , a provocative serologic analysis by Zuo et al provides a novel perspective on autoantibody expression in patients with antiphospholipid antibodies (aPL) (1). As the data from a large patient cohort indicate, patients whose serum is persistently positive for APL, including those with the antiphospholipid syndrome (APS), produce IgM and IgG antibodies to neutrophil extracellular traps (NETs), a large DNA-rich structure released by activated neutrophils (2,3). Furthermore, these patients can display antibodies to DNA and nucleosomes, both speci fi c markers of systemic lupus erythema-tosus (SLE). Demonstrating intriguing similarity in immunologic fi ndings between APS and SLE, the study supports the importance of anti-NETs in both autoimmunity and immunothrombosis, the critical junction where in fl ammation and thrombosis inter-sect (4).