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Journal of Immunology Research
Volume 2017, Article ID 8415179, 10 pages
Research Article

Increased Neutrophil Extracellular Trap Formation in Uremia Is Associated with Chronic Inflammation and Prevalent Coronary Artery Disease

1Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
2Department of Clinical Immunology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
3Department of Physiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

Correspondence should be addressed to Sung Gyun Kim; moc.liamg@ksknmi

Received 31 August 2016; Revised 22 December 2016; Accepted 24 January 2017; Published 27 March 2017

Academic Editor: Fabiano Carvalho

Copyright © 2017 Jwa-Kyung Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Neutrophils are involved in the pathogenesis of atherosclerosis by neutrophil extracellular trap (NET) formation. We hypothesized that the NET formation of neutrophils might be changed in end-stage renal disease (ESRD) patients, explaining their higher incidence of coronary artery diseases (CAD). Method. A cross-sectional study was performed in 60 maintenance hemodialysis (MHD) patients, 30 age- and sex-matched healthy individuals (HV, negative control), and 30 patients with acute infection (positive control). Neutrophil activation and function were measured with reactive oxygen species (ROS) activity, degranulation, NET formation, and phenotypical changes. Result. Compared with HV, neutrophils extracted from MHD patients displayed significantly increased levels of basal NET formation, ROS production, and degranulation, suggesting spontaneous activation in uremia. Also, an increase in citrullinated histone H3 was detected in this group compared to the HV. And neutrophils from HV were normal CD16bright/CD62Lbright cells; however, neutrophils from MHD were CD16bright/CD62Ldim, similar to those from patients with acute infections. Interestingly, multivariate analyses identified the prevalent CAD and neutrophil counts as independent determinants of baseline NET formation (, and , , resp.). Conclusions. Uremia-associated-increased NET formation may be a sign of increased burden of atherosclerosis.