RRML - Neutrophil extracellular traps (NETs): Relevance to thrombosis and hemostasis. A narrative review

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ISSN online: 2284-5623

ISSN-L: 1841-6624

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Ahead of print DOI:10.2478/rrlm-2025-0008

Review

Neutrophil extracellular traps (NETs): Relevance to thrombosis and hemostasis. A narrative review

Amin A. Alamin

Correspondence should be addressed to: Amin A. Alamin

Abstract:

Background: Neutrophil extracellular traps (NETs) are released by neutrophils and comprise web-like structures that play a vital role in fighting infections. NETs have also been involved in various thrombosis and hemostasis mechanisms. This review aims to outline the current understanding of NETs in these processes, their mechanisms of action, their clinical importance, and potential treatment strategies to counteract adverse events. Methods: A search of the literature was conducted up to June 2024 via PubMed, Scopus, Google Scholar, and Web of Science, with a focus on studies linking neutrophil extracellular traps to thrombosis and hemostasis. Results: NETs have been directly implicated in thrombosis by activating platelets, providing a substrate for thrombus formation, and directly activating coagulation. NETs are associated with venous thromboembolism, arterial thrombosis, and cancer-related thrombosis, among other thrombotic events. NETs can also support clot formation and hemostasis at sites of vascular damage. NETs could serve as potential biomarkers for thrombotic events, and various strategies are being explored to reduce their adverse events, such as inhibiting their formation, degrading extracellular DNA, and modifying associated proteins. Conclusions: An improved understanding of NET-mediated thrombosis and hemostasis processes might aid in the development of effective strategies to prevent life-threatening thrombus formation and aid in the prevention of thromboembolic diseases, ultimately benefiting affected patients.

Keywords: hemostasis, neutrophil extracellular traps, NETs, platelet activation, thrombosis, thromboembolic disorders

Received: 24.1.2025
Accepted: 21.2.2025
Published: 3.3.2025

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