Neutrophil Extracellular Traps (NETs) in Kidney Disease: Role in Pathogenesis and Possibilities of NET Regulatory Therapy

Excessive uncontrolled inflammatory and immune reactions often lead to the development of acute and chronic forms of damage to various organs, including the kidneys. Neutrophils are the cells of the innate immune system, which are the first cellular effectors in protecting the host from a variety of pathogens, including bacteria, fungi and protozoa. As the most numerous leukocytes present in human blood, neutrophils migrate early to the foci of inflammation or tissue damage, where they play a significant role in the development of inflammation, recruitment of immune cells, removal of pathogens and tissue repair. Neutrophils also produce pro-inflammatory cytokines and release, in a process called netosis, a network of DNA and granular proteins known as neutrophil extracellular traps (NETs). NETs are potentially toxic, contribute to glomerular damage, activate autoimmune processes, cause vascular damage, and promote renal fibrosis. Numerous studies show that an imbalance between NET production and clearance is detrimental to kidney function. Therefore, strategies aimed at modulating the processes associated with NET may have a favorable prognostic effect. The review discusses the role of the netosis in the pathogenesis of kidney diseases, describes the mechanisms of tissue damage associated with NET, and the therapeutic potential of NET regulatory therapy.