Elucidating the involvement of neutrophil extracellular traps in hemarthrosis pathophysiology

Abstract

BACKGROUND: Hemophilia is an inherited bleeding disorder that could cause many complications, one of which is hemarthrosis. Neutrophils are the predominant immune cells that infiltrate joints after hemorrhage. Tissue injury is often accompanied by the production of neutrophil extracellular traps (NETs), which are DNA constructs containing attached granular enzymes. AIMS OF STUDY: The aim of this study was to identify the presence of neutrophil extracellular traps including the neutrophil elastase (NE) and myeloperoxidase (MPO), in patients with hemophilia A presented with hemarthrosis. SUBJECTS AND METHODS: During a period of 8 months from November 2022 to June 2023, 50 persons were recruited cross-sectional study was conducted. In the current study, a sample of 25 individuals with hemophilia A presenting with hemarthrosis were included. Additionally, a control group of 25 unrelated, almost healthy persons,matched in terms of age and sex were also included. NE and MPO levels in blood were measured by flow cytometry technique. RESULTS: The level of MPO and NE in the blood was significantly higher in hemophilia A patients than controls. In the results of hemophilia A patients, the mean and standard deviation of MPO were 3253.36 +_1865.48, while for NE it was 5229.08+_2667.43. These values were found to be statistically significant P<0.05 when compared to the control group. In the control group, the mean and standard deviation of MPO were 2285.48+_811.89, and for NE, it was 3816.92+_1890.45. CONCLUSIONS: Patients with hemarthrosis had a considerably increase level of NETs in their blood than healthy individuals, and these findings indicate a function of NETs in the pathology of hemophilia A with hemarthrosis.