Abstract
Neutrophils represent up to 70% of circulating leukocytes in healthy humans and combat infection mostly by phagocytosis, degranulation and NETosis. It has been reported that neutrophils are centrally involved in abdominal aortic aneurysm (AAA) pathogenesis. The natural course of AAA is growth and rupture, if left undiagnosed or untreated. The rupture of AAA has a very high mortality and is currently among the leading causes of death worldwide. The use of noninvasive cardiovascular imaging techniques for patient screening, surveillance and postoperative follow-up is well established and recommended by the current guidelines. Neutrophil-derived biomarkers may offer clinical value to the monitoring and prognosis of AAA patients, allowing for potential early therapeutic intervention. Numerous promising biomarkers have been studied. In this review, we discuss neutrophils and neutrophil-derived molecules as regulators and biomarkers of AAA, and our aim was to specifically highlight diagnostic and prognostic markers. Neutrophil-derived biomarkers may potentially, in the future, assist in determining AAA presence, predict size, expansion rate, rupture risk, and postoperative outcome once validated in highly warranted future prospective clinical studies.
Highlights
Neutrophils are the most abundant type of circulating leukocytes in healthy adults and play a central role during the innate immune response [1]
Beside the manifold strategies to execute the tasks of the non-specific, innate immune response including phagocytosis, cytokine secretion, and degranulation, neutrophils contribute to chronic inflammatory conditions by the release of reactive oxygen species (ROS) and neutrophil-derived microvesicles or the formation of neutrophil extracellular traps (NETs) [3,4,5]
Another aspect of how neutrophil gelatinase-associated lipocalin (NGAL) could be involved in aneurysm development is that it has been proven that c-Jun N-terminal-kinase is an important molecule in the pathophysiology of abdominal aortic aneurysm (AAA), which upregulates both, NGAL and matrix metalloproteinase (MMP)-9 [95]
Summary
Neutrophils are the most abundant type of circulating leukocytes in healthy adults and play a central role during the innate immune response [1]. These diverse cells are not limited to the elimination of pathogens, but further act as mediators with specialized functions in health and inflammation [2]. We discuss the potential biomarker role of neutrophils and neutrophilderived factors in abdominal aortic aneurysm (AAA) disease and elucidate relevant molecular mechanisms through which these cells are activated in inflammatory conditions.
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