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. 2026 Jan 13;23(2):123–149. doi: 10.1038/s41423-025-01380-w

Table 1.

Role of neutrophils and neutrophil-derived components in different chronic inflammatory diseases

Chronic inflammatory disease In vitro/murine (model) / human Sample type/experimental set-up Findings concerning neutrophils References
RA -In vitro -Plasma and synovial fluid neutrophils from patients with RA -Spontaneous NET formation [115,116]
-Healthy control human neutrophils -Release of PAD2/4 upon NET release [118]
-Synovial fibroblasts from patients with RA -NET uptake by synovial fibroblasts is mediated by TLR9 [121]
-RA neutrophils -IL-33 induces NET formation by RA neutrophils [122]
-RA synovial fibroblasts -NETs are taken up by synovial fibroblast through TLR9 and induce IL-33 production [122]
-T cells harvested from the peripheral blood of patients with ACPA + RA -Cryptic epitopes presented in the MHCII context activate ACPA + T cells [125]
-Incubation of osteoblasts with NETs -NETs induce osteoclastogenesis through upregulation of the RANKL/OPG ratio (TLR4/9 mediated) [129]
-Co-culture of neutrophils with human gingival-derived stem cells (with or without COX2 gene silencing) -The COX2-mediated inhibition of neutrophil NET release occurs through the activation of PKA which inhibits ERK [130]
-RA synovial fluid neutrophils -Increased ROS production independent of priming [49]
-Healthy control human neutrophils -Soluble immune complexes activate only primed human neutrophils [49]
-RA peripheral blood neutrophils -Increased expression of anti-apoptotic proteins [134]
-RA synovial fluid neutrophils -Neutrophils from the synovial fluid only undergo apoptosis when incubated with synovial fluid that has high levels of HIF-1α [140]
-RA synovial fluid neutrophils -FAP-α activates PI3K, stimulating NOX2-dependent ROS production thereby inducing necroptosis [151]
-Peripheral blood RA neutrophils -Decreased levels of NLRP3 with increased levels of caspase-1 [154]
-Whole blood protein expression from patients with active RA -Increased levels of NLRP3, ASC and caspase-1 [155]
-Healthy control neutrophils IL-18 primes neutrophils, upregulates expression of CD11b and FPR1, increases levels of intracellular calcium, activates the p38 MAPK signaling pathway and induces ROS production and NE release [156]
-Synovial fluid RA neutrophils -Increased expression of LC3 [157]
-Peripheral blood RA neutrophils -Increased autophagosome formation [157]
-Peripheral blood RA neutrophils -Increased autophagosome formation [158]
-Murine (CIA) -X-ray and H&E staining of knees and ankle joint -Treatment with a therapeutic ACPA inhibits NET-induced tissue damage [120]
-Murine (HLA-DRB1*04:01) -Quantification of serum ACPA levels -NETs are taken up and presented by synovial fibroblasts to T cells eventually resulting in the generation of ACPAs [121]
-Murine (CAIA) -Modified ELISA to measure citH3-DNA in the serum of these mice -IL-33 stimulates NET release [122]
-Murine (Tlr2-/-) -qPCR and flow cytometry -NET histones stimulate the release of IL-17 by Th17 cells through TLR2 [123]
-Murine (HLA-DRB1*04:01) - The tibiofemoral compartment (TRAP staining) - Carbamylated NETs induced osteoclastogenesis [127]
-Murine (Micl−/ −) -Immunofluorescence and sytox green staining -Increased NET formation in these mice due to loss of negative feedback through MICL [128]
-Murine (AIA) -Histology and CT (bone loss) -NETs induce osteoclastogenesis [129]
-Murine (STIA) -Immunofluorescence, clinical score, gene silencing and flow cytometry -Human gingival-derived mesenchymal stem cells release prostaglandin E2 which decreases NET formation in neutrophils. [130]
-Mice (Ncf1-/-) -Neutrophil recruitment, gene expression, flow cytometry -Mice deficient in NOX2 showed higher levels of Cxcl2, Cxcl3 and Cxcl10 as well as Mmp3 alongside decreased expression of PD-L1 [132]
-Murine (CIA) -Arthritis score, paw swelling, recruited neutrophils -Inhibition of NOX2 resulted in the development of arthritis [133]
-Murine (CIA) -Arthritis severity -In early RA, inhibition of TIM-4 worsened arthritis [144]
-Murine (CAIA) -Arthritis severity -In established RA, inhibition of TIM-4 improved arthritis [144]
-Murine (Tyro3-/-, Axl -/-, Mertk -/-) -Levels of inflammatory cytokines and arthritis assessment -KO of Tyro3 improved inflammation and decreased the levels of inflammatory cytokines, opposite findings for Axl and Mertk KO mice [143]
-Murine (Elmo1-/-) -Arthritis assessment, bone degradation and neutrophil recruitment -ELMO1, involved in efferocytosis, promotes inflammatory arthritis [145]
-Murine (CIA) -Loss of Rac1 function -Rac1, which works downstream of ELMO1 also promotes arthritis [144]
-Murine (STIA) -Flow cytometry and arthritis scores -Less neutrophil infiltration and reduced inflammation upon treatment with anti-SIRPa agonistic antibody [146]
-Murine (Ifng-/-) -Measurment of necroptosis markers and severity of inflammation - Increased levels of MLKL, RIPK1, and RIPK3, along with more severe joint damage and hyperinflammation150 [152]
-Human -Synovial fluid -Increased levels of IL-33 [122]
-Frequency of albumin carbamylation correlates with synovial fluid MPO activity [126]
-carbamylated NET proteins are increased [127]
-Plasma -Cell-free nucleosomes as a potential diagnostic biomarkers [115]
-Carbamylated NET proteins are increased [127]
-Serum [117]
-Synovial fluid -Cell-free nucleosomes as a potential diagnostic biomarkers [128]
-Synovial fluid -Presence of anti-MICL antibodies [134137]
-Synovial fluid -Increased levels of G-CSF, GM-CSF, IL-1β, TNF, IFN-α and IFN-γ [138,139]
-Peripheral blood -Adenosin and lactoferrin are upregulated and regulate apoptosis [147]
[148]
-Serum -Ferrous ion levels correlating with DAS28 scores [153]
-Synovial fluid -Decreased levels of glutathione and GPX4 [158]
-Increased levels of IL-18 and caspase –1
-Increased levels of IL-6, IL-10, CCL2 and CXCL8, inducing autophagy
Atherosclerosis -Murine (Apoe−/−) -Intravital imaging -Neutrophil infiltration during early atherosclerosis [163]
-Murine (Apoe−/−) -Intravital imaging -High neutrophil counts in rupture prone lesions [164]
-Murine (Lysmgfp/gfpApoe-/-) -Intravital imaging -Luminal adherence and NETs release at atherosclerotic prone regions [168]
-Murine (ApoE/PR3/NE−/−) - Intravital imaging, ELISA,.. - NET-mediated priming of macrophages to produce inflammatory cytokines [78]
-Human - Plasma -Increased S100A12 correlating with increased risk of major cardiovascular events [160]
-Immunohistochemistry carotid plaques -High neutrophil counts in rupture prone atherosclerotic lesions [165]
-Immunohistochemistry - High NETs count in complicated coronary plaque segments [172]
IBD -In vitro - Incubation of CCD-18Co cells (human fibroblast cell line derived from colon tissue) with NGAL - NGAL mediated induction of profibrotic phenotype in CCD-18Co cells (data also validated in mice with DSS-induced colitis) [177]
- Incubation of butyrate with neutrophils from patients with IBD -Reduced production of inflammatory mediators (e.g. IL-6, TNF, S100A8/A9, LCN2,…) [199]
-Murine (PAD4-/-) - Western blot,… -PAD4 mediated citrullination of CKMT1 exacerbating mucosal inflammation in IBD [181]
-Human -Faecal samples - S100A8/A9 used as biomarker for disease activity [174]
- Immunohistochemistry colon biopsies -Increased levels of PAD4 [180]
- Blood and biopsies -Correlation between MPO concentrations and disease activity [182]
-Neutrophil-dominant inflammation within corticoid-resistance [183]
-Increased expression of OSM (mRNA) correlates with poor response to anti-TNF therapy. [185]
- Potential protective role of CD177+ neutrophils (e.g. rol in maintaining mucosal integrity) [188]
SLE In vitro -HC neutrophils stimulated with SLE plasma samples -TLR8 is important for the recognition of RNA-containing immune complexes by neutrophils in SLE [206]
-Neutrophils from patients with SLE -Neutrophils and platelets form TLR-7-dependent complexes, inducing NETosis [195]
-Neutrophils from blood of patients with SLE -Normal density neutrophils express more CXCL10 and MMP8 but lower CD66b and release less NETs [208]
-Healthy control neutrophils incubated with SLE serum -Circulating immune complexes in the serum are responsible for ROS production [211]
-Neutrophils from the peripheral blood of patients with SLE -Loss of the inhibitory Gal1- VSTM1 loop in patients with SLE [216]
-Incubation of HC neutrophils with SLE serum stimulated with GM-CSF -Decreased apoptosis [216]
-Incubation of HC neutrophils with SLE serum containing caspase-8 and caspase-9 inhibitors -Decreased apoptosis [54,201,219]
-Neutrophils harvested from patients with SLE incubated with SLE serum -Increased expression of autoantigens on the cellular surface which bind TLR3,8 and 9 on PBMCs [54]
-Neutrophils incubated with microparticles from SLE patients -NETosis was induced [221,222]
-Dendritic cells incubated with microparticles from SLE patients -Release of IL-6, TNF and IFN-α [224]
- Incubation of neutrophils with SLE serum -FcγR-mediated activation of caspases 1 and 11, activating gasdermin D [225]
-In vitro incubation of neutrophils with SLE serum -Expression of GPX4 is regulated through CREM-α [226]
[227]
-Murine (MRL/lpr) -IV administration of CXCL5 -IV administration of CXCL5 reduced neutrophil proliferation, activation and recruitment [210]
-Murine (Ncf1m1J) -Gene expression, ELISA, flow cytometry -Impaired ROS production, increased expression of IFN type I-regulated genes and increased levels of autoantibodies [217]
- Murine (MRL/lpr) -Neutrophils isolated from these mice -SLE IgGs stimulate neutrophil apoptosis through FcγRIII and the upregulation of FasL [220]
-Human -Whole blood and plasma of patients with SLE -Improved neutropenia, decreased apoptosis and decreased NETosis [228]
-Blood transcriptomics -Treatment with belimumab reduced neutrophil counts and activation, neutrophil degranulation was a predictor of response to belimumab treatment [229]
-Peripheral blood -Lower levels of CXCL5 compared to HCs [210]
-Peripheral blood -Increased levels of oxidized Gal1 and reduced glutathione [216]
-Peripheral blood -NETs or NET-related genes HMGB1, ITGB2 and CREB5 as biomarkers [202205]
-SLE patients carrying a mutation in the NCF1 gene -Lower levels of CXCL5 compared to HCs [210]
-Serum -Impaired ROS production related to SLE development [218]
-Macrophages from SLE patients -Increased levels of FasL, TRAIL and decreased levels of GM-CSF [54,201,219]
-Serum -Reduced CD44 expression and reduced phagocytotic capacity, correlating with anti-nuclear antibodies and disease activity [54,223]
-Increased levels of TAM receptors [54,223]
COPD -Murine (C57BL/6 J; FVB/N exposed to ciragette smoke) -Microscopy -Decreased efferocytosis [233]
-Murine (C57BL/6 J) -ELISA - Increased NE [252]
-Murine (cGAS-/-/TLR9-/-) -Immunofluorescence microscopy - Increased NETs / inducing NETs mediated inflammation [254]
-Murine (Balb/c mice exposed to ciragette smoke) -BALF - Increased MMPs (e.g. MMP9) [248]
-Murine (IKTA) -NE mediated inhibition of elastic fiber assembly in fibroblasts [255]
-Human -Exhaled breath condensate -Increased NE [234237]
-Human -Serum -Increase of MMPs (e.g. MMP-9) [249251]
-Sputum -Increased NETs [238]
-Sputum -Increased neutrophil and CXCL8 counts [234237]
-Sputum -Increased amount of PGP matricryptin (i.e. suggested to interact with CXCR1/2). [284]
Fibrotic diseases (IPF) -In vitro - Co-culture of MMP-9 with human lung embryonic fibroblasts (MRC-5) - Activation of TGF-β and induces expression of αSMA in fibroblasts [275]
-Human -BALF -Increased NE & NETs [265,266]
-BALF -Increased S100A9 counts [256]
-BALF & serum -Increased CXCL8 counts [258,259]
Fibrotic diseases (MF) -Human -Peripheral blood neutrophils -Increased basal ROS produced by JAK2+ neutrophils [297]
-Plasma -Increased NE [299]
-Serum -Increased MMP9/TIMP1 [300]

-Peripheral blood

Neutrophils

-Increased CD24 expression on neutrophils in JAK2+ neutrophils (e.g. resulting in decreased efferocytosis) [301]
-Bone marrow biopsies -Increased emperipolesis of neutrophils by megakaryocytes [304306]

α- SMA α-smooth muscle actin, ACPA anti-citrullinated protein antibodies, AIA antibody-induced arthritis, ApoE apolipoprotein E, ASC apoptosis-associated speck-like protein containing a CARD, AXL axl tyrosine-protein kinase receptor, BALF bal fluid, CAIA collagen antibody-induced arthritis, CCL CC chemokine ligand, cGAS cyclic GMP-AMP synthase, CIA collagen-induced arthritis, CKMT1 mitochondrial creatine kinase 1, COX cyclooxygenase, COPD chronic obstructive pulmonary disease, CREB5 cAMP responsive element binding protein 5, CREM-α cAMP-responsive element modulator-α, CXCL CXC chemokine ligand, DAS disease activity score, DSS dextran sodium sulfate, ELISA enzyme-linked immunosorbent assay, ELMO1 engulfment and cell motility protein 1, ERK extracellular signal-regulated kinase, FAP-α fibroblast activation protein-α, FasL Fas ligand, FcγR Fc-γ receptor, FPR1 formyl peptide receptor 1, Gal-1 galectine-1, G-CSF granulocyte-colony stimulating factor, GM-CSF granulocyte macrophage-colony stimulating factor, GPX4 glutathion peroxidase 4, H3 histone 3, HIF-1α hypoxia-inducible factor-1α, HLA human leucocyte antigen, HMGB1 high mobility group box 1, IFN interferon, IgG immunoglobulin G, IL interleukin, IPF idiopathic pulmonary fibrosis, ITGB2 integrin beta 2, JAK janus-kinase, LC3 microtubule-associated protein 1 light chain 3, LysM lysine motif, MAPK mitogen-activated protein kinase, MERTK mer tyrosine kinase, MHC major histocompatibility complex, MICL myeloid inhibitory C-type lectin-like receptor, MLKL mixed lineage kinase domain-like, MMP matrix metalloproteinase, MPO myeloperoxidase, MF myelofibrosis, MPN myeloproliferative neoplasm, NCF neutrophil cytosolic factor, NE neutrophil elastase, NET neutrophil extracellular trap, NGAL neutrophil gelatinase-associated lipocalin, NLRP3 NLR family pyrin domain containing 3, OPG osteoprotegerin, OSM oncostatin M, PAD peptidylarginine deiminase, PBMCs peripheral blood mononuclear cells, PD-L1 programmed death-ligand 1, PI3K phosphatidylinositol 3-kinase, PKA protein kinase A, PR3 proteinase 3, RAC small GTPase of the rho family, RA rheumatoid arthritis, RANKL receptor activator of nuclear factor kappa-B ligand, RIPK receptor-interacting protein kinases, ROS reactive oxygen species, S100A12 S100 calcium-binding protein A12, SIRP-α signal-regulatory protein-α, SLE systemic lupus erythematosus, STIA serum-transfer-induced arthritis, TAM tyro3 axl mertk, TGF-β tumor growth factor-β, Th T helper, TIM-4 T-cell immunoglobulin and mucin domain-containing protein-4, TIMP tissue inhibitor of metalloproteinases, TLR toll- like receptor, TNF tumor necrosis factor, TRAIL TNF-related apoptosis-inducing ligand, TRAP tartrate resistant acid phosphatase, TYRO3 tyro3 protein tyrosine kinase, VSTM1 V-Set and transmembrane domain containing 1