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. 2026 Oct 20;17:1972426. doi: 10.3389/fimmu.2026.1972426

Figure 2.

Infographic illustrating the role of neutrophil extracellular traps (NETs) in intestinal inflammation and immunothrombosis in NEC, comparing context-dependent protective effects such as pathogen trapping and barrier maintenance to pathogenic immunothrombotic effects like endothelial injury, microthrombosis, and intestinal necrosis, with visual pathways and summarized risk factors including prematurity, enteral feeding, microbial imbalance, and hypoxia-ischemia.

NETs in NEC: a context dependent model. Prematurity, feeding, dysbiosis, and hypoxia ischemia promote barrier injury, neutrophil recruitment, and NET formation. CD177+ aggregates, platelet exosome GSDMD signaling, and IP6K1 polyphosphates amplify thromboinflammation. Moderate NETs with effective clearance limit bacterial spread, whereas excessive NETs injure epithelium and endothelium and promote microthrombosis. The net effect depends on infection burden, disease stage, developmental age, and clearance capacity.