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The proposed role of PMNs in the immunopathogenesis of gout. Phase (1) shows the deposition of needle-shaped MSU crystals. Phase (2) depicts PMNs phagocytosing crystals and releasing chemoattractants and NETs. Phase (3) shows the formation of aggregated NETs (aggNET) that provide the structural basis of gouty tophi and contain high concentration of PMN proteases degrading PMN chemoattractants.
