Table 3. Therapeutic approaches and potential anti-histone therapies.
Blocking release | Neutralisation | Blocking signalling |
---|---|---|
PAD4i60 | Anti-H mAb2, 16, 19, 35, 36, 53, 57, 58, 59 | TLR blocking mAb |
Blocks NETosis | Neutralises histone in circulation | PreventsTLR2/4/9 signal transduction |
Inhibits citrullination of H3 | DNase155 | Reduces cytokine release |
DNase157 | Degrades NET linker-DNA | Significant immunosuppressive side effects likely |
Disperses NET-derived histone within circulation | Disperses histone | CRP73 |
Prevents NET-mediated NETosis | aPC35 | Endogenous anionic acute phase protein |
Serum protease | Prevents cationic histone from binding to phosphodiester bonds on phospholipids | |
Degrades eHistone | ||
PSA35 | ||
Endogenous Anionic protein | ||
Ionic interaction with H |
Abbreviations: aPC, activated Protein C; BWA3, H4 histone neutralising antibody; CRP, C-reactive protein; H, histone; NET, neutrophil extracellular trap; NETosis, NET release; PAD4i, protein arginine deiminase 4; PSA, polysialic acid; TLR, Toll-like receptor