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. 2022 Dec 1;43(2):267–285. doi: 10.1161/ATVBAHA.122.317800

Figure 5.

Figure 5.

PAD4 (peptidylarginine deiminase 4)-mediated NET (neutrophil extracellular traps) release neither protects against nor promotes infective endocarditis. A–E, In vitro assay: neutrophils were isolated from control (MRP8+ or PAD4fl/fl) or neutrophil-selective PAD4 knockout mice (MRP8Cre+×PAD4fl/fl), incubated with Staphylococcus aureus USA300 or ionomycin, and the different stages of NETosis were assessed according to nuclear morphology. A, Schematic overview of the different stages of NET formation. B, Percentage of cells at various NETosis stages in control (average of n=8) and neutrophil-selective PAD4 knockout mice (average of n=9). C and D, Percentage of NETs induced by ionomycin (C) and S. aureus USA300 (D) in neutrophil-selective PAD4 knockout (n=9) mice compared with controls (n=8). Medians (interquartile ranges) are shown. E, Schematic overview (created with Biorender.com) of endocarditis experiments performed in neutrophil-selective PAD4 knockout and control mice. F and G, Proportions of mice that developed inflammation-induced endocarditis (red, F) or sterile thrombi (orange, G) at day 3 in neutrophil-selective PAD4 knockout mice compared with control mice. H, Bacteremia levels at end point with corresponding median (interquartile range; n=18, 16). I, Survival graph of neutrophil-selective PAD4 knockout (black, n=23) and control mice (gray, n=25). Mann-Whitney (C and D, H), Fisher Exact (F and G) or log-rank (Mantel-Cox) test (I). CFU indicates colony-forming units; MRP8, myeloid related protein 8; and NETosis, the process of NET formation.