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| The role of NETs in the prediction and prevention of cancer‑associated venous thromboembolism |
| Zhang Yi, Cui Jiuwei |
| Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
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Abstract Neutrophil extracellular traps (NETs) are extracellular decondensed chromatin webs decorated with granule proteins
post neutrophils activation. In recent years, the pathological role of NETs in the occurrence and development of tumor and related
complications has been gradually recognized. Recent studies have suggested that the occurrence of cancer⁃associated venous
thromboembolism (VTE) may be related to the overproduction of NETs in cancer patients. The chromatin fiber network, cell⁃free DNA
(cfDNA), and histones that constitute NETs contribute to and accelerate thrombosis by participating in the formation of blood
hypercoagulable states and endothelial damage. Based on the understanding of the mechanism of NETs formation and how NETs
promote VTE, NETs marker P⁃selectin, citrullinated histone H3 and cfDNA are the most promising potential markers for predicting
VTE. Inhibition of NETs generation and elimination of NETs are two main directions for preventing VTE caused by abnormal
accumulation of NETs. More and more studies have found that heparin, aspirin, chloroquine and other drugs can inhibit the formation
of NETs. The discovery of these drugs will help to further reveal the mechanism of NETs formation and how NETs promote VTE,
and also contribute to the development of more efficient prevention and treatment strategies for VTE. At the same time, inhibitors
of substances that play a key role in the formation of NETs are also expected to reduce the incidence of VTE. Herein, we will mainly
discuss the mechanism by which NETs promote tumor⁃associated VTE, and summarize the research progress on prediction and
prevention of tumor⁃associated VTE by NETs.
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Received: 22 December 2021
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Corresponding Authors:
崔久嵬，电子邮箱：cuijw@jlu.edu.cn
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