Neutrophils release nucleosomes, a complex of DNA and histones, in response to infection or inflammatory stimuli. Neutrophil extracellular traps (NETs) are composed of nucleosomes decorated with granular components including myeloperoxidase (MPO), neutrophil elastase, and cathepsin G.4 NETs bind and kill microbes.4 NETs also immobilize platelets10 and erythrocytes. Histones are known to stimulate thrombosis and to cause cytotoxicity in mice.5–7 Once patients with pre-existing risk factors for thrombotic microangiopathy (TMA) are infected, DNA and histones, in conjunction with granular proteins, are released and acute TMAs would be induced. Another possible origin of extracellular DNA and histones is necrotic tissue released after ischemic damage. Professional illustration by Kenneth X. Probst.

Neutrophils release nucleosomes, a complex of DNA and histones, in response to infection or inflammatory stimuli. Neutrophil extracellular traps (NETs) are composed of nucleosomes decorated with granular components including myeloperoxidase (MPO), neutrophil elastase, and cathepsin G. NETs bind and kill microbes. NETs also immobilize platelets10  and erythrocytes. Histones are known to stimulate thrombosis and to cause cytotoxicity in mice.5-7  Once patients with pre-existing risk factors for thrombotic microangiopathy (TMA) are infected, DNA and histones, in conjunction with granular proteins, are released and acute TMAs would be induced. Another possible origin of extracellular DNA and histones is necrotic tissue released after ischemic damage. Professional illustration by Kenneth X. Probst.

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