Dysregulation of innate immunity has been proposed as an important contributing factor for advanced atherosclerosis and resultant high mortality in hemodialysis (HD) patients. To evaluate the long-term prognostic role of in vivo neutrophil extracellular traps (NETs), we measured circulating serum nucleosome, myeloperoxidase (MPO), and DNase I levels in 281 incident HD patients. Circulating nucleosome level was significantly higher in HD patients compared to controls, and it was closely associated with MPO levels, suggesting increased in vivo NETs in uremia. Patients in the nucleosome Q4 group had significantly increased all-cause and adverse CV mortality compared to those in the Q1-3 group even after adjusting traditional risk factors Also, serum DNase I level was significantly higher in HD patients than controls (2.76 ± 1.02 ng/ml and 1.93 ± 0.85 ng/ml), but it had no correlation with NETs. Interestingly, it serves an additive biomarker for predicting poor CV outcomes. The two novel biomarkers might provide an importance independent prognostic significance in incident HD patients.

中文翻译：

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循环中性粒细胞胞外陷阱水平对新的终末期肾病患者的长期死亡率的预后作用。

已经提出先天免疫的失调是晚期动脉粥样硬化以及在血液透析（HD）患者中导致高死亡率的重要促成因素。为了评估体内嗜中性粒细胞细胞外陷阱（NETs）的长期预后作用，我们测量了281例HD患者的循环血清核小体，髓过氧化物酶（MPO）和DNase I水平。与对照组相比，HD患者的循环核小体水平显着更高，并且与MPO水平密切相关，提示尿毒症体内的NETs增加。即使在调整传统危险因素后，Q4核小体组患者的全因和不良CV死亡率仍显着高于Q1-3组，而且HD患者的血清DNase I水平也显着高于对照组（2.76±1.02 ng / ml和1.93±0。85 ng / ml），但与NET没有相关性。有趣的是，它可作为预测不良心血管结果的附加生物标志物。这两种新的生物标志物可能在事件高清患者中提供重要的独立预后意义。