Neutrophil Extracellular Traps (NETs) and Therapeutic Apheresis
Access the full article via the journal publisher:
Neutrophil Extracellular Traps (NETs) as a Potential Target for Anti-Aging – Hormone and Metabolic Research (DOI: 10.1055/a-2444-3422)
Study Citation
J, Passauer J, Kok Y, Weiss N, Bornstein SR, Aswani A.
Neutrophil Extracellular Traps (NETs) as a Potential Target for Anti-Aging: Role of Therapeutic Apheresis.
Horm Metab Res. 2025.
DOI: 10.1055/a-2444-3422
Study Overview
This open-access review by Jarzebska and colleagues explores the role of neutrophil extracellular traps (NETs) in ageing and age-associated inflammatory conditions. The authors examine whether NETs may represent a potential therapeutic target and discuss the possible role of therapeutic apheresis in modifying circulating NET levels.
The review was published in Hormone and Metabolic Research in 2025.
Background: What Are NETs?
Neutrophil extracellular traps (NETs) are structures composed of chromatin, histones and granule proteins released by neutrophils during a specialised immune process known as NETosis. NETs form part of the innate immune response and are involved in trapping and neutralising pathogens.
However, excessive or dysregulated NET formation has been associated in research settings with inflammatory, cardiovascular, autoimmune and age-related conditions.
The authors review existing literature suggesting that:
NET levels and function may change with ageing
Dysregulated NET formation may contribute to inflammatory and vascular processes
NETs may be involved in fibrosis, thrombosis and autoimmune activity
The review discusses these mechanisms in the context of ageing biology and chronic inflammation.
Therapeutic Apheresis and NET Levels
The paper explores whether therapeutic apheresis — an extracorporeal blood filtration method — may influence circulating NET levels.
In an observational component, the authors collected plasma samples from 52 patients undergoing lipoprotein apheresis. Measurements were taken:
Before treatment
Immediately after treatment
One week after treatment
The study observed:
An increase in circulating NET markers immediately following conventional apheresis
A return to baseline NET levels one week later
Similar patterns across different apheresis techniques
The authors suggest that conventional lipoprotein apheresis does not reduce NET levels and may transiently increase them immediately post-treatment.
Exploratory NET-Specific Filtration
The review also describes a single patient case involving the use of a NET-targeting column (NucleoCapture). In that case, reductions in circulating cell-free DNA were observed alongside clinical improvement in systemic lupus erythematosus (SLE).
The authors emphasise:
The observational nature of the findings
The need for further research
That mechanisms and long-term clinical implications remain unclear
They conclude that targeted NET removal may warrant further investigation but requires careful consideration of timing and immune balance.
Limitations
The authors note several important limitations:
The observational design
Lack of mechanistic investigation into NET increases post-apheresis
Small sample sizes
The need for controlled clinical trials
No conclusions regarding clinical efficacy for anti-ageing or disease treatment are made.
Clinical Context
This study contributes to the broader scientific discussion regarding:
NETs and inflammatory biology
Age-related immune changes
The physiological effects of therapeutic apheresis
It does not establish therapeutic benefit for specific diseases and does not constitute clinical treatment recommendations.