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Semin Thromb Hemost
DOI: 10.1055/a-2605-8019
Review Article

Neutrophil-Mediated Effects on Hemostasis and Thrombosis: Unraveling Their Complex Interaction in Thrombotic Events

Saeed Hassani
1   Department of Medical Laboratory Sciences, School of Paramedical Sciences, Arak University of Medical Sciences, Arak, Iran
,
Alieh Fazeli
2   Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
,
Akbar Dorgalaleh
3   Hamin Pazhuhan Tis Institute, Tehran, Iran
,
Shadi Tabibian
4   Blood Disease Research Center (BDRC), Iranian Comprehensive Hemophilia Care Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
,
Jalal Lomei
5   Independent Researcher, Stockholm, Sweden
,
Maedeh Alipour
6   Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R., Iran
,
Masoumeh Kiani Zadeh
2   Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
,
Mahmood Shams
7   Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R., Iran
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Abstract

Neutrophils are astonishing cells involved in nonspecific immunity, especially against bacterial and fungal infections. Their half-life is short, but despite their important role in nonspecific immunity, they defend the host even after their death by providing secondary structures such as neutrophil extracellular traps (NETs). NETs are a network comprising DNA, histones, and proteins, including elastase, cathepsin G, and myeloperoxidase. In this context, in addition to their primary role in hemostasis, they also play a role in thrombosis, an area that has received less attention. Nonetheless, NETs can promote both venous and arterial thrombus formation (immuno-thrombosis), by their effects on primary and secondary hemostasis; their participation in thrombus formation includes the release of microparticles and components of the inflammasome. Neutrophils in interaction with other cells including platelets can further contribute to thrombosis. Activated platelets can capture neutrophil-derived microparticles containing tissue factor (TF), leading to TF accumulation and increased fibrin deposition. Furthermore, neutrophil inflammasomes as a regulator of the generation of IL-1 family proteins have been shown to augment thrombosis formation in response to hypoxia. Overall, understanding the complex and reciprocal effects of neutrophils with other hemostasis-related cells and components provides important insights into hemostatic mechanisms, and this may open avenues in medical research and potential therapeutic interventions.

Keywords

neutrophil - thrombosis - hemostasis - fibrinolysis - neutrophil extracellular traps

Declaration of GenAI Use

During the writing process of this paper, the authors used Claude to assist with improving the readability of the text. The authors have reviewed and edited the text and take full responsibility for the content of the article.


Ethical Approval

The study was approved by the Ethics Committee at the Babol University of Medical Sciences (No. IR.MUBABOL.REC.1399.150) and does not contain any studies with human participants or animals performed by any of the authors.




Publication History

Received: 02 March 2025

Accepted: 11 May 2025

Article published online:
03 June 2025

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