title: Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis.
abstract: The majority of patients with cancer undergo at least one surgical procedure as part of their treatment. Severe postsurgical infection is associated with adverse oncologic outcomes; however, the mechanisms underlying this phenomenon are unclear. Emerging evidence suggests that neutrophils, which function as the first line of defense during infections, facilitate cancer progression. Neutrophil extracellular traps (NETs) are extracellular neutrophil-derived DNA webs released in response to inflammatory cues that trap and kill invading pathogens. The role of NETs in cancer progression is entirely unknown. We report that circulating tumor cells become trapped within NETs in vitro under static and dynamic conditions. In a murine model of infection using cecal ligation and puncture, we demonstrated microvascular NET deposition and consequent trapping of circulating lung carcinoma cells within DNA webs. NET trapping was associated with increased formation of hepatic micrometastases at 48 hours and gross metastatic disease burden at 2 weeks following tumor cell injection. These effects were abrogated by NET inhibition with DNAse or a neutrophil elastase inhibitor. These findings implicate NETs in the process of cancer metastasis in the context of systemic infection and identify NETs as potential therapeutic targets.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cools-Lartigue
authors.forename: Jonathan
authors.initials: J
authors.lastname: Spicer
authors.forename: Braedon
authors.initials: B
authors.lastname: McDonald
authors.forename: Stephen
authors.initials: S
authors.lastname: Gowing
authors.forename: Simon
authors.initials: S
authors.lastname: Chow
authors.forename: Betty
authors.initials: B
authors.lastname: Giannias
authors.forename: France
authors.initials: F
authors.lastname: Bourdeau
authors.forename: Paul
authors.initials: P
authors.lastname: Kubes
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ferri