Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps

Background Intracranial aneurysms (IAs) are more prevalent in women than men, and aneurysmal subarachnoid hemorrhage disproportionately affects postmenopausal women. These sex differences suggest estrogen protects against IA progression that can lead to rupture, but the underlying mechanisms are not...

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Main Authors: Devan Patel, William S. Dodd, Brandon Lucke‐Wold, Muhammad Abdul Baker Chowdhury, Koji Hosaka, Brian L. Hoh
Format: Article
Language:English
Published: Wiley 2023-11-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.123.029917
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author Devan Patel
William S. Dodd
Brandon Lucke‐Wold
Muhammad Abdul Baker Chowdhury
Koji Hosaka
Brian L. Hoh
author_facet Devan Patel
William S. Dodd
Brandon Lucke‐Wold
Muhammad Abdul Baker Chowdhury
Koji Hosaka
Brian L. Hoh
author_sort Devan Patel
collection DOAJ
description Background Intracranial aneurysms (IAs) are more prevalent in women than men, and aneurysmal subarachnoid hemorrhage disproportionately affects postmenopausal women. These sex differences suggest estrogen protects against IA progression that can lead to rupture, but the underlying mechanisms are not fully understood. Although studies have demonstrated estrogen regulates inflammatory processes that contribute to IA pathogenesis, the role of neutrophils remains to be characterized. Using a murine model, we tested our hypothesis that neutrophils contribute to IA pathophysiology in an estrogen‐dependent manner. Methods and Results We compared neutrophil infiltration in C57BL/6 female mice that develop IAs to those with a normal circle of Willis. Next, we investigated the estrogen‐dependent role of neutrophils in IA formation, rupture, and symptom‐free survival using a neutrophil depletion antibody. Finally, we studied the role of neutrophil extracellular trap formation (NETosis) as an underlying mechanism of aneurysm progression. Mice that developed aneurysms had increased neutrophil infiltration compared with those with a normal circle of Willis. In estrogen‐deficient female mice, both neutrophil depletion and NETosis inhibition decreased aneurysm rupture. In estrogen‐deficient female mice treated with estrogen rescue and estrogen‐intact female mice, neither neutrophil depletion nor NETosis inhibition affected IA formation, rupture, or symptom‐free survival. Conclusions Neutrophils contribute to aneurysm rupture in an estrogen‐dependent manner. NETosis appears to be an underlying mechanism for neutrophil‐mediated IA rupture in estrogen deficiency. Targeting NETosis may lead to the development of novel therapeutics to protect against IA rupture in the setting of estrogen deficiency.
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spelling doaj.art-ee25e712f237488ba6c20c6415f02eed2023-12-08T11:09:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-11-01122110.1161/JAHA.123.029917Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular TrapsDevan Patel0William S. Dodd1Brandon Lucke‐Wold2Muhammad Abdul Baker Chowdhury3Koji Hosaka4Brian L. Hoh5Department of Neurosurgery University of Florida Gainesville FL USADepartment of Neurosurgery University of Florida Gainesville FL USADepartment of Neurosurgery University of Florida Gainesville FL USADepartment of Neurosurgery University of Florida Gainesville FL USADepartment of Neurosurgery University of Florida Gainesville FL USADepartment of Neurosurgery University of Florida Gainesville FL USABackground Intracranial aneurysms (IAs) are more prevalent in women than men, and aneurysmal subarachnoid hemorrhage disproportionately affects postmenopausal women. These sex differences suggest estrogen protects against IA progression that can lead to rupture, but the underlying mechanisms are not fully understood. Although studies have demonstrated estrogen regulates inflammatory processes that contribute to IA pathogenesis, the role of neutrophils remains to be characterized. Using a murine model, we tested our hypothesis that neutrophils contribute to IA pathophysiology in an estrogen‐dependent manner. Methods and Results We compared neutrophil infiltration in C57BL/6 female mice that develop IAs to those with a normal circle of Willis. Next, we investigated the estrogen‐dependent role of neutrophils in IA formation, rupture, and symptom‐free survival using a neutrophil depletion antibody. Finally, we studied the role of neutrophil extracellular trap formation (NETosis) as an underlying mechanism of aneurysm progression. Mice that developed aneurysms had increased neutrophil infiltration compared with those with a normal circle of Willis. In estrogen‐deficient female mice, both neutrophil depletion and NETosis inhibition decreased aneurysm rupture. In estrogen‐deficient female mice treated with estrogen rescue and estrogen‐intact female mice, neither neutrophil depletion nor NETosis inhibition affected IA formation, rupture, or symptom‐free survival. Conclusions Neutrophils contribute to aneurysm rupture in an estrogen‐dependent manner. NETosis appears to be an underlying mechanism for neutrophil‐mediated IA rupture in estrogen deficiency. Targeting NETosis may lead to the development of novel therapeutics to protect against IA rupture in the setting of estrogen deficiency.https://www.ahajournals.org/doi/10.1161/JAHA.123.029917aneurysm formationaneurysm ruptureestrogen deficiencyNETosisneutrophils
spellingShingle Devan Patel
William S. Dodd
Brandon Lucke‐Wold
Muhammad Abdul Baker Chowdhury
Koji Hosaka
Brian L. Hoh
Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
aneurysm formation
aneurysm rupture
estrogen deficiency
NETosis
neutrophils
title Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps
title_full Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps
title_fullStr Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps
title_full_unstemmed Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps
title_short Neutrophils: Novel Contributors to Estrogen‐Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps
title_sort neutrophils novel contributors to estrogen dependent intracranial aneurysm rupture via neutrophil extracellular traps
topic aneurysm formation
aneurysm rupture
estrogen deficiency
NETosis
neutrophils
url https://www.ahajournals.org/doi/10.1161/JAHA.123.029917
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