Fig. 6
From: Neutrophil extracellular traps in homeostasis and disease
NETs in modulating cancer biology. NET components play a direct role in shaping the biology of cancer. NETs are implicated in tumor cell immunosuppression, proliferation, metastasis, and cancer-associated thrombosis. In tumor proliferation, NETs directly promote tumor growth, angionenesis, and ECM remodeling. In cancer immune surveillance, NETs may contribute to the suppressive TME by: 1. Directly affecting the killing function of NK cells and cytotoxic T cells. 2. Forming a shield to protect tumor cells from effector cells. 3. Promoting Treg activity to inhibit the function of effector cells targeting abnormal cells. For cancer metastasis, NETs capture CTCs through integrin β1, CEACAM 1, TLRs, and CCDC25. NETs also promote EMT and contribute to endothelial damage and increasing vascular permeability. Moreover, NETs can awaken dormant cancer cells at distant sites. NETs also contribute to cancer-associated thrombosis. These mechanisms are associated with the immunothrombosis function of NETs, wherein they trap platelets, red blood cells, and extracellular vesicles containing tissue factor activity, leading to vessel occlusion and promoting cancer-associated thrombosis. This figure was created by Adobe Illustrator Artwork 16.0 (Adobe Systems, USA)
