Targeting NETosis to Treat Delayed Wound Healing in a Humanized Mouse Model of Sickle Cell Disease

    Quang Chi Ngo, Mansour Alkobtawi, Lakshmi Sandhow, Shreen Matar, C. Al Youssef, Diana Passaro, Tallya Maciel, Olivier Hermine, S. Aractingi, Bénédicte Oulès
    TLDR Reducing neutrophils or inhibiting NETs improves wound healing in sickle cell disease.
    This study investigates the role of neutrophils and neutrophil extracellular traps (NETs) in delayed wound healing in sickle cell disease (SCD) using the humanized Townes mouse model. Sickle cell mice (SS) exhibited delayed skin healing, reduced neo-epidermis formation, and angiogenesis compared to control mice (AA), despite no major architectural skin differences. SS mice had more circulating neutrophils and increased bone marrow hematopoietic stem and progenitor cells. Neutrophils in SS mice were more activated, releasing more NETs, which were also elevated in the wound bed. Treatments reducing neutrophil counts or inhibiting NETs, such as hydroxyurea, DNAse, or PAD4 inhibitors, improved wound healing. Grafting experiments confirmed that delayed healing was due to defects in bone marrow-recruited cells. The study highlights the pathogenic role of neutrophils and NETs in impaired wound healing in SCD.
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