Formation of neutrophil extracellular traps (NETs) in periapical lesions

an integrative review

Resumo

Objective: to map and synthesize evidence on the formation of neutrophil extracellular traps (NETs) in periapical lesions. Method: a bibliographic study was conducted following the integrative review method. Searches were carried out in the MEDLINE/PubMed, Web of Science, Scopus, Embase, and Google Scholar databases using a search strategy based on descriptors and key terms. Both experimental studies (animal models) and studies using samples from human periapical lesions were eligible, with no restrictions regarding publication date or language. Results: after the screening, 1,135 references were retrieved, and 3 were included. The analysis of these studies demonstrated that NET formation is a mechanism present in experimental periapical lesions (confirmed by different methods), being associated with granular protease activation, persistent inflammation, and bone resorption. It was also observed that NET formation was correlated with the expression of REDOX enzymes in periapical tissues, indicating a probable involvement of oxidative stress in this process. Furthermore, the degradation of these structures by DNase I resulted in reduced osteolysis and local inflammation, demonstrating their likely proinflammatory role during periapical aggression by microorganisms. Conclusion: based on the literature, it can be inferred that NETs are formed in periapical lesions and may represent a potential therapeutic target for controlling inflammation and bone destruction in the periapical region.