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Histone (extracellular, neutrophil-derived) and neutrophil extracellular trap (NET; (for histone, abbreviations are H2A, H2B, H3, H4 individually))

Target
NET; (for histone, abbreviations are H2A, H2B, H3, H4 individually)
Molecular classification
For histones: Histone protein; nuclear structural protein; antimicrobial protein (when extracellular), For NET: Nucleoprotein complex; innate immune effector structure; "Other"
01

Overview

Histones (notably H2A, H2B, H3, and H4) are highly conserved nuclear proteins essential for DNA packaging within cells. When released extracellularly, commonly as a major component of neutrophil extracellular traps (NETs), histones gain potent antimicrobial and immunomodulatory properties[1][2][3][4][6]. NETs are web-like structures composed of decondensed nuclear DNA, histones, and neutrophil proteins, extruded by neutrophils during immune activation[3][4][6]. These complexes immobilize and neutralize pathogens extracellularly, act as pro-inflammatory agents, and, when dysregulated or in excess, contribute to tissue damage and drive pathology in various infectious, autoimmune, inflammatory, and thrombotic diseases[1][3][4][5][6]. Extracellular histones, whether NET-bound or free, display direct cytotoxicity to mammalian cells, promote inflammation, thrombosis, and can act via Toll-like receptors (such as TLR2) to drive T cell (Th17) differentiation. While their physiological purpose is host defense, targeting of NETs and extracellular histones is an emerging therapeutic area in diseases where their overactivity is pathogenic[1][4][6].

Other names
Histone (when referring to individual proteins: Histone H2A, Histone H2B, Histone H3, Histone H4)Neutrophil extracellular trapNETExtracellular histone
02

Mechanism of action

DNase I: Degrades NET DNA backbone, reduces NET burden and sputum viscosity[2] Heparin: Neutralizes positive charges on histones, reduces cytotoxicity and pro-thrombotic activity[4] Pentraxin 3: Binds extracellular histones to suppress their cytotoxicity[4]

03

Biological functions

Antimicrobial activity (against bacteria, fungi, some viruses, protozoa)Immune response modulation (including activation of Th17 T cells)Inflammatory mediatorThrombosis promotion (immunothrombosis)Tissue damage (when dysregulated)
04

Disease associations

Infection (bacterial, viral, fungal, protozoal)Autoimmune disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, vasculitis)Cancer (pro- and anti-tumor actions, cancer immunothrombosis)Cardiovascular disease (atherosclerosis, thrombosis)Inflammatory disease (periodontitis, cystic fibrosis, diabetes)Organ injury (acute organ damage, sepsis, trauma)
05

Safety considerations

Potential exacerbation of infection (suppression of NETs)Risk of bleeding (anticoagulant strategies, heparin)Off-target cytotoxicity (broad action of extracellular histones)Autoimmunity (amplifying immune responses)
06

Interacting drugs

DNase I

3 more in the full profile.

07

Biomarkers

Circulating cell-free DNA (cfDNA), specifically NET-DNACitH3 (citrullinated histone H3, a specific NET marker)[5]Myeloperoxidase-DNA complexNucleosomesExtracellular histone levels

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