Volume 24 Issue 4
Apr.  2026
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Article Navigation >  Chinese Journal of General Practice  > 2026  >  24(4): 574-576
SHI Lilu, HUANG Zaizhong, WEIMO Luyu, QING Cao, HUANG Wenhui, WANG Ke. Clinical analysis of NETs biomarkers and their relationship with leukocytes and neutrophils in empyema-associated pleural effusion[J]. Chinese Journal of General Practice, 2026, 24(4): 574-576. doi: 10.16766/j.cnki.issn.1674-4152.004442
Citation: SHI Lilu, HUANG Zaizhong, WEIMO Luyu, QING Cao, HUANG Wenhui, WANG Ke. Clinical analysis of NETs biomarkers and their relationship with leukocytes and neutrophils in empyema-associated pleural effusion[J]. Chinese Journal of General Practice, 2026, 24(4): 574-576. doi: 10.16766/j.cnki.issn.1674-4152.004442
shu

Clinical analysis of NETs biomarkers and their relationship with leukocytes and neutrophils in empyema-associated pleural effusion

doi: 10.16766/j.cnki.issn.1674-4152.004442

  • Department of Respiratory and Critical Care, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China

Funds:

 82260023

 2022GXNSFAA035646

  • Received Date: 2025-07-12
    Abstract
  •   Objective  To investigate the correlation between neutrophil extracellular traps (NETs) in pleural fluid and leukocytes, neutrophils, and the inflammatory marker C-reactive protein (CRP) in patients with empyema, in order to provide references for clinical diagnosis and treatment.  Methods  Clinical data were collected from patients with pyothorax admitted to the Third Ward of the Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangxi Medical University, from June 2017 to June 2021. Pleural effusion samples were collected under sterile conditions, and 38 eligible samples along with corresponding clinical data were included after rigorous screening. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of NETs markers in pleural effusion, and all data were summarized and statistically analyzed.  Results  The data showed a trend of elevated leukocytes, neutrophils, and NETs biomarkers were observed in 38 pleural fluid samples. The concentration of citrullinated histone H3 (citH3) was 14.63(0.99, 21.45) ng/mL, and extracellular DNA (eDNA) 14.09(3.22, 21.93) ng/μL. The leukocytes count was (15.08±8.15)×109/L, the count of neutrophils was [12.04(7.57, 17.99)]×109/L, and CRP level was 100.50(44.63, 187.00) mg/L. In the group with positive pleural fluid microbial cultures, the concentrations were as follows: citH3 at 19.12(0.37, 21.23)ng/mL, eDNA at 13.15(4.48, 19.62)ng/μL, white blood cell count at (15.58±5.23)×109/L, neutrophil count at [14.92(12.21, 16.73)]×109/L, and C-reactive protein level at 147.00(103.50, 189.75) mg/L. Spearman correlation analysis revealed that, in the microbial culture-positive pleural fluid group, citH3 levels were highly correlated with both leukocytes count and neutrophil count (r=0.833, 0.867, P < 0.05). No other significant correlations were observed among the remaining indicators across the groups.  Conclusion  NET biomarkers, particularly eDNA and citH3, are associated with white blood cells, neutrophils, and C-reactive protein, and may serve as potential indicators for assessing inflammatory severity and disease progression in empyema.

     

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