Fig. 8

Up-regulation of ferritin in patients with sepsis leads to increased NETs production and exacerbates sepsis-associated acute lung injury. A Serum ferritin in healthy people and patients with sepsis (n = 30) and controls (n = 30). B Serum ferritin was detected in alive and dead sepsis patients. Alive (n = 11) and dead (n = 19). C and D Evaluate the correlation between serum ferritin concentration and the degree of lung damage (SOFA score and PaO2/FiO2) in sepsis patients. E and F MPO-DNA and DNA concentration in healthy people and patients with sepsis (n = 30) and controls (n = 30). G Representative NETosis images of alive-, dead-sepsis patients in comparison with healthy control. (MPO, red; CitH3, green; DAPI, blue. Scale bar = 30 μm). H SEM images depicting the release of NETs in septic or healthy neutrophils. (Scale bar = 10 μm). I, J, K and L The correlation between ferritin and NETs-related indicators (cfDNA, citH3-DNA, MPO-DNA and NE-DNA). M and N Stimulation of healthy donor neutrophils was performed using serum from five septic patients (serum ferritin absorbed and unabsorbed, respectively). Cell-free DNA and MPO-DNA complexes were quantified. O, P and Q Inhibition of ferritin-induced NET formation by PAD4, NE, ROS, and Msr1 inhibitors detected by IF of MPO (green), citH3 (red), and DAPI (blue) (Scale bar = 100 μm) in corresponding with MPO-DNA and cell-free DNA complexes