The Use of Neutrophil Elastase and Neutrophil Myeloperoxidase as Biomarker in Hemarthrosis

Abstract

Background: Hemophilia is an inherited bleeding disorder that could cause many complications one of them is hemarthrosis. Neutrophils are the predominant immune cells that infiltrate joints after hemorrhage. Tissue injury is often accompanied by the productions of neutrophil extracellular traps (NETs), which are DNA constructs containing attached granular enzymes. Aims of Study: Measuring the circulating NETs, neutrophil elastase (NE), and myeloperoxidase (MPO) in the plasma of hemophilia A patients with hemarthrosis, for an understanding of hemarthrosis’ underlying pathology. Subjects and Methods: Fifty persons were recruited in this study, during a period of 8 months from November 2022 to June 2023: 25 patients were diagnosed as hemophilia A with hemarthrosis and another 25 individuals served as a control group who were unrelated, apparently healthy, and were age and sex matched. Plasma NE and MPO were measured by ELIZA technique. Results: The plasma MPO and NE levels were significantly higher in hemophilia A patients than controls: 12.714 ± 19.439 and 1535.34 ± 2059.87 ng/mL, respectively, at (P < 0.05) compared to control group 3.672 ± 3.623 and 235.26 ± 274.61 ng/mL. Conclusions and Recommendations: Patients with hemarthrosis had a considerably higher level of NETs in their plasma than healthy individuals. These findings may indicate the function of NETs in the pathology of hemophilia A with hemarthrosis, and the identification of high NETs might serve as a biomarker, as well as a possible prognostic and therapeutic target for such individuals.

Keywords

• hemarthrosis
• myeloperoxidase
• neutrophil elastase
• neutrophil extracellular traps