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Neutrophil extracellular traps (NETs) are involved in the pathogenesis of many autoimmune diseases, including vascular APS; however, their role in obstetric APS is unclear. Herein, we investigated the role of NETs by quantifying cell\u2010free DNA and NET marker levels. Live\u2010cell imaging was used to visualize NET formation, and MAPK signalling pathway proteins were analysed. Cell migration, invasion and tube formation assays were performed to observe the effects of NETs on trophoblasts and human umbilical vein endothelial cells (HUVECs). The concentrations of cell\u2010free DNA and NETs in sera of pregnant patients with APS were elevated compared with that of healthy controls (HCs) matched to gestational week. APS neutrophils were predisposed to spontaneous NET release and IgG purified from the patients (APS\u2010IgG) induced neutrophils from HCs to release NETs. Additionally, APS\u2010IgG NET induction was abolished with inhibitors of reactive oxygen species, AKT, p38 MAPK and ERK1\/2. Moreover, NETs were detrimental to trophoblasts and HUVECs. In summary, APS\u2010IgG\u2010induced NET formation deserves further investigation as a potential novel therapeutic target in obstetrical APS.<\/jats:p>","DOI":"10.1111\/jcmm.15321","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T19:59:20Z","timestamp":1588708760000},"page":"6690-6703","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Antiphospholipid antibody\u2010activated NETs exacerbate trophoblast and endothelial cell injury in obstetric antiphospholipid syndrome"],"prefix":"10.1111","volume":"24","author":[{"given":"Yuan","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Shandong Provincial Hospital Affiliated to Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Linyi People\u2019s Hospital Linyi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Shandong Provincial Hospital Affiliated to Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Maternal and Child Health Care of Shandong Province Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Shandong Provincial Hospital Affiliated to Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxiu","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Shandong Provincial Hospital Affiliated to Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meihua","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Laboratory of Placenta\u2010Related Diseases Key Laboratory of Birth Regulation and Control Technology of National Health and Family Planning Commission of China Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3894-3146","authenticated-orcid":false,"given":"Yu","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Central Laboratory Shandong Provincial Hospital Affiliated to Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xietong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Shandong Provincial Hospital Affiliated to Shandong University Jinan China"},{"name":"Department of Obstetrics and Gynaecology Maternal and Child Health 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