{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:33:00Z","timestamp":1790742780020,"version":"4.1.0"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["R-844801"],"award-info":[{"award-number":["R-844801"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006722","name":"Center for Clinical Research Dalarna","doi-asserted-by":"publisher","award":["1"],"award-info":[{"award-number":["1"]}],"id":[{"id":"10.13039\/501100006722","id-type":"DOI","asserted-by":"publisher"}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons Foundation","award":["1"],"award-info":[{"award-number":["1"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["LIO-791961"],"award-info":[{"award-number":["LIO-791961"]}]},{"name":"German Research Foundation project","award":["GRK\u20101660"],"award-info":[{"award-number":["GRK\u20101660"]}]},{"name":"EU (H2020-MSCE-RISE-2015) project","award":["690836 PANG"],"award-info":[{"award-number":["690836 PANG"]}]},{"name":"Volkswagen\u2010Stiftung","award":["90361"],"award-info":[{"award-number":["90361"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Neutrophils operate as part of the innate defence in the skin and may eliminate the Borrelia spirochaete via phagocytosis, oxidative bursts, and hydrolytic enzymes. However, their importance in Lyme neuroborreliosis (LNB) is unclear. Neutrophil extracellular trap (NET) formation, which is associated with the production of reactive oxygen species, involves the extrusion of the neutrophil DNA to form traps that incapacitate bacteria and immobilise viruses. Meanwhile, NET formation has recently been studied in pneumococcal meningitis, the role of NETs in other central nervous system (CNS) infections has previously not been studied. Here, cerebrospinal fluid (CSF) samples from clinically well-characterised children (N = 111) and adults (N = 64) with LNB and other CNS infections were analysed for NETs (DNA\/myeloperoxidase complexes) and elastase activity. NETs were detected more frequently in the children than the adults (p = 0.01). NET presence was associated with higher CSF levels of CXCL1 (p &lt; 0.001), CXCL6 (p = 0.007), CXCL8 (p = 0.003), CXCL10 (p &lt; 0.001), MMP-9 (p = 0.002), TNF (p = 0.02), IL-6 (p &lt; 0.001), and IL-17A (p = 0.03). NETs were associated with fever (p = 0.002) and correlated with polynuclear pleocytosis (rs = 0.53, p &lt; 0.0001). We show that neutrophil activation and active NET formation occur in the CSF samples of children and adults with CNS infections, mainly caused by Borrelia and neurotropic viruses. The role of NETs in the early phase of viral\/bacterial CNS infections warrants further investigation.<\/jats:p>","DOI":"10.3390\/cells9010043","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T05:56:15Z","timestamp":1577166975000},"page":"43","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Neutrophil Extracellular Traps (NETs) in the Cerebrospinal Fluid Samples from Children and Adults with Central Nervous System Infections"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3328-5060","authenticated-orcid":false,"given":"Daniel","family":"Appelgren","sequence":"first","affiliation":[{"name":"Division of Drug Research, Department of Medical and Health Sciences, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2125-2931","authenticated-orcid":false,"given":"Helena","family":"Enocsson","sequence":"additional","affiliation":[{"name":"Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbro H.","family":"Skogman","sequence":"additional","affiliation":[{"name":"Center for Clinical Research Dalarna-Uppsala University, Region Dalarna and Faculty of Medicine and Health Sciences, \u00d6rebro University, SE-702 81 \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Nordberg","sequence":"additional","affiliation":[{"name":"\u00c5land Central Hospital, Department of Infectious Diseases, AX-22 100 Mariehamn, \u00c5land, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Perander","sequence":"additional","affiliation":[{"name":"\u00c5land Central Hospital, Department of Infectious Diseases, AX-22 100 Mariehamn, \u00c5land, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag","family":"Nyman","sequence":"additional","affiliation":[{"name":"Bimelix AB, AX-22 100 Mariehamn, \u00c5land, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Nyberg","sequence":"additional","affiliation":[{"name":"\u00c5land Central Hospital, Department of Infectious Diseases, AX-22 100 Mariehamn, \u00c5land, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Knopf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3-Rheumatology and Immunology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), DE-91 054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5395-804X","authenticated-orcid":false,"given":"Luis E.","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3-Rheumatology and Immunology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-University Erlangen-N\u00fcrnberg (FAU), DE-91 054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0900-2048","authenticated-orcid":false,"given":"Christopher","family":"Sj\u00f6wall","sequence":"additional","affiliation":[{"name":"Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-866X","authenticated-orcid":false,"given":"Johanna","family":"Sj\u00f6wall","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Link\u00f6ping University Hospital, SE-581 85 Link\u00f6ping, Sweden"},{"name":"Department of Clinical and Experimental Medicine, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/QCO.0000000000000545","article-title":"Lyme neuroborreliosis","volume":"32","author":"Halperin","year":"2019","journal-title":"Curr. 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