Our findings reveal altered perivascular inflammatory cell infiltration in pulmonary vascular lesions of patients with idiopathic pulmonary arterial hypertension. Targeting attraction of inflammatory cells by blocking stromal-derived factor-1 may be a novel approach for treatment of PAH.

Extracellular trap (ET) formation has been demonstrated as an important novel effector mechanism of polymorphonuclear neutrophils (PMN), eosinophils, mast cells and macrophages acting extracellularly against pathogens. In the present study, we show that tachyzoites of the emerging apicomplexan parasite Besnoitia besnoiti, that have recently been reported as potent inducers of PMN-derived ETosis, also trigger the release of ETs in an additional cell type, namely in monocytes. Fluorescence illustrations as well as scanning electron microscopy analyses (SEM) showed monocyte-promoted ET formation to be rapidly induced upon exposure to viable tachyzoites of B. besnoiti. Classical characteristics of ETs were confirmed by the co-localization of extracellular DNA with histones (H3) or myeloperoxidase (MPO) in parasite-entrapping structures. Monocyte-derived ETs were efficiently abolished by DNase I treatment and significantly reduced by treatments with inhibitors of MPO and NADPH oxidase, thus strengthening the key roles of reactive oxygen species (ROS) and MPO in monocyte ET formation. For comparative reasons, we additionally tested sporozoite stages of the closely related parasite Eimeria bovis for their capacity to induce monocyte-derived ETs and showed that these stages indeed induce ETs. To our best knowledge, we here report for the first time on monocyte ETs against the apicomplexan parasites B. besnoiti and E. bovis. Our results indicate that monocyte-triggered ETs may represent an important effector mechanism of the host early innate immune response against B. besnoiti and add a new cell type to the list of cells capable to release ETs.