Immobilized IgG-containing immune complexes require platelets to recruit neutrophils during inflammation

During vascular injury, platelets are essential for halting bleeding and recruiting neutrophils to prevent microbial invasion. However, in antibody-mediated autoimmune diseases occurring without vascular damage, neutrophils infiltrate tissues and contribute to pathology. Here, we investigated whether the dependence of neutrophils on platelets is conserved in the context of antibody-driven inflammation. Using human cells from individuals with rheumatoid arthritis and a microfluidic system mimicking physiological shear over IgG-containing immune complexes, we demonstrate that despite expressing Fc receptors, neutrophils required platelets to stably adhere to immune complexes under flow. Platelet Fcγ receptor 2a (FcγRIIA) binding was critical for resisting shear stress, while neutrophils used FcγRIIA and FcγRIIIB for immune complex recognition. Platelet P-selectin binding to neutrophil P-selectin glycoprotein ligand 1 (PSGL-1) was essential for recruitment, whereas macrophage-1 antigen (Mac-1) was dispensable. In a mouse model of autoantibody-mediated arthritis, intravital imaging confirmed that neutrophil recruitment relied on PSGL-1. Importantly, expression of FcγRIIA aggravated arthritis, and blockade of PSGL-1, but not Mac-1, in these mice abrogated both the platelet and neutrophil interactions and disease. These findings identify key molecular interactions in platelet-neutrophil cooperation and reveal that platelets are essential enablers of FcR-mediated neutrophil adhesion in antibody-driven inflammation.