Neutrophil Extracellular Traps in Dry Eye: A Comprehensive Review of Pathogenic Mechanisms and Implications for Targeted Therapy

Xiaocong Guo,1,* Chunlei Wang,1,* Wei Liu,1,2,* Yi Sun,3 Li Su,1 Hong Wang,1 Bo Liu1 1Acupuncture and Massage Rehabilitation Center, Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, Shandong, People’s Republic of China; 2Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China; 3Ophthalmology Department, Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bo Liu; Hong Wang, Email [email protected]; [email protected]: Dry eye (DE) is a multifactorial ocular surface disease characterized primarily by tear film instability and ocular discomfort. Nearly all forms of DE exhibit elevated inflammatory markers in tear fluid, accompanied by clinical signs of tear dysfunction including reduced secretion and shortened breakup time. Although the pathophysiology of dry eye disease remains incompletely understood, accumulating evidence implicates neutrophil extracellular traps (NETs) as key pathogenic drivers. Robust clinical associations and mechanistic studies have established causal links between NETs and ocular surface pathology. This review summarizes current research on the role of NETs in the development of dry eye, aiming to identify potential therapeutic targets.Keywords: neutrophils, neutrophil extracellular traps, dry eye, NETosis