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Review

Neutrophils and Neutrophil Extracellular Traps in Hepatic Ischemia–Reperfusion Injury: Molecular Mechanisms and Therapeutic Strategies

1
Department of Emergency, The First Affiliated Hospital of Shihezi University, Shihezi 832000, China
2
School of Medicine, Shihezi University, Shihezi 832000, China
3
School of Pharmacy, Shihezi University, Shihezi 832003, China
4
Key Laboratory of Xinjiang Phytomedicine Resources and Utilization, Ministry of Education, Shihezi 832003, China
5
Collaborative Innovation Center for Efficient Production and Resource Utilization of Safflower, Institute for Safflower Industry Research of Shihezi University, Shihezi 832003, China
*
Authors to whom correspondence should be addressed.
Int. J. Mol. Sci. 2026, 27(11), 4839; https://doi.org/10.3390/ijms27114839
Submission received: 8 April 2026 / Revised: 5 May 2026 / Accepted: 9 May 2026 / Published: 27 May 2026
(This article belongs to the Special Issue Immune-Liver Axis—from Disease Pathogenesis to Therapeutic Target)

Abstract

Hepatic ischemia–reperfusion injury (HIRI) is an unavoidable clinical challenge in liver transplantation, major hepatectomy and trauma resuscitation, with no approved specific therapeutics to date. As core innate immune effector cells, neutrophils are the central driver of the sterile inflammatory cascade in HIRI. Centered on the Mac-1-Syk core regulatory axis, this review systematically elaborates the neutrophil recruitment cascade and intracellular signaling network in HIRI, focuses on the sequential formation pathways of neutrophil extracellular traps (NETs) and their multi-dimensional injury mechanisms, and dissects the inflammation–thrombosis amplification crosstalk between neutrophils and multiple hepatic non-parenchymal cells. Furthermore, this review clarifies research controversies of core therapeutic targets, analyzes key translational bottlenecks, and proposes a NETs-centered sequential multi-target combination strategy, providing a solid theoretical basis and clear translational direction for the precise targeted therapy of HIRI.
Keywords: hepatic ischemia–reperfusion injury (HIRI); neutrophils; neutrophil extracellular traps (NETs); sterile inflammation; targeted therapy hepatic ischemia–reperfusion injury (HIRI); neutrophils; neutrophil extracellular traps (NETs); sterile inflammation; targeted therapy

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MDPI and ACS Style

Xu, F.; Wang, M.; Wang, B.; Yang, J.; Qian, X. Neutrophils and Neutrophil Extracellular Traps in Hepatic Ischemia–Reperfusion Injury: Molecular Mechanisms and Therapeutic Strategies. Int. J. Mol. Sci. 2026, 27, 4839. https://doi.org/10.3390/ijms27114839

AMA Style

Xu F, Wang M, Wang B, Yang J, Qian X. Neutrophils and Neutrophil Extracellular Traps in Hepatic Ischemia–Reperfusion Injury: Molecular Mechanisms and Therapeutic Strategies. International Journal of Molecular Sciences. 2026; 27(11):4839. https://doi.org/10.3390/ijms27114839

Chicago/Turabian Style

Xu, Furong, Meiyan Wang, Bingxin Wang, Jian Yang, and Xiaoqing Qian. 2026. "Neutrophils and Neutrophil Extracellular Traps in Hepatic Ischemia–Reperfusion Injury: Molecular Mechanisms and Therapeutic Strategies" International Journal of Molecular Sciences 27, no. 11: 4839. https://doi.org/10.3390/ijms27114839

APA Style

Xu, F., Wang, M., Wang, B., Yang, J., & Qian, X. (2026). Neutrophils and Neutrophil Extracellular Traps in Hepatic Ischemia–Reperfusion Injury: Molecular Mechanisms and Therapeutic Strategies. International Journal of Molecular Sciences, 27(11), 4839. https://doi.org/10.3390/ijms27114839

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