Which statement best describes the relationship between neutrophil extracellular traps and ADDE?

• A. They always prevent inflammation
• B. They can clog the meibomian glands
• C. They occur only in humans
• D. They are not documented

Answer: (B)

Neutrophil extracellular traps are webs of DNA and antimicrobial proteins released by neutrophils. In the eye, these NETs can accumulate on the eyelid margins and within the meibomian glands. When NETs lodge in the ducts, they can physically obstruct the orifices of the meibomian glands, leading to meibomian gland dysfunction. This disruption reduces the regular lipid secretion that stabilizes the tear film, promotes tear evaporation, and contributes to dry-eye symptoms. In the setting of aqueous-deficient dry eye, where tear production is already compromised, any additional instability or obstruction of the tear film from gland blockage can worsen the condition, making the relationship between NETs and ADDE biologically plausible. NETs are not exclusive to humans, and they do not inherently prevent inflammation; they have been documented across species and can drive inflammatory processes, so the idea that they are not documented or that they always prevent inflammation would be incorrect.