Low density granulocytes (LDGs) are a poorly understood class of immune cells found in patients with chronic inflammatory diseases including psoriasis and systemic lupus erythematosus (SLE). Research completed at the National Institutes of Health (NIH) revealed that in the context of SLE, LDGs release higher levels of type 1 interferons, undergo increased NETosis, and accordingly drive inflammation. Meanwhile, advances in mechanical phenotyping at the University of Cambridge have driven hypotheses of neutrophil trafficking and immune function being intimately linked to cellular biomechanical properties (e.g. density, stiffness, morphology). This thesis analyses the intersection of immune cellular biomechanical phenotypes and their function. Specifically, it focuses on the role of neutrophils and LDGs in inflammatory diseases.

In this thesis, real-time deformability cytometry (RT-DC) was optimised as a high-throughput mechanical phenotyping technique for the analysis of neutrophils. This enabled development of a protocol to recover purified neutrophils to their whole blood mechanical phenotype. Neutrophil biomechanical properties were analysed by RT-DC, lattice light-sheet microscopy, confocal microscopy and scanning electron microscopy. Neutrophil immunologic functions (e.g. NETosis, macropinocytosis) were imaged using florescence microscopy. To analyse the contribution of biomechanical properties to neutrophil trafficking, a novel microfluidic microvasculature mimetic was developed. An endothelial flow assay was used to image neutrophils interacting with endothelial cells. Finally, the complete proteomes and phosphoproteomes of LDGs and normal dense neutrophils (NDNs) were obtained from five healthy donors and five SLE patients.

Several key insights were gained. Firstly, hypotonic lysis and magnetic column-based isolation techniques are damaging to neutrophil biomechanical properties, but purification of neutrophils retaining their biomechanical properties can be achieved by using gradients and column-free magnetic systems followed by recovery at 37 degrees Celsius. Secondly, the biphasic biomechanical kinetics of neutrophil priming were described; cells contract briefly before immediately expanding. The expansion phase was determined to be macropinocytosis dependent. Thirdly, SLE LDGs are phenotypically rougher than autologous SLE NDNs or healthy LDGs. This appears to impact their microvasculature trafficking abilities, as SLE LDGs were increasingly trapped in the narrow channels of a three- dimensional microvasculature mimetic. These results suggest a role for biomechanical properties in modulation of neutrophil trafficking, indicating that SLE LDGs may be increasingly retained in microvasculature networks, similar to what has been described for primed neutrophils. Finally, unbiased proteomics quantified 4109 proteins and 875 phosphoproteins in four neutrophil subsets (healthy unstimulated NDNs, healthy primed NDNs, SLE NDNs, and SLE LDG). This shed new light into neutrophil heterogeneity at the protein level and to my knowledge, is the first proteomic profile of the SLE LDG. In addition to findings pertaining to SLE LDG biology and function, differential phosphorylation of proteins associated with cytoskeletal organisation were identified in SLE LDGs relative to SLE NDNs, suggesting a phosphoproteomic explanation for the SLE LDGs’ distinct biomechanical phenotype. When taken together, this work could have important pathogenic implications in the context of SLE manifestations in various organs and the development of small vessel vasculopathy.