201
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Soo AKS, Inwald DP. Pulmonary hemorrhage as a complication of Respiratory Syncyntial Virus (RSV) bronchiolitis. Pediatr Pulmonol 2017; 52:E32-E36. [PMID: 28029754 DOI: 10.1002/ppul.23637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 09/19/2016] [Accepted: 10/25/2016] [Indexed: 11/12/2022]
Abstract
Respiratory Syncytial Virus (RSV) is a common cause of bronchiolitis. Although there are a number of recognized complications, pulmonary hemorrhage has not been reported previously. A retrospective case notes review was performed through an electronic search of a Pediatric Intensive Care Unit's medical records. Seven patients with RSV infection and pulmonary hemorrhage were identified and included in this case series. Six of the seven patients were born prematurely (30-36 weeks gestation). All patients required blood transfusion. The pulmonary hemorrhage events all occurred after a period of mechanical ventilation and following extubation. All of the patients required reintubation with a mean of 5 further days of mechanical ventilation. Pulmonary hemorrhage is an uncommon complication of RSV infection, which has not been reported previously in the literature. Further studies are required to determine incidence, pathogenesis, and outcome. Pediatr Pulmonol. 2017;52:E32-E36. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Audrey K S Soo
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - David P Inwald
- Imperial College Healthcare NHS Trust, London, United Kingdom
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202
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Tchilian E, Holzer B. Harnessing Local Immunity for an Effective Universal Swine Influenza Vaccine. Viruses 2017; 9:v9050098. [PMID: 28475122 PMCID: PMC5454411 DOI: 10.3390/v9050098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 02/06/2023] Open
Abstract
Influenza A virus infections are a global health threat to humans and are endemic in pigs, contributing to decreased weight gain and suboptimal reproductive performance. Pigs are also a source of new viruses of mixed swine, avian, and human origin, potentially capable of initiating human pandemics. Current inactivated vaccines induce neutralising antibody against the immunising strain but rapid escape occurs through antigenic drift of the surface glycoproteins. However, it is known that prior infection provides a degree of cross-protective immunity mediated by cellular immune mechanisms directed at the more conserved internal viral proteins. Here we review new data that emphasises the importance of local immunity in cross-protection and the role of the recently defined tissue-resident memory T cells, as well as locally-produced, and sometimes cross-reactive, antibody. Optimal induction of local immunity may require aerosol delivery of live vaccines, but it remains unclear how long protective local immunity persists. Nevertheless, a universal vaccine might be extremely useful for disease prevention in the face of a pandemic. As a natural host for influenza A viruses, pigs are both a target for a universal vaccine and an excellent model for developing human influenza vaccines.
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Affiliation(s)
- Elma Tchilian
- The Pirbright Institute, Woking, Surrey GU24 0NF, UK.
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203
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Openshaw PJ, Chiu C, Culley FJ, Johansson C. Protective and Harmful Immunity to RSV Infection. Annu Rev Immunol 2017; 35:501-532. [DOI: 10.1146/annurev-immunol-051116-052206] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Peter J.M. Openshaw
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
| | - Chris Chiu
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
| | - Fiona J. Culley
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
| | - Cecilia Johansson
- Respiratory Infections, National Heart and Lung Institute, Imperial College London, London W2 1PG, United Kingdom
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204
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Russell CD, Unger SA, Walton M, Schwarze J. The Human Immune Response to Respiratory Syncytial Virus Infection. Clin Microbiol Rev 2017; 30:481-502. [PMID: 28179378 PMCID: PMC5355638 DOI: 10.1128/cmr.00090-16] [Citation(s) in RCA: 230] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Respiratory syncytial virus (RSV) is an important etiological agent of respiratory infections, particularly in children. Much information regarding the immune response to RSV comes from animal models and in vitro studies. Here, we provide a comprehensive description of the human immune response to RSV infection, based on a systematic literature review of research on infected humans. There is an initial strong neutrophil response to RSV infection in humans, which is positively correlated with disease severity and mediated by interleukin-8 (IL-8). Dendritic cells migrate to the lungs as the primary antigen-presenting cell. An initial systemic T-cell lymphopenia is followed by a pulmonary CD8+ T-cell response, mediating viral clearance. Humoral immunity to reinfection is incomplete, but RSV IgG and IgA are protective. B-cell-stimulating factors derived from airway epithelium play a major role in protective antibody generation. Gamma interferon (IFN-γ) has a strongly protective role, and a Th2-biased response may be deleterious. Other cytokines (particularly IL-17A), chemokines (particularly CCL-5 and CCL-3), and local innate immune factors (including cathelicidins and IFN-λ) contribute to pathogenesis. In summary, neutrophilic inflammation is incriminated as a harmful response, whereas CD8+ T cells and IFN-γ have protective roles. These may represent important therapeutic targets to modulate the immunopathogenesis of RSV infection.
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Affiliation(s)
- Clark D Russell
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Stefan A Unger
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - Marc Walton
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Jürgen Schwarze
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
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205
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Lung Homeostasis: Influence of Age, Microbes, and the Immune System. Immunity 2017; 46:549-561. [DOI: 10.1016/j.immuni.2017.04.005] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/24/2022]
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206
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Brown PM, Harford TJ, Agrawal V, Yen-Lieberman B, Rezaee F, Piedimonte G. Prenatal Exposure to Respiratory Syncytial Virus Alters Postnatal Immunity and Airway Smooth Muscle Contractility during Early-Life Reinfections. PLoS One 2017; 12:e0168786. [PMID: 28178290 PMCID: PMC5298216 DOI: 10.1371/journal.pone.0168786] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/06/2016] [Indexed: 12/27/2022] Open
Abstract
Maternal viral infections can have pathological effects on the developing fetus which last long after birth. Recently, maternal-fetal transmission of respiratory syncytial virus (RSV) was shown to cause postnatal airway hyperreactivity (AHR) during primary early-life reinfection; however, the influence of prenatal exposure to RSV on offspring airway immunity and smooth muscle contractility during recurrent postnatal reinfections remains unknown. Therefore, we sought to determine whether maternal RSV infection impairs specific aspects of cell-mediated offspring immunity during early-life reinfections and the mechanisms leading to AHR. Red fluorescent protein-expressing recombinant RSV (rrRSV) was inoculated into pregnant rat dams at midterm, followed by primary and secondary postnatal rrRSV inoculations of their offspring at early-life time points. Pups and weanlings were tested for specific lower airway leukocyte populations by flow cytometry; serum cytokine/chemokine concentrations by multiplex ELISA and neurotrophins concentrations by standard ELISA; and ex vivo lower airway smooth muscle (ASM) contraction by physiological tissue bath. Pups born to RSV-infected mothers displayed elevated total CD3+ T cells largely lacking CD4+ and CD8+ surface expression after both primary and secondary postnatal rrRSV infection. Cytokine/chemokine analyses revealed reduced IFN-γ, IL-2, IL-12, IL-17A, IL-18, and TNF-α, as well as elevated nerve growth factor (NGF) expression. Prenatal exposure to RSV also increased ASM reactivity and contractility during early-life rrRSV infection compared to non-exposed controls. We conclude that maternal RSV infection can predispose offspring to postnatal lower airways dysfunction by altering immunity development, NGF signaling, and ASM contraction during early-life RSV reinfections.
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Affiliation(s)
- Paul M. Brown
- Center for Pediatric Research, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Pediatric Institute and Children’s Hospital, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
| | - Terri J. Harford
- Center for Pediatric Research, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Pediatric Institute and Children’s Hospital, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
| | - Vandana Agrawal
- Center for Pediatric Research, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Pediatric Institute and Children’s Hospital, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
| | - Belinda Yen-Lieberman
- Center for Pediatric Research, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Pediatric Institute and Children’s Hospital, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
| | - Fariba Rezaee
- Center for Pediatric Research, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Pediatric Institute and Children’s Hospital, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
| | - Giovanni Piedimonte
- Center for Pediatric Research, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Pediatric Institute and Children’s Hospital, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
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207
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Abstract
Respiratory syncytial virus (RSV) is a common cause of upper respiratory tract infection in children and adults. However, infection with this virus sometimes leads to severe lower respiratory disease and is the major cause of infant hospitalisations in the developed world. Several risk factors such as baby prematurity and congenital heart disease are known to predispose towards severe disease but previously healthy, full-term infants can also develop bronchiolitis and viral pneumonia during RSV infection. The causes of severe disease are not fully understood but may include dysregulation of the immune response to the virus, resulting in excessive recruitment and activation of innate and adaptive immune cells that can cause damage. This review highlights recent discoveries on the balancing act of immune-mediated virus clearance versus immunopathology during RSV infection.
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Affiliation(s)
- Cecilia Johansson
- Respiratory Infections Section, St Mary's campus, National Heart and Lung Institute, Imperial College London, London, W2 1PG, UK
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208
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Abstract
Pneumonia is of great global public health importance. Viral infections play both direct and indirect parts in its cause across the globe. Influenza is a leading cause of viral pneumonia in both children and adults, and respiratory syncytial virus is increasingly recognized as causing disease at both extremes of age. Vaccination offers the best prospect for prevention but current influenza vaccines do not provide universal and durable protection, and require yearly reformulation. In the future, it is hoped that influenza vaccines will give better and universal protection, and that new vaccines can be found for other causes of viral pneumonia.
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Affiliation(s)
- Clementine S Fraser
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Akhilesh Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Peter J M Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK.
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209
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Rosato PC, Beura LK, Masopust D. Tissue resident memory T cells and viral immunity. Curr Opin Virol 2016; 22:44-50. [PMID: 27987416 DOI: 10.1016/j.coviro.2016.11.011] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/23/2016] [Indexed: 11/17/2022]
Abstract
Tissue resident memory T cells (TRM) constitute a recently identified T cell lineage that is responsible for frontline defense against viral infections. In contrast to central and effector memory T cells, which constitutively recirculate between tissues and blood, TRM reside permanently within tissues. As the main surveyors of non-lymphoid tissues, TRM are positioned to rapidly respond upon reinfection at barrier sites. During a viral reinfection, TRM trigger the local tissue environment to activate and recruit immune cells and establish an antiviral state. Consistent with this function, there is empirical evidence that TRM accelerate control in the event of reinfection or possible reactivation of latent infections in solid organs and barrier tissues. Here we review recent literature highlighting the protective functions of TRM in multiple viral challenge models and contextualize the implications of these findings for vaccine development.
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Affiliation(s)
- Pamela C Rosato
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455, United States; Center for Immunology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Lalit K Beura
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455, United States; Center for Immunology, University of Minnesota, Minneapolis, MN 55455, United States
| | - David Masopust
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455, United States; Center for Immunology, University of Minnesota, Minneapolis, MN 55455, United States.
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210
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González AE, Lay MK, Jara EL, Espinoza JA, Gómez RS, Soto J, Rivera CA, Abarca K, Bueno SM, Riedel CA, Kalergis AM. Aberrant T cell immunity triggered by human Respiratory Syncytial Virus and human Metapneumovirus infection. Virulence 2016; 8:685-704. [PMID: 27911218 DOI: 10.1080/21505594.2016.1265725] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Human Respiratory syncytial virus (hRSV) and human metapneumovirus (hMPV) are the two major etiological viral agents of lower respiratory tract diseases, affecting mainly infants, young children and the elderly. Although the infection of both viruses trigger an antiviral immune response that mediate viral clearance and disease resolution in immunocompetent individuals, the promotion of long-term immunity appears to be deficient and reinfection are common throughout life. A possible explanation for this phenomenon is that hRSV and hMPV, can induce aberrant T cell responses, which leads to exacerbated lung inflammation and poor T and B cell memory immunity. The modulation of immune response exerted by both viruses include different strategies such as, impairment of immunological synapse mediated by viral proteins or soluble factors, and the induction of pro-inflammatory cytokines by epithelial cells, among others. All these viral strategies contribute to the alteration of the adaptive immunity in order to increase the susceptibility to reinfections. In this review, we discuss current research related to the mechanisms underlying the impairment of T and B cell immune responses induced by hRSV and hMPV infection. In addition, we described the role each virulence factor involved in immune modulation caused by these viruses.
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Affiliation(s)
- Andrea E González
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Margarita K Lay
- b Departamento de Biotecnología , Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta , Antofagasta , Chile
| | - Evelyn L Jara
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Janyra A Espinoza
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Roberto S Gómez
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Jorge Soto
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Claudia A Rivera
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Katia Abarca
- c Departamento de Pediatría , Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Susan M Bueno
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile.,d INSERM UMR1064 , Nantes , France
| | - Claudia A Riedel
- e Millennium Institute of Immunology and Immunotherapy , Departamento de Ciencias Biológicas , Facultad de Ciencias Biológicas y Facultad de Medicina, Universidad Andrés Bello , Santiago , Chile
| | - Alexis M Kalergis
- a Millennium Institute of Immunology and Immunotherapy , Departamento de Genética Molecular y Microbiología , Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile.,c Departamento de Pediatría , Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago , Chile.,f Millennium Institute of Immunology and Immunotherapy , Departamento de Endocrinología , Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago , Chile
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211
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Vitelli A, Nicosia A. Virus vs. virus: adenovirus vectored vaccine to defeat respiratory syncytial virus. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:489. [PMID: 28149851 PMCID: PMC5233505 DOI: 10.21037/atm.2016.12.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
| | - Alfredo Nicosia
- ReiThera Srl, Rome, Italy
- CEINGE, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy
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212
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Adnan S, Reeves RK, Gillis J, Wong FE, Yu Y, Camp JV, Li Q, Connole M, Li Y, Piatak M, Lifson JD, Li W, Keele BF, Kozlowski PA, Desrosiers RC, Haase AT, Johnson RP. Persistent Low-Level Replication of SIVΔnef Drives Maturation of Antibody and CD8 T Cell Responses to Induce Protective Immunity against Vaginal SIV Infection. PLoS Pathog 2016; 12:e1006104. [PMID: 27959961 PMCID: PMC5189958 DOI: 10.1371/journal.ppat.1006104] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 12/27/2016] [Accepted: 11/30/2016] [Indexed: 12/31/2022] Open
Abstract
Defining the correlates of immune protection conferred by SIVΔnef, the most effective vaccine against SIV challenge, could enable the design of a protective vaccine against HIV infection. Here we provide a comprehensive assessment of immune responses that protect against SIV infection through detailed analyses of cellular and humoral immune responses in the blood and tissues of rhesus macaques vaccinated with SIVΔnef and then vaginally challenged with wild-type SIV. Despite the presence of robust cellular immune responses, animals at 5 weeks after vaccination displayed only transient viral suppression of challenge virus, whereas all macaques challenged at weeks 20 and 40 post-SIVΔnef vaccination were protected, as defined by either apparent sterile protection or significant suppression of viremia in infected animals. Multiple parameters of CD8 T cell function temporally correlated with maturation of protection, including polyfunctionality, phenotypic differentiation, and redistribution to gut and lymphoid tissues. Importantly, we also demonstrate the induction of a tissue-resident memory population of SIV-specific CD8 T cells in the vaginal mucosa, which was dependent on ongoing low-level antigenic stimulation. Moreover, we show that vaginal and serum antibody titers inversely correlated with post-challenge peak viral load, and we correlate the accumulation and affinity maturation of the antibody response to the duration of the vaccination period as well as to the SIVΔnef antigenic load. In conclusion, maturation of SIVΔnef-induced CD8 T cell and antibody responses, both propelled by viral persistence in the gut mucosa and secondary lymphoid tissues, results in protective immune responses that are able to interrupt viral transmission at mucosal portals of entry as well as potential sites of viral dissemination.
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Affiliation(s)
- Sama Adnan
- Yerkes National Primate Research Center, Emory University, Atlanta GA, United States of America
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
| | - R. Keith Reeves
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Jacqueline Gillis
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
| | - Fay E. Wong
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
| | - Yi Yu
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
| | - Jeremy V. Camp
- Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Qingsheng Li
- Nebraska Center for Virology and School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, United States of America
| | - Michelle Connole
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
| | - Yuan Li
- AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Michael Piatak
- AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Jeffrey D. Lifson
- AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Wenjun Li
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Brandon F. Keele
- AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Pamela A. Kozlowski
- Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Ronald C. Desrosiers
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Ashley T. Haase
- Department of Microbiology, Medical School, University of Minnesota, MMC 196, 420 Delaware Street S.E., Minneapolis, Minnesota, United States of America
| | - R. Paul Johnson
- Yerkes National Primate Research Center, Emory University, Atlanta GA, United States of America
- New England Primate Research Center, Harvard Medical School, Southborough Campus, Pine Hill Drive, Southborough, MA, United States of America
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, United States of America
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213
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Habibi MS, Chiu C. Controlled human infection with RSV: The opportunities of experimental challenge. Vaccine 2016; 35:489-495. [PMID: 27889256 DOI: 10.1016/j.vaccine.2016.08.086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 08/24/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
Abstract
Despite the recent explosion in RSV vaccine development, there remain substantial hurdles to overcome before licensing of effective vaccines will allow widespread use, particularly in high-risk populations. Incomplete understanding of mechanisms and correlates of protection against RSV mean that, for the time being, successful RSV vaccines must directly demonstrate efficacy, which necessitates large and costly clinical trials in naturally infected patients. To mitigate the risks inherent in progressing to these late-stage trials, experimental human RSV infection studies have recently been re-established, representing the interface between pre-clinical models and observational studies of patients. Not only can they be used for early proof-of-concept clinical trials to test vaccine efficacy, but human challenge studies also offer the potential to better understand protective immunity against RSV infection to improve vaccine design and delivery. In the past, controlled human infection studies with RSV have been instrumental in elucidating the influence of factors such as route of infection and type of inoculum on the course of disease. Recently, efficacy trials of novel RSV antiviral drugs have also been successfully undertaken. Now, with advances in technology, detailed investigations of human mucosal immunity in the RSV-infected airway are possible. These have indicated defects in RSV-induced humoral and CD8+ T cell immunity that may contribute to the recurrent symptomatic infection that occurs throughout life and should be circumvented by optimal vaccines. Here, we discuss the insights derived from RSV human challenge models; the major impediments to their more widespread uptake; and their potential benefit in accelerating vaccine development, including future directions to further enhance the relevance of these models to at-risk patient populations.
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Affiliation(s)
| | - Christopher Chiu
- Section of Infectious Diseases & Immunity, Imperial College London, London W12 0NN, UK.
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214
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Seasonal influenza vaccines and hurdles to mutual protection. Clin Microbiol Infect 2016; 22 Suppl 5:S113-S119. [PMID: 27568914 DOI: 10.1016/j.cmi.2016.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/19/2016] [Indexed: 11/22/2022]
Abstract
While vaccines against seasonal influenza are available, major hurdles still exist that prevent their use having any impact on epidemic spread. Recent epidemiologic data question the appropriateness of traditional vaccination timing (prior to the winter season) in many parts of the world. Furthermore, vaccine uptake in most countries even in high-risk populations does not reach the 75% target recommended by the World Health Organization. Influenza viruses continually undergo antigenic variation, and both inactivated and live attenuated influenza vaccines confer only short-lived strain-specific immunity, so annual revaccination is required. Improving vaccine-induced immunity is therefore an important goal. A vaccine that could confer durable protection against emerging influenza strains could significantly reduce onward transmission. Therefore, further understanding of protective immunity against influenza (including broadly cross-protective immune mechanisms such as haemagglutinin stem-binding antibodies and T cells) offers the hope of vaccines that can confer the long-lived heterosubtypic immune responses required for mutual protection.
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215
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Woon HG, Braun A, Li J, Smith C, Edwards J, Sierro F, Feng CG, Khanna R, Elliot M, Bell A, Hislop AD, Tangye SG, Rickinson AB, Gebhardt T, Britton WJ, Palendira U. Compartmentalization of Total and Virus-Specific Tissue-Resident Memory CD8+ T Cells in Human Lymphoid Organs. PLoS Pathog 2016; 12:e1005799. [PMID: 27540722 PMCID: PMC4991796 DOI: 10.1371/journal.ppat.1005799] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 07/08/2016] [Indexed: 12/13/2022] Open
Abstract
Disruption of T cell memory during severe immune suppression results in reactivation of chronic viral infections, such as Epstein Barr virus (EBV) and Cytomegalovirus (CMV). How different subsets of memory T cells contribute to the protective immunity against these viruses remains poorly defined. In this study we examined the compartmentalization of virus-specific, tissue resident memory CD8+ T cells in human lymphoid organs. This revealed two distinct populations of memory CD8+ T cells, that were CD69+CD103+ and CD69+CD103-, and were retained within the spleen and tonsils in the absence of recent T cell stimulation. These two types of memory cells were distinct not only in their phenotype and transcriptional profile, but also in their anatomical localization within tonsils and spleen. The EBV-specific, but not CMV-specific, CD8+ memory T cells preferentially accumulated in the tonsils and acquired a phenotype that ensured their retention at the epithelial sites where EBV replicates. In vitro studies revealed that the cytokine IL-15 can potentiate the retention of circulating effector memory CD8+ T cells by down-regulating the expression of sphingosine-1-phosphate receptor, required for T cell exit from tissues, and its transcriptional activator, Kruppel-like factor 2 (KLF2). Within the tonsils the expression of IL-15 was detected in regions where CD8+ T cells localized, further supporting a role for this cytokine in T cell retention. Together this study provides evidence for the compartmentalization of distinct types of resident memory T cells that could contribute to the long-term protection against persisting viral infections.
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Affiliation(s)
- Heng Giap Woon
- Centenary Institute, The University of Sydney, Newtown, New South Wales, Australia
| | - Asolina Braun
- Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Jane Li
- Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Corey Smith
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Jarem Edwards
- Centenary Institute, The University of Sydney, Newtown, New South Wales, Australia
| | - Frederic Sierro
- Centenary Institute, The University of Sydney, Newtown, New South Wales, Australia
| | - Carl G. Feng
- Centenary Institute, The University of Sydney, Newtown, New South Wales, Australia
- Discipline of Infectious Diseases and Immunology, Sydney Medical School, The University of Sydney, Newtown, New South Wales, Australia
| | - Rajiv Khanna
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Michael Elliot
- Chris O’Brien Lifehouse Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Newtown, New South Wales, Australia
| | - Andrew Bell
- School of Cancer Sciences and MRC Centre for Immune Regulation, University of Birmingham, Edgbaston, United Kingdom
| | - Andrew D. Hislop
- School of Cancer Sciences and MRC Centre for Immune Regulation, University of Birmingham, Edgbaston, United Kingdom
| | - Stuart G. Tangye
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- St Vincent’s Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Alan B. Rickinson
- School of Cancer Sciences and MRC Centre for Immune Regulation, University of Birmingham, Edgbaston, United Kingdom
| | - Thomas Gebhardt
- Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Warwick J. Britton
- Centenary Institute, The University of Sydney, Newtown, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Newtown, New South Wales, Australia
| | - Umaimainthan Palendira
- Centenary Institute, The University of Sydney, Newtown, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Newtown, New South Wales, Australia
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216
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Abstract
Human respiratory syncytial virus (RSV) is the leading cause of severe lower respiratory tract infection, such as bronchiolitis, bronchitis, or pneumonia, in both infants and the elderly. Despite the global burden of diseases attributable to RSV infection, no clinically approved vaccine is available, and a humanized monoclonal antibody for prophylaxis is not readily affordable in developing countries. There are several hurdles to the successful development of RSV vaccines: immune-vulnerable target populations such as premature infants, pregnant women, and immunocompromised people; safety concerns associated with vaccine-enhanced diseases; repeated infection; and waning memory. To develop successful strategies for the prevention of RSV infection, it is necessary to understand the protective and pathologic roles of host immune responses to RSV infection. In this review, we will summarize the positive and negative relationship between RSV infection and host immunity and discuss strategies for the development of the first successful RSV vaccine.
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Affiliation(s)
- Joo Young Kim
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Korea
| | - Jun Chang
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Korea.
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217
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Graham BS. Vaccines against respiratory syncytial virus: The time has finally come. Vaccine 2016; 34:3535-41. [PMID: 27182820 DOI: 10.1016/j.vaccine.2016.04.083] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 04/11/2016] [Accepted: 04/15/2016] [Indexed: 11/27/2022]
Abstract
Respiratory syncytial virus causes a significant public health burden, particularly in very young infants and the frail elderly. The legacy of enhanced RSV disease (ERD) from a whole formalin-inactivated RSV vaccine, and the complex biology of the virus and the neonate have delayed the development of effective vaccines. However, new insights into factors associated with ERD and breakthroughs in understanding the antigenic structure of the fusion (F) glycoprotein have increased optimism that vaccine development is possible. This has led to investment of time and resources by industry, regulatory authorities, governments, and nonprofit organizations to develop the infrastructure needed to make the advanced clinical development of RSV vaccine candidates a reality.
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Affiliation(s)
- Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
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218
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Erratum: RSV-specific airway resident memory CD8+ T cells and differential disease severity after experimental human infection. Nat Commun 2016; 7:11011. [PMID: 26957359 PMCID: PMC4786878 DOI: 10.1038/ncomms11011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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