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Moore KM, Foster SL, Kar M, Floyd KA, Elrod EJ, Williams ME, Velden JV, Ellis M, Malik A, Wali B, Lapp S, Metz A, Bosinger SE, Menachery VD, Seder RA, Amara RR, Kohlmeier JE, Grakoui A, Suthar MS. Eosinophils protect against SARS-CoV-2 following a vaccine breakthrough infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.08.607190. [PMID: 39211190 PMCID: PMC11361157 DOI: 10.1101/2024.08.08.607190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Waning immunity and the emergence of immune evasive SARS-CoV-2 variants jeopardize vaccine efficacy leading to breakthrough infections. We have previously shown that innate immune cells play a critical role in controlling SARS-CoV-2. To investigate the innate immune response during breakthrough infections, we modeled breakthrough infections by challenging low-dose vaccinated mice with a vaccine-mismatched SARS-CoV-2 Beta variant. We found that low-dose vaccinated infected mice had a 2-log reduction in lung viral burden, but increased immune cell infiltration in the lung parenchyma, characterized by monocytes, monocyte-derived macrophages, and eosinophils. Single cell RNA-seq revealed viral RNA was highly associated with eosinophils that corresponded to a unique IFN-γ biased signature. Antibody-mediated depletion of eosinophils in vaccinated mice resulted in increased virus replication and dissemination in the lungs, demonstrating that eosinophils in the lungs are protective during SARS-CoV-2 breakthrough infections. These results highlight the critical role for the innate immune response in vaccine mediated protection against SARS-CoV-2.
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Tong S, Scott JC, Eyoh E, Werthmann DW, Stone AE, Murrell AE, Sabino-Santos G, Trinh IV, Chandra S, Elliott DH, Smira AR, Velazquez JV, Schieffelin J, Ning B, Hu T, Kolls JK, Landry SJ, Zwezdaryk KJ, Robinson JE, Gunn BM, Rabito FA, Norton EB. Altered COVID-19 immunity in children with asthma by atopic status. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100236. [PMID: 38590754 PMCID: PMC11000189 DOI: 10.1016/j.jacig.2024.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/13/2023] [Accepted: 01/03/2024] [Indexed: 04/10/2024]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes a spectrum of clinical outcomes that may be complicated by severe asthma. Antiviral immunity is often compromised in patients with asthma; however, whether this is true for SARS-CoV-2 immunity and children is unknown. Objective We aimed to evaluate SARS-CoV-2 immunity in children with asthma on the basis of infection or vaccination history and compared to respiratory syncytial viral or allergen (eg, cockroach, dust mite)-specific immunity. Methods Fifty-three children from an urban asthma study were evaluated for medical history, lung function, and virus- or allergen-specific immunity using antibody or T-cell assays. Results Polyclonal antibody responses to spike were observed in most children from infection and/or vaccination history. Children with atopic asthma or high allergen-specific IgE, particularly to dust mites, exhibited reduced seroconversion, antibody magnitude, and SARS-CoV-2 virus neutralization after SARS-CoV-2 infection or vaccination. TH1 responses to SARS-CoV-2 and respiratory syncytial virus correlated with antigen-respective IgG. Cockroach-specific T-cell activation as well as IL-17A and IL-21 cytokines negatively correlated with SARS-CoV-2 antibodies and effector functions, distinct from total and dust mite IgE. Allergen-specific IgE and lack of vaccination were associated with recent health care utilization. Reduced lung function (forced expiratory volume in 1 second ≤ 80%) was independently associated with (SARS-CoV-2) peptide-induced cytokines, including IL-31, whereas poor asthma control was associated with cockroach-specific cytokine responses. Conclusion Mechanisms underpinning atopic and nonatopic asthma may complicate the development of memory to SARS-CoV-2 infection or vaccination and lead to a higher risk of repeated infection in these children.
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Affiliation(s)
- Sherry Tong
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Jordan C. Scott
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Enwono Eyoh
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Derek W. Werthmann
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, La
| | - Addison E. Stone
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Amelie E. Murrell
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Gilberto Sabino-Santos
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Ivy V. Trinh
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - Sruti Chandra
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, La
| | - Debra H. Elliott
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, La
| | - Ashley R. Smira
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, La
| | - Jalene V. Velazquez
- Paul G. Allen School of Global Health, Washington State University, Pullman, Wash
| | - John Schieffelin
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, La
| | - Bo Ning
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, La
- Department of Biochemistry & Molecular Biology, Tulane University School of Medicine, New Orleans, La
| | - Tony Hu
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, La
- Department of Biochemistry & Molecular Biology, Tulane University School of Medicine, New Orleans, La
| | - Jay K. Kolls
- Department of Medicine, Tulane University School of Medicine, New Orleans, La
| | - Samuel J. Landry
- Department of Biochemistry & Molecular Biology, Tulane University School of Medicine, New Orleans, La
| | - Kevin J. Zwezdaryk
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
| | - James E. Robinson
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, La
| | - Bronwyn M. Gunn
- Paul G. Allen School of Global Health, Washington State University, Pullman, Wash
| | - Felicia A. Rabito
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, La
| | - Elizabeth B. Norton
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, La
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Cvietusa PJ, Goodrich GK, Steiner JF, Shoup JA, King DK, Ritzwoller DP, Shetterly SM, Bender BG. Transition to Virtual Asthma Care During the COVID-19 Pandemic: An Observational Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:1569-1576. [PMID: 35263682 PMCID: PMC8898589 DOI: 10.1016/j.jaip.2022.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic increased reliance on virtual care for patients with persistent asthma. OBJECTIVE This retrospective cohort study assessed changes from in-person to virtual care during the pandemic. In patients with persistent asthma, compared with the same period before the pandemic. METHODS Kaiser Permanente Colorado members aged 18 to 99 years with persistent asthma were evaluated during two periods (March to October 2019 and March to October 2020). Comparison of asthma exacerbations (hospitalizations, emergency department visits, and courses of oral prednisone) and asthma medication metrics were evaluated between the two periods and by type of care received during the pandemic (no care, virtual care only, in-person care only, or a mix of virtual and in-person care). Population characteristics by type of care received during the pandemic were also evaluated. RESULTS Among 7,805 adults with persistent asthma, those who used more virtual care or sought no care during the pandemic were younger and had fewer comorbidities, mental health diagnoses, or financial barriers. Exacerbations decreased (0.264 to 0.214; P <.001) as did courses of prednisone (0.213 to 0.169). Asthma medication adherence (0.53 to 0.54; P <.001) and the asthma medication ratio, a quality-of-care metric (0.755 to 0.762; P = .019), increased slightly. Patients receiving a mix of in-person and virtual care had the highest rate of exacerbations (0.83) and a lower asthma medication ratio (0.74) despite having the highest adherence (.57). CONCLUSIONS Despite an increase in virtual care, asthma exacerbations decreased except among individuals who received both in-person and virtual care, likely because they had more severe disease.
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Affiliation(s)
- Peter J. Cvietusa
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colo,Department of Asthma, Allergy, and Immunology, Permanente Medical Group, Denver, Colo,Corresponding author: Peter J. Cvietusa, MD, Department of Asthma, Allergy, and Immunology, Colorado Permanente Medical Group, Kaiser Permanente Colorado, 10400 East Alameda Ave, Denver, Colo 80247
| | - Glenn K. Goodrich
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colo
| | - John F. Steiner
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colo
| | - Jo Ann Shoup
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colo
| | - Diane K. King
- Center for Behavioral Health Research and Services, Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, Alaska
| | | | | | - Bruce G. Bender
- Division of Pediatric Behavioral Health, National Jewish Health, Denver, Colo
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Feng X, Lawrence MG, Payne SC, Mattos J, Etter E, Negri JA, Murphy D, Kennedy JL, Steinke JW, Borish L. Lower viral loads in subjects with rhinovirus-challenged allergy despite reduced innate immunity. Ann Allergy Asthma Immunol 2022; 128:414-422.e2. [PMID: 35031416 PMCID: PMC10666001 DOI: 10.1016/j.anai.2022.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/04/2021] [Accepted: 01/05/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Viral infections, especially those caused by rhinovirus, are the most common cause of asthma exacerbations. Previous studies have argued that impaired innate antiviral immunity and, as a consequence, more severe infections contribute to these exacerbations. OBJECTIVE These studies explored the innate immune response in the upper airway of volunteers with allergic rhinitis and asthma in comparison to healthy controls and interrogated how these differences corresponded to severity of infection. METHODS Volunteers with allergic rhinitis, those with asthma, and those who are healthy were inoculated with rhinovirus A16 and monitored for clinical symptoms. Tissue and nasal wash samples were evaluated for antiviral signature and viral load. RESULTS Both subjects with allergic rhinitis and asthma were found to have more severe cold symptoms. Subjects with asthma had worsened asthma control and increased bronchial hyperreactivity in the setting of higher fractional exhaled breath nitric oxide and blood eosinophils. These studies confirmed reduced expression of interferons and virus-specific pattern recognition receptors in both cohorts with atopy. Nevertheless, despite this defect in innate immunity, volunteers with allergic rhinitis/asthma had reduced rhinovirus concentrations in comparison to the controls. CONCLUSION These results confirm that the presence of an allergic inflammatory disorder of the airway is associated with reduced innate immune responsive to rhinovirus infection. Despite this, these volunteers with allergy have reduced viral loads, arguing for the presence of a compensatory mechanism to clear the infection. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02910401.
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Affiliation(s)
- Xin Feng
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, Shandong, People's Republic of China
| | - Monica G Lawrence
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia
| | - Spencer C Payne
- Department of Otolaryngology, University of Virginia Health System, Charlottesville, Virginia
| | - Jose Mattos
- Department of Otolaryngology, University of Virginia Health System, Charlottesville, Virginia
| | - Elaine Etter
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Julie A Negri
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Deborah Murphy
- Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia
| | - Joshua L Kennedy
- Department of Pediatrics and Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas
| | - John W Steinke
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Larry Borish
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; Department of Microbiology, University of Virginia Health System, Charlottesville, Virginia.
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