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Hiller NL, Orihuela CJ. Biological puzzles solved by using Streptococcus pneumoniae: a historical review of the pneumococcal studies that have impacted medicine and shaped molecular bacteriology. J Bacteriol 2024; 206:e0005924. [PMID: 38809015 DOI: 10.1128/jb.00059-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
The major human pathogen Streptococcus pneumoniae has been the subject of intensive clinical and basic scientific study for over 140 years. In multiple instances, these efforts have resulted in major breakthroughs in our understanding of basic biological principles as well as fundamental tenets of bacterial pathogenesis, immunology, vaccinology, and genetics. Discoveries made with S. pneumoniae have led to multiple major public health victories that have saved the lives of millions. Studies on S. pneumoniae continue today, where this bacterium is being used to dissect the impact of the host on disease processes, as a powerful cell biology model, and to better understand the consequence of human actions on commensal bacteria at the population level. Herein we review the major findings, i.e., puzzle pieces, made with S. pneumoniae and how, over the years, they have come together to shape our understanding of this bacterium's biology and the practice of medicine and modern molecular biology.
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Affiliation(s)
- N Luisa Hiller
- Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Carlos J Orihuela
- Department of Microbiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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2
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Ramírez-Sánchez IC, Diaz-Sanabria RA, Alza-Arcila J. Invasive pulmonary aspergillosis following human metapneumovirus infection in solid-organ transplant recipients: Another virus to add to the list. Transpl Infect Dis 2024; 26:e14188. [PMID: 37938791 DOI: 10.1111/tid.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023]
Abstract
There is increasing recognition that respiratory viral infections such as influenza, respiratory syncytial virus, parainfluenza virus, adenovirus, and SARS-CoV-2 can promote the development of invasive fungal pulmonary coinfections, particularly invasive aspergillosis, both in immunocompetent and immunocompromised patients. To date, there are no case reports exploring the role of human metapneumovirus as a risk factor for fungal coinfection. Below, we describe the case of a 63-year-old woman who received a kidney transplant and developed invasive pulmonary aspergillosis after a human metapneumovirus infection and discuss the possible phenomena that could favor this association.
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Affiliation(s)
- Isabel Cristina Ramírez-Sánchez
- Infectious Diseases Section, Internal Medicine Department, Hospital Pablo Tobón Uribe, Medical School, Medellín, Colombia
- Infectious Diseases Section, Internal Medicine Department, Universidad de Antioquia, Medical School, Medellín, Colombia
| | - Ricardo Augusto Diaz-Sanabria
- Infectious Diseases Section, Internal Medicine Department, Universidad de Antioquia, Medical School, Medellín, Colombia
| | - Jhongert Alza-Arcila
- Infectious Diseases Section, Internal Medicine Department, Universidad de Antioquia, Medical School, Medellín, Colombia
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3
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Nadiger M, Sendi P, Martinez PA, Totapally BR. Epidemiology and Clinical Features of Human Metapneumovirus and Respiratory Syncytial Viral Infections in Children. Pediatr Infect Dis J 2023; 42:960-964. [PMID: 37523504 DOI: 10.1097/inf.0000000000004055] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
BACKGROUND Human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) are 2 common causes of acute respiratory tract infections in infants and young children. The objective of this study is to compare the demographics and outcomes of children hospitalized with HMPV and RSV infections in the United States. METHODS We performed a retrospective cohort analysis of children 1 month to less than 3 years old discharged during 2016 with HMPV or RSV infection using the Kids' Inpatient Database. Children with HMPV and RSV coinfection were excluded. Data were weighted for national estimates. RESULTS There were 6585 children with HMPV infection and 70,824 with RSV infection discharged during the study period. The mean age of children with HMPV infection was higher than that of children with RSV infection (0.73 ± 0.8 vs. 0.42 ± 0.7 years; P < 0.05). The mortality rate was significantly higher in children with the presence of any complex chronic conditions compared to those without, in both HMPV [odds ratio (OR): 32.42; CI: 9.931-105.857; P < 0.05] as well as RSV (OR: 35.81; CI: 21.12-57.97; P < 0.05) groups. The adjusted median length of stay was longer (4.64 days; CI: 4.52-4.76 days vs. 3.33 days; CI: 3.31-3.35 days; P < 0.001) and total charges were higher ($44,358; CI: $42,145-$46,570 vs. $22,839; CI: $22,512-$23,166; P < 0.001), with HMPV infection. The mortality rate was similar in HMPV infection compared to RSV infection on multivariable analysis (OR: 1.48; P > 0.05). CONCLUSION In hospitalized children in the United States, HMPV infection is less common than RSV infection. Complex chronic conditions are more prevalent in children hospitalized with HMPV infection. Hospitalization with HMPV is associated with longer length of stay and higher hospital charges. The adjusted mortality is similar with both infections.
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Affiliation(s)
- Meghana Nadiger
- From the Division of Critical Care Medicine, Department of Pediatrics, University of Illinois College of Medicine, Peoria Illinois
| | - Prithvi Sendi
- Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida
- Division of Critical Care Medicine, Department of Pediatrics, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Paul A Martinez
- Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida
- Division of Critical Care Medicine, Department of Pediatrics, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Balagangadhar R Totapally
- Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida
- Division of Critical Care Medicine, Department of Pediatrics, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
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4
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Marandu TF, Dombek M, Gutknecht M, Griessl M, Riça IG, Vlková B, Macáková K, Panagioti E, Griffith A, Lederer J, Yaffe M, Shankar S, Otterbein L, Itagaki K, Hauser CJ, Cook CH. Cytomegalovirus durably primes neutrophil oxidative burst. J Leukoc Biol 2023; 114:459-474. [PMID: 37566762 DOI: 10.1093/jleuko/qiad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 08/13/2023] Open
Abstract
Cytomegalovirus (CMV) is a ubiquitous herpes virus that infects most humans, thereafter persisting lifelong in tissues of the host. It is a known pathogen in immunosuppressed patients, but its impact on immunocompetent hosts remains less understood. Recent data have shown that CMV leaves a significant and long-lasting imprint in host immunity that may confer some protection against subsequent bacterial infection. Such innate immune activation may come at a cost, however, with potential to cause immunopathology. Neutrophils are central to many models of immunopathology, and while acute CMV infection is known to influence neutrophil biology, the impact of chronic CMV infection on neutrophil function remains unreported. Using our murine model of CMV infection and latency, we show that chronic CMV causes persistent enhancement of neutrophil oxidative burst well after resolution of acute infection. Moreover, this in vivo priming of marrow neutrophils is associated with enhanced formyl peptide receptor expression, and ultimately constitutive c-Jun N-terminal kinase phosphorylation and enhanced CD14 expression in/on circulating neutrophils. Finally, we show that neutrophil priming is dependent on viral load, suggesting that naturally infected human hosts will show variability in CMV-related neutrophil priming. Altogether, these findings represent a previously unrecognized and potentially important impact of chronic CMV infection on neutrophil responsiveness in immunocompetent hosts.
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Affiliation(s)
- Thomas F Marandu
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
- Department of Microbiology & Immunology, Mbeya College of Health and Allied Sciences, Hospital Hill Rd, University of Dar es Salaam, Mbeya 53107, Tanzania
| | - Michael Dombek
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Michael Gutknecht
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Marion Griessl
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Ingred Goretti Riça
- Department of Biology and Biological Engineering, and Center for Precision Cancer Medicine, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 500 Main St, Cambridge, MA 02139, United States
| | - Barbora Vlková
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, 4 Sasinkova St, Bratislava 811 08, Slovakia
| | - Kristína Macáková
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, 4 Sasinkova St, Bratislava 811 08, Slovakia
| | - Eleni Panagioti
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Alec Griffith
- Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St., Boston, MA 02215, United States
| | - James Lederer
- Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St., Boston, MA 02215, United States
| | - Michael Yaffe
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
- Department of Biology and Biological Engineering, and Center for Precision Cancer Medicine, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 500 Main St, Cambridge, MA 02139, United States
| | - Sidharth Shankar
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Leo Otterbein
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Kiyoshi Itagaki
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Carl J Hauser
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
| | - Charles H Cook
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Boston, MA 02215, United States
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Loevenich S, Montaldo NP, Wickenhagen A, Sherstova T, van Loon B, Boyartchuk V, Anthonsen MW. Human metapneumovirus driven IFN-β production antagonizes macrophage transcriptional induction of IL1-β in response to bacterial pathogens. Front Immunol 2023; 14:1173605. [PMID: 37435074 PMCID: PMC10330783 DOI: 10.3389/fimmu.2023.1173605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Human metapneumovirus (HMPV) is a pneumovirus that may cause severe respiratory disease in humans. HMPV infection has been found to increase susceptibility to bacterial superinfections leading to increased morbidity and mortality. The molecular mechanisms underlying HMPV-mediated increase in bacterial susceptibility are poorly understood and largely understudied. Type I interferons (IFNs), while critical for antiviral defenses, may often have detrimental effects by skewing the host immune response and cytokine output of immune cells. It is currently unknown if HMPV skews the inflammatory response in human macrophages triggered by bacterial stimuli. Here we report that HMPV pre-infection impacts production of specific cytokines. HMPV strongly suppresses IL-1β transcription in response to LPS or heat-killed Pseudomonas aeruginosa and Streptococcus pneumonia, while enhancing mRNA levels of IL-6, TNF-α and IFN-β. We demonstrate that in human macrophages the HMPV-mediated suppression of IL-1β transcription requires TANK-binding kinase 1 (TBK1) and signaling via the IFN-β-IFNAR axis. Interestingly, our results show that HMPV pre-infection did not impair the LPS-stimulated activation of NF-κB and HIF-1α, transcription factors that stimulate IL-1β mRNA synthesis in human cells. Furthermore, we determined that sequential HMPV-LPS treatment resulted in accumulation of the repressive epigenetic mark H3K27me3 at the IL1B promoter. Thus, for the first time we present data revealing the molecular mechanisms by which HMPV shapes the cytokine output of human macrophages exposed to bacterial pathogens/LPS, which appears to be dependent on epigenetic reprogramming at the IL1B promoter leading to reduced synthesis of IL-1β. These results may improve current understanding of the role of type I IFNs in respiratory disease mediated not only by HMPV, but also by other respiratory viruses that are associated with superinfections.
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Affiliation(s)
- Simon Loevenich
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Biotechnology and Nanomedicine, SINTEF Industry, Trondheim, Norway
| | - Nicola P. Montaldo
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Arthur Wickenhagen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Viroscience, Erasmus Medical Center, Rotterdam, Netherlands
| | - Tatyana Sherstova
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Barbara van Loon
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Victor Boyartchuk
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Surgery, St Olav Hospital HF, Trondheim, Norway
| | - Marit W. Anthonsen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Fang X, Lian H, Bi S, Liu S, Yuan X, Liao C. Roles of pattern recognition receptors in response to fungal keratitis. Life Sci 2022; 307:120881. [PMID: 35963303 DOI: 10.1016/j.lfs.2022.120881] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
Fungal keratitis is one of the leading causes of blindness worldwide, which has become an increasingly serious threat to public ocular health, but no effective treatment strategies are available now. Pattern recognition receptors (PRRs) of the innate immune system are the first line of host defense against fungal infections. They could recognize pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs) and trigger an array of inflammatory responses. Over the last decades, research has resulted in significant progress regarding the roles of PRRs in fungal keratitis. This review will highlight the importance of several pattern recognition receptors (C-type lectin-like receptors, Toll-like receptors, and NOD-like receptors) in regulating the innate immunity under fungal keratitis and describe the crosstalk and collaboration in PRRs contributing to disease pathology. Meanwhile, some potential therapy-based PRRs against corneal fungal infections are discussed.
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Affiliation(s)
- Xiaolong Fang
- The School of Medicine, Nankai University, Tianjin 300071, China; Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin 300020, China; State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Huifang Lian
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China; Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin 300020, China; State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; Department of Ophthalmology, Baoding First Central Hospital, Baoding, Hebei 071000, China
| | - Shihao Bi
- Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong 250062, China
| | - Sijin Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Xiaoyong Yuan
- The School of Medicine, Nankai University, Tianjin 300071, China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China; Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin 300020, China.
| | - Chunyang Liao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
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Debnath N, Kumar A, Yadav AK. Probiotics as a biotherapeutics for the management and prevention of respiratory tract diseases. Microbiol Immunol 2022; 66:277-291. [DOI: 10.1111/1348-0421.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/20/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Nabendu Debnath
- Centre for Molecular Biology Central University of Jammu Samba 181143 Jammu and Kashmir (UT) India
| | - Ashwani Kumar
- Department of Nutrition Biology Central University of Haryana, Mahendergarh Jant‐Pali 123031 Haryana India
| | - Ashok Kumar Yadav
- Centre for Molecular Biology Central University of Jammu Samba 181143 Jammu and Kashmir (UT) India
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8
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Burstein R, Althouse BM, Adler A, Akullian A, Brandstetter E, Cho S, Emanuels A, Fay K, Gamboa L, Han P, Huden K, Ilcisin M, Izzo M, Jackson ML, Kim AE, Kimball L, Lacombe K, Lee J, Logue JK, Rogers J, Chung E, Sibley TR, Van Raay K, Wenger E, Wolf CR, Boeckh M, Chu H, Duchin J, Rieder M, Shendure J, Starita LM, Viboud C, Bedford T, Englund JA, Famulare M. Interactions among 17 respiratory pathogens: a cross-sectional study using clinical and community surveillance data. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.02.04.22270474. [PMID: 35169816 PMCID: PMC8845514 DOI: 10.1101/2022.02.04.22270474] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Co-circulating respiratory pathogens can interfere with or promote each other, leading to important effects on disease epidemiology. Estimating the magnitude of pathogen-pathogen interactions from clinical specimens is challenging because sampling from symptomatic individuals can create biased estimates. Methods We conducted an observational, cross-sectional study using samples collected by the Seattle Flu Study between 11 November 2018 and 20 August 2021. Samples that tested positive via RT-qPCR for at least one of 17 potential respiratory pathogens were included in this study. Semi-quantitative cycle threshold (Ct) values were used to measure pathogen load. Differences in pathogen load between monoinfected and coinfected samples were assessed using linear regression adjusting for age, season, and recruitment channel. Results 21,686 samples were positive for at least one potential pathogen. Most prevalent were rhinovirus (33·5%), Streptococcus pneumoniae (SPn, 29·0%), SARS-CoV-2 (13.8%) and influenza A/H1N1 (9·6%). 140 potential pathogen pairs were included for analysis, and 56 (40%) pairs yielded significant Ct differences (p < 0.01) between monoinfected and co-infected samples. We observed no virus-virus pairs showing evidence of significant facilitating interactions, and found significant viral load decrease among 37 of 108 (34%) assessed pairs. Samples positive with SPn and a virus were consistently associated with increased SPn load. Conclusions Viral load data can be used to overcome sampling bias in studies of pathogen-pathogen interactions. When applied to respiratory pathogens, we found evidence of viral-SPn facilitation and several examples of viral-viral interference. Multipathogen surveillance is a cost-efficient data collection approach, with added clinical and epidemiological informational value over single-pathogen testing, but requires careful analysis to mitigate selection bias.
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Affiliation(s)
- Roy Burstein
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
| | - Benjamin M. Althouse
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
- Department of Biology, New Mexico State University, Las Cruces, NM
| | - Amanda Adler
- Seattle Children’s Research Institute, Seattle WA USA
| | - Adam Akullian
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
| | | | - Shari Cho
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
| | - Anne Emanuels
- Department of Medicine, University of Washington, Seattle WA USA
| | - Kairsten Fay
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | - Luis Gamboa
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
| | - Peter Han
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
| | - Kristen Huden
- Department of Medicine, University of Washington, Seattle WA USA
| | - Misja Ilcisin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | - Mandy Izzo
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
| | | | - Ashley E. Kim
- Department of Medicine, University of Washington, Seattle WA USA
| | - Louise Kimball
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | | | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | | | - Julia Rogers
- Department of Medicine, University of Washington, Seattle WA USA
| | - Erin Chung
- Department of Pediatrics, University of Washington, Seattle Children’s Hospital, Seattle
| | - Thomas R. Sibley
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | | | - Edward Wenger
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
| | - Caitlin R. Wolf
- Department of Medicine, University of Washington, Seattle WA USA
| | - Michael Boeckh
- Department of Medicine, University of Washington, Seattle WA USA
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | - Helen Chu
- Department of Medicine, University of Washington, Seattle WA USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
| | - Jeff Duchin
- Department of Medicine, University of Washington, Seattle WA USA
- Public Health Seattle & King County, Seattle WA USA
| | - Mark Rieder
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
- Department of Genome Sciences, University of Washington, Seattle WA USA
- Howard Hughes Medical Institute, Seattle WA USA
| | - Lea M. Starita
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
- Department of Genome Sciences, University of Washington, Seattle WA USA
| | - Cecile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Trevor Bedford
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA
- Howard Hughes Medical Institute, Seattle WA USA
| | - Janet A. Englund
- Seattle Children’s Research Institute, Seattle WA USA
- Brotman Baty Institute for Precision Medicine, Seattle WA USA
| | - Michael Famulare
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle WA USA
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9
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Bhattacharya S, Agarwal S, Shrimali NM, Guchhait P. Interplay between hypoxia and inflammation contributes to the progression and severity of respiratory viral diseases. Mol Aspects Med 2021; 81:101000. [PMID: 34294412 PMCID: PMC8287505 DOI: 10.1016/j.mam.2021.101000] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/07/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023]
Abstract
History of pandemics is dominated by viral infections and specifically respiratory viral diseases like influenza and COVID-19. Lower respiratory tract infection is the fourth leading cause of death worldwide. Crosstalk between resultant inflammation and hypoxic microenvironment may impair ventilatory response of lungs. This reduces arterial partial pressure of oxygen, termed as hypoxemia, which is observed in a section of patients with respiratory virus infections including SARS-CoV-2 (COVID-19). In this review, we describe the interplay between inflammation and hypoxic microenvironment in respiratory viral infection and its contribution to disease pathogenesis.
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Affiliation(s)
- Sulagna Bhattacharya
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India; School of Biotechnology, Kalinga Institute of Industrial Technology, Orissa, India
| | - Sakshi Agarwal
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India
| | - Nishith M Shrimali
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India
| | - Prasenjit Guchhait
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India.
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10
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Johansson C, Kirsebom FCM. Neutrophils in respiratory viral infections. Mucosal Immunol 2021; 14:815-827. [PMID: 33758367 PMCID: PMC7985581 DOI: 10.1038/s41385-021-00397-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 02/04/2023]
Abstract
Viral respiratory infections are a common cause of severe disease, especially in infants, people who are immunocompromised, and in the elderly. Neutrophils, an important innate immune cell, infiltrate the lungs rapidly after an inflammatory insult. The most well-characterized effector mechanisms by which neutrophils contribute to host defense are largely extracellular and the involvement of neutrophils in protection from numerous bacterial and fungal infections is well established. However, the role of neutrophils in responses to viruses, which replicate intracellularly, has been less studied. It remains unclear whether and, by which underlying immunological mechanisms, neutrophils contribute to viral control or confer protection against an intracellular pathogen. Furthermore, neutrophils need to be tightly regulated to avoid bystander damage to host tissues. This is especially relevant in the lung where damage to delicate alveolar structures can compromise gas exchange with life-threatening consequences. It is inherently less clear how neutrophils can contribute to host immunity to viruses without causing immunopathology and/or exacerbating disease severity. In this review, we summarize and discuss the current understanding of how neutrophils in the lung direct immune responses to viruses, control viral replication and spread, and cause pathology during respiratory viral infections.
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Affiliation(s)
- Cecilia Johansson
- National Heart and Lung Institute, Imperial College London, London, UK.
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11
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Weerts EAWS, Matthijs MGR, Bonhof J, van Haarlem DA, Dwars RM, Gröne A, Verheije MH, Jansen CA. The contribution of the immune response to enhanced colibacillosis upon preceding viral respiratory infection in broiler chicken in a dual infection model. Vet Immunol Immunopathol 2021; 238:110276. [PMID: 34126552 DOI: 10.1016/j.vetimm.2021.110276] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 05/07/2021] [Accepted: 05/25/2021] [Indexed: 01/10/2023]
Abstract
Colibacillosis in chickens caused by avian pathogenic Escherichia coli (APEC) is known to be aggravated by preceding infections with infectious bronchitis virus (IBV), Newcastle disease virus (NDV) and avian metapneumovirus (aMPV). The mechanism behind these virus-induced predispositions for secondary bacterial infections is poorly understood. Here we set out to investigate the immunopathogenesis of enhanced respiratory colibacillosis after preceding infections with these three viruses. Broilers were inoculated intratracheally with APEC six days after oculonasal and intratracheal inoculation with IBV, NDV, aMPV or buffered saline. After euthanasia at 1 and 8 days post infection (dpi) with APEC, birds were macroscopically examined and tissue samples were taken from the trachea, lungs and air sacs. In none of the groups differences in body weight were observed during the course of infection. Macroscopic lesion scoring revealed most severe tissue changes after NDV-APEC and IBV-APEC infection. Histologically, persistent tracheitis was detected in all virus-APEC groups, but not after APEC-only infection. In the lungs, mostly APEC-associated transient pneumonia was observed. Severe and persistent airsacculitis was present after NDV-APEC and IBV-APEC infection. Bacterial antigen was detected by immunohistochemistry only at 1 dpi APEC, predominantly in NDV-APEC- and IBV-APEC-infected lungs. Higher numbers of CD4+ and CD8+ lymphocytes persisted over time in NDV-APEC- and IBV-APEC-infected tracheas, as did CD4+ lymphocytes in NBV-APEC- and IBV-APEC-infected air sacs. KUL01+ cells, which include monocytes and macrophages, and TCRγδ+ lymphocytes were observed mostly in lung tissue in all infected groups with transient higher numbers of KUL01+ cells over time and higher numbers of TCRγδ+ lymphocytes mainly at 8 dpi. qPCR analysis revealed mostly trends of transient higher levels of IL-6 and IFNγ mRNA in lung tissue after IBV-APEC and also NDV-APEC infection and persistent higher levels of IL-6 mRNA after aMPV-APEC infection. In spleens, transient higher levels of IL-17 mRNA and more persistent higher levels of IL-6 mRNA were observed after all co-infections. No changes in IL-10 mRNA expression were seen. These results demonstrate a major impact of dual infections with respiratory viruses and APEC, compared to a single infection with APEC, on the chicken respiratory tract and suggest that immunopathogenesis contributes to lesion persistence.
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Affiliation(s)
- Erik A W S Weerts
- Division of Pathology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, the Netherlands.
| | - Mieke G R Matthijs
- Division of Farm Animal Health, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL Utrecht, the Netherlands
| | - Josette Bonhof
- Division of Infectious Diseases and Immunology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, the Netherlands
| | - Daphne A van Haarlem
- Division of Infectious Diseases and Immunology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, the Netherlands
| | - R Marius Dwars
- Division of Farm Animal Health, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL Utrecht, the Netherlands
| | - Andrea Gröne
- Division of Pathology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, the Netherlands
| | - M Hélène Verheije
- Division of Pathology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, the Netherlands
| | - Christine A Jansen
- Division of Infectious Diseases and Immunology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, the Netherlands
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12
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Papenburg J, Alghounaim M. Unraveling the Pneumonia Burden Associated With Human Metapneumovirus Infection. Clin Infect Dis 2021; 72:118-120. [PMID: 31900479 DOI: 10.1093/cid/ciz1249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 12/31/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jesse Papenburg
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Microbiology, Department of Clinical Laboratory Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mohammad Alghounaim
- Department of Pediatrics, National Bank of Kuwait Specialized Children's Hospital, Kuwait City, Kuwait
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13
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Biggs HM, Van Beneden CA, Kurkjian K, Kobayashi M, Peret TCT, Watson JT, Schneider E, Gerber SI, Ravishankar J. Severe Human Metapneumovirus and Group A Streptococcus Pneumonia in an Immunocompetent Adult. Clin Infect Dis 2021; 70:2712-2714. [PMID: 31563939 DOI: 10.1093/cid/ciz961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/25/2019] [Indexed: 11/12/2022] Open
Abstract
An immunocompetent adult with asthma developed severe human metapneumovirus (HMPV) illness complicated by group A Streptococcus coinfection, progressing to acute respiratory distress syndrome and shock. Several coworkers had less severe HMPV infection. HMPV can cause severe respiratory illness in healthy adults and should be considered as a potential cause of community respiratory outbreaks.
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Affiliation(s)
- Holly M Biggs
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Chris A Van Beneden
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katie Kurkjian
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Virginia Department of Health, Richmond, Virginia, USA
| | - Miwako Kobayashi
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Teresa C T Peret
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John T Watson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eileen Schneider
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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14
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Abstract
Purpose of Review This investigation aims to understand the role and burden of viral co-infections for acute respiratory illnesses in children. Co-infection can be either viral-viral or viral-bacterial and with new technology there is more information on the role they play on the health of children. Recent Findings With the proliferation of multiplex PCR for rapid diagnosis of multiple viruses as well as innovations on identification of bacterial infections, research has been attempting to discover how these co-infections affect each other and the host. Studies are aiming to discern if the epidemiology of viruses seen at a population level is related to the interaction between different viruses on a host level. Studies are also attempting to discover the burden of morbidity and mortality of these viral-viral co-infections on the pediatric population. It is also becoming important to understand the interplay of certain viruses with specific bacteria and understanding the impact of viral-bacterial co-infections. Summary RSV continues to contribute to a large burden of disease for pediatric patients with acute respiratory illnesses. However, recent literature suggests that viral-viral co-infections do not add to this burden and might, in some cases, be protective of severe disease. Viral-bacterial co-infections, on the other hand, are most likely adding to the burden of morbidity in pediatric patients because of the synergistic way they can infect the nasopharyngeal space. Future research needs to focus on confirming these conclusions as it could affect hospital cohorting, role of molecular testing, and therapeutic interventions.
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Affiliation(s)
- Sarah D Meskill
- Department of Pediatrics, Sections of Emergency Medicine, Baylor College of Medicine, 6621 Fannin St. A2210, Houston, TX, USA.
| | - Shelease C O'Bryant
- Department of Pediatrics, Sections of Emergency Medicine, Baylor College of Medicine, 6621 Fannin St. A2210, Houston, TX, USA
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15
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David SC, Norton T, Tyllis T, Wilson JJ, Singleton EV, Laan Z, Davies J, Hirst TR, Comerford I, McColl SR, Paton JC, Alsharifi M. Direct interaction of whole-inactivated influenza A and pneumococcal vaccines enhances influenza-specific immunity. Nat Microbiol 2019; 4:1316-1327. [PMID: 31110357 DOI: 10.1038/s41564-019-0443-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 04/02/2019] [Indexed: 12/21/2022]
Abstract
The upper respiratory tract is continuously exposed to a vast array of potentially pathogenic viruses and bacteria. Influenza A virus (IAV) has particular synergism with the commensal bacterium Streptococcus pneumoniae in this niche, and co-infection exacerbates pathogenicity and causes significant mortality. However, it is not known whether this synergism is associated with a direct interaction between the two pathogens. We have previously reported that co-administration of a whole-inactivated IAV vaccine (γ-Flu) with a whole-inactivated pneumococcal vaccine (γ-PN) enhances pneumococcal-specific responses. In this study, we show that mucosal co-administration of γ-Flu and γ-PN similarly augments IAV-specific immunity, particularly tissue-resident memory cell responses in the lung. In addition, our in vitro analysis revealed that S. pneumoniae directly interacts with both γ-Flu and with live IAV, facilitating increased uptake by macrophages as well as increased infection of epithelial cells by IAV. These observations provide an additional explanation for the synergistic pathogenicity of IAV and S. pneumoniae, as well as heralding the prospect of exploiting the phenomenon to develop better vaccine strategies for both pathogens.
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Affiliation(s)
- Shannon C David
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Todd Norton
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Timona Tyllis
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Jasmine J Wilson
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Eve V Singleton
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Zoe Laan
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Justin Davies
- Australian Nuclear Science and Technology Organisation, Sydney, New South Wales, Australia
| | - Timothy R Hirst
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Gamma Vaccines Pty Ltd, Yarralumla, Australian Capital Territory, Australia.,GPN Vaccines Pty Ltd, Yarralumla, Australian Capital Territory, Australia
| | - Iain Comerford
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Shaun R McColl
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - James C Paton
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia.,GPN Vaccines Pty Ltd, Yarralumla, Australian Capital Territory, Australia
| | - Mohammed Alsharifi
- Research Centre for Infectious Diseases, and Department of Molecular and Biomedical Science, School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia. .,Gamma Vaccines Pty Ltd, Yarralumla, Australian Capital Territory, Australia. .,GPN Vaccines Pty Ltd, Yarralumla, Australian Capital Territory, Australia.
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16
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Abstract
Human metapneumovirus (HMPV) is a leading cause of acute respiratory infection, particularly in children, immunocompromised patients, and the elderly. HMPV, which is closely related to avian metapneumovirus subtype C, has circulated for at least 65 years, and nearly every child will be infected with HMPV by the age of 5. However, immunity is incomplete, and re-infections occur throughout adult life. Symptoms are similar to those of other respiratory viral infections, ranging from mild (cough, rhinorrhea, and fever) to more severe (bronchiolitis and pneumonia). The preferred method for diagnosis is reverse transcription-polymerase chain reaction as HMPV is difficult to culture. Although there have been many advances made in the past 16 years since its discovery, there are still no US Food and Drug Administration-approved antivirals or vaccines available to treat HMPV. Both small animal and non-human primate models have been established for the study of HMPV. This review will focus on the epidemiology, transmission, and clinical manifestations in humans as well as the animal models of HMPV pathogenesis and host immune response.
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Affiliation(s)
- Nazly Shafagati
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - John Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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17
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Jia L, Xie J, Zhao J, Cao D, Liang Y, Hou X, Wang L, Li Z. Mechanisms of Severe Mortality-Associated Bacterial Co-infections Following Influenza Virus Infection. Front Cell Infect Microbiol 2017; 7:338. [PMID: 28824877 PMCID: PMC5540941 DOI: 10.3389/fcimb.2017.00338] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/10/2017] [Indexed: 01/15/2023] Open
Abstract
Influenza virus infection remains one of the largest disease burdens on humans. Influenza-associated bacterial co-infections contribute to severe disease and mortality during pandemic and seasonal influenza episodes. The mechanisms of severe morbidity following influenza-bacteria co-infections mainly include failure of an antibacterial immune response and pathogen synergy. Moreover, failure to resume function and tolerance might be one of the main reasons for excessive mortality. In this review, recent advances in the study of mechanisms of severe disease, caused by bacterial co-infections following influenza virus pathogenesis, are summarized. Therefore, understanding the synergy between viruses and bacteria will facilitate the design of novel therapeutic approaches to prevent mortality associated with bacterial co-infections.
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Affiliation(s)
- Leili Jia
- Institute of Disease Control and Prevention of Chinese People's Liberation ArmyBeijing, China
| | - Jing Xie
- Institute of Disease Control and Prevention of Chinese People's Liberation ArmyBeijing, China
| | - Jiangyun Zhao
- Institute of Disease Control and Prevention of Chinese People's Liberation ArmyBeijing, China
| | - Dekang Cao
- Center for Disease Control and Prevention of Chinese People's Armed Police ForcesBeijing, China
| | - Yuan Liang
- Institute of Disease Control and Prevention of Chinese People's Liberation ArmyBeijing, China
| | - Xuexin Hou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionBeijing, China
| | - Ligui Wang
- Institute of Disease Control and Prevention of Chinese People's Liberation ArmyBeijing, China
| | - Zhenjun Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionBeijing, China
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18
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Wu M, Gibbons JG, DeLoid GM, Bedugnis AS, Thimmulappa RK, Biswal S, Kobzik L. Immunomodulators targeting MARCO expression improve resistance to postinfluenza bacterial pneumonia. Am J Physiol Lung Cell Mol Physiol 2017; 313:L138-L153. [PMID: 28408365 DOI: 10.1152/ajplung.00075.2017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/27/2017] [Accepted: 04/04/2017] [Indexed: 01/12/2023] Open
Abstract
Downregulation of the alveolar macrophage (AM) receptor with collagenous structure (MARCO) leads to susceptibility to postinfluenza bacterial pneumonia, a major cause of morbidity and mortality. We sought to determine whether immunomodulation of MARCO could improve host defense and resistance to secondary bacterial pneumonia. RNAseq analysis identified a striking increase in MARCO expression between days 9 and 11 after influenza infection and indicated important roles for Akt and Nrf2 in MARCO recovery. In vitro, primary human AM-like monocyte-derived macrophages (AM-MDMs) and THP-1 macrophages were treated with IFNγ to model influenza effects. Activators of Nrf2 (sulforaphane) or Akt (SC79) caused increased MARCO expression and a MARCO-dependent improvement in phagocytosis in IFNγ-treated cells and improved survival in mice with postinfluenza pneumococcal pneumonia. Transcription factor analysis also indicated a role for transcription factor E-box (TFEB) in MARCO recovery. Overexpression of TFEB in THP-1 cells led to marked increases in MARCO. The ability of Akt activation to increase MARCO expression in IFNγ-treated AM-MDMs was abrogated in TFEB-knockdown cells, indicating Akt increases MARCO expression through TFEB. Increasing MARCO expression by targeting Nrf2 signaling or the Akt-TFEB-MARCO pathway are promising strategies to improve bacterial clearance and survival in postinfluenza bacterial pneumonia.
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Affiliation(s)
- Muzo Wu
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - John G Gibbons
- Biology Department, Clark University, Worcester, Massachusetts; and
| | - Glen M DeLoid
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Alice S Bedugnis
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Rajesh K Thimmulappa
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Shyam Biswal
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Lester Kobzik
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts;
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19
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Billard L, Le Berre R, Pilorgé L, Payan C, Héry-Arnaud G, Vallet S. Viruses in cystic fibrosis patients' airways. Crit Rev Microbiol 2017; 43:690-708. [PMID: 28340310 DOI: 10.1080/1040841x.2017.1297763] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Although bacteria have historically been considered to play a major role in cystic fibrosis (CF) airway damage, a strong impact of respiratory viral infections (RVI) is also now recognized. Emerging evidence confirms that respiratory viruses are associated with deterioration of pulmonary function and exacerbation and facilitation of bacterial colonization in CF patients. The aim of this review is to provide an overview of the current knowledge on respiratory viruses in CF airways, to discuss the resulting inflammation and RVI response, to determine how to detect the viruses, and to assess their clinical consequences, prevalence, and interactions with bacteria. The most predominant are Rhinoviruses (RVs), significantly associated with CF exacerbation. Molecular techniques, and especially multiplex PCR, help to diagnose viral infections, and the coming rise of metagenomics will extend knowledge of viral populations in the complex ecosystem of CF airways. Prophylaxis and vaccination are currently available only for Respiratory syncytial and Influenza virus (IV), but antiviral molecules are being tested to improve CF patients' care. All the points raised in this review highlight the importance of taking account of RVIs and their potential impact on the CF airway ecosystem.
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Affiliation(s)
- Lisa Billard
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France
| | - Rozenn Le Berre
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,b Département de Médecine Interne et Pneumologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Léa Pilorgé
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Christopher Payan
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Geneviève Héry-Arnaud
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Sophie Vallet
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
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20
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Hendriks W, Boshuizen H, Dekkers A, Knol M, Donker GA, van der Ende A, Korthals Altes H. Temporal cross-correlation between influenza-like illnesses and invasive pneumococcal disease in The Netherlands. Influenza Other Respir Viruses 2017; 11:130-137. [PMID: 27943624 PMCID: PMC5304567 DOI: 10.1111/irv.12442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 11/28/2022] Open
Abstract
Background While the burden of community‐acquired pneumonia and invasive pneumococcal disease (IPD) is still considerable, there is little insight in the factors contributing to disease. Previous research on the lagged relationship between respiratory viruses and pneumococcal disease incidence is inconclusive, and studies correcting for temporal autocorrelation are lacking. Objectives To investigate the temporal relation between influenza‐like illnesses (ILI) and IPD, correcting for temporal autocorrelation. Methods Weekly counts of ILI were obtained from the Sentinel Practices of NIVEL Primary Care Database. IPD data were collected from the Dutch laboratory‐based surveillance system for bacterial meningitis from 2004 to 2014. We analysed the correlation between time series, pre‐whitening the dependent time series with the best‐fit seasonal autoregressive integrated moving average (SARIMA) model to the independent time series. We performed cross‐correlations between ILI and IPD incidences, and the (pre‐whitened) residuals, in the overall population and in the elderly. Results We found significant cross‐correlations between ILI and IPD incidences peaking at lags ‐3 overall and at 1 week in the 65+ population. However, after pre‐whitening, no cross‐correlations were apparent in either population group. Conclusion Our study suggests that ILI occurrence does not seem to be the major driver of IPD incidence in The Netherlands.
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Affiliation(s)
- Wilke Hendriks
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hendriek Boshuizen
- Department for Statistics, Informatics and Modeling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Arnold Dekkers
- Department for Statistics, Informatics and Modeling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mirjam Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ge A Donker
- NIVEL Primary Care Database, Sentinel Practices, Utrecht, The Netherlands
| | - Arie van der Ende
- Department of Medical Microbiology, Academic Medical Center, Center for Infection and Immunity Amsterdam, Amsterdam, The Netherlands.,Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam, The Netherlands
| | - Hester Korthals Altes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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21
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Affiliation(s)
- Raj D Shah
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Arkes 14-045, Chicago, IL 60611, USA
| | - Richard G Wunderink
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Arkes 14-045, Chicago, IL 60611, USA.
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22
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DE LASTOURS V, MALOSH R, RAMADUGU K, SRINIVASAN U, DAWID S, OHMIT S, FOXMAN B. Co-colonization by Streptococcus pneumoniae and Staphylococcus aureus in the throat during acute respiratory illnesses. Epidemiol Infect 2016; 144:3507-3519. [PMID: 27535335 PMCID: PMC9150196 DOI: 10.1017/s0950268816001473] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/20/2016] [Accepted: 06/20/2016] [Indexed: 12/16/2022] Open
Abstract
Pneumonia due to either Streptococcus pneumoniae (Sp) or Staphylococcus aureus (Sa) accounts for most mortality after influenza and acute respiratory illness (ARI). Because carriage precedes infection, we estimated Sp and Sa carriage to examine the co-colonization dynamics between Sp, Sa and respiratory viruses in the presence of ARI in the oropharynx. We tested oropharyngeal specimens of community subjects (aged ⩾2 years) with ARI for the presence of influenza A and B, 11 other common respiratory viruses, Sp and Sa, using real-time PCR. A total of 338 participants reported 519 ARI episodes of which 119 (35%) carried Sp, 52 (13%) carried Sa and 25 (7%) carried both. Thirty-five subjects tested positive for influenza, of which 14 (40%) carried Sp and six (17%) carried Sa, significantly more than in the influenza-negative group (P = 0·03 and P = 0·04, respectively). In subjects infected by any virus compared to those with no virus, Sp carriage (39·2% vs. 27·9%, P = 0·03) but not Sa carriage (11·6% vs. 14%, P = 0·6) was more frequent. For children, when Sa was present, Sp carriage tended to be less frequent than expected given the presence of viral infection, but not significantly [observed relative risk 1·14, 95% confidence interval (CI) 0·4-3·1; with a relative excess risk due to interaction of -0·11]. Independent of age, Sp carriers were more likely to return that season with subsequent ARI (odds ratio 2·14, 95% CI 1·1-4·3, P = 0·03). Both Sp and Sa carriage rates in the oropharynx increase during influenza infection in children. However, no negative interaction between Sp and Sa was observed. Sp carriers are more likely to suffer subsequent ARI episodes than non-carriers.
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Affiliation(s)
- V. DE LASTOURS
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - R. MALOSH
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - K. RAMADUGU
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - U. SRINIVASAN
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - S. DAWID
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - S. OHMIT
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - B. FOXMAN
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Abd El Ghany M, Sharaf H, Hill-Cawthorne GA. Hajj vaccinations-facts, challenges, and hope. Int J Infect Dis 2016; 47:29-37. [PMID: 27260241 DOI: 10.1016/j.ijid.2016.05.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/19/2016] [Accepted: 05/23/2016] [Indexed: 12/13/2022] Open
Abstract
Vaccination is an effective preventive measure that has been used in the unique Hajj pilgrimage setting to control the transmission of infectious diseases. The current vaccination policy applied during Hajj is reviewed herein, highlighting the effectiveness of the approaches applied and identifying research gaps that need to be filled in order to improve the development and dissemination of Hajj vaccination strategies.
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Affiliation(s)
- Moataz Abd El Ghany
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.
| | | | - Grant A Hill-Cawthorne
- The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia; School of Public Health, The University of Sydney, Australia.
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24
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Choi MJ, Song JY, Yang TU, Jeon JH, Noh JY, Hong KW, Cheong HJ, Kim WJ. Acute Myopericarditis caused by Human Metapneumovirus. Infect Chemother 2016; 48:36-40. [PMID: 27104014 PMCID: PMC4835433 DOI: 10.3947/ic.2016.48.1.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 08/27/2014] [Accepted: 08/28/2014] [Indexed: 11/24/2022] Open
Abstract
Human metapneumovirus is known to be similar to respiratory syncytial virus. Because of an incomplete protective immune response to new genotypes, re-infection occurs frequently, especially in the elderly. However, the clinical manifestations of human metapneumovirus need to be further characterized in adults. A 73-year-old woman presented to the emergency room with acute dyspnea, chest discomfort and influenza-like illness. The patient was diagnosed with human metapneumovirus infection, complicated by pneumonia and myopericarditis. With supportive care including oxygen supplementation, the patient recovered completely without any serious sequelae. Human metapneumovirus infection may contribute to the development of cardiovascular manifestations, particularly in the elderly population.
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Affiliation(s)
- Min Joo Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Korea
| | - Tae Un Yang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Ho Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Korea
| | - Kyung Wook Hong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Korea
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25
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Pathogen profiles and molecular epidemiology of respiratory viruses in Japanese inpatients with community-acquired pneumonia. Respir Investig 2016; 54:255-63. [PMID: 27424825 PMCID: PMC7185461 DOI: 10.1016/j.resinv.2016.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/27/2015] [Accepted: 01/04/2016] [Indexed: 11/23/2022]
Abstract
Background The etiological profile of viruses among adult patients with community-acquired pneumonia (CAP) has not been characterized yet. The aim of this study was twofold: first, investigate the pathogen profiles and the molecular epidemiology of respiratory viruses among Japanese CAP patients; and second, explore the clinical significance of viral infections. Methods A cross-sectional observational study was conducted at Kyorin University Hospital. To identify respiratory pathogens, hospitalized CAP patients were enrolled, and reverse transcriptase–polymerase chain reaction technology was applied alongside conventional microbiological methods. Phylogenetic and pairwise distance analyses of 10 viruses were performed. CAP patients were divided into four etiological groups (virus alone, bacteria alone, co-detection of virus and bacteria, and not detected) and the clinical findings were compared. Results Seventy-six patients were enrolled. Bacteria alone were detected in 39.5% (n=30) of CAP patients. Virus alone or co-detection were found in 10.5% (n=8) and 11.8% (n=9) of cases, respectively. Streptococcus pneumoniae and human metapneumovirus were the most frequently detected bacterium and virus, respectively. Phylogenetic analyses of human metapneumovirus, human rhinovirus, and human respiratory syncytial virus showed that different subgroups and genotypes might be associated with CAP. Respiratory failure was more common when a virus was detected (both virus alone and co-detection groups; n=17, 100%, p<0.05) than when a bacteria alone was detected (n=17, 56.7%). Conclusion Prevalence of respiratory virus infection in CAP inpatients was 22.3%. The detected viruses display high genetic divergence and correlate with increased respiratory failure.
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26
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Lee KH, Gordon A, Foxman B. The role of respiratory viruses in the etiology of bacterial pneumonia: An ecological perspective. Evol Med Public Health 2016; 2016:95-109. [PMID: 26884414 PMCID: PMC4801059 DOI: 10.1093/emph/eow007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/29/2016] [Indexed: 12/18/2022] Open
Abstract
Pneumonia is the leading cause of death among children less than 5 years old worldwide. A wide range of viral, bacterial and fungal agents can cause pneumonia: although viruses are the most common etiologic agent, the severity of clinical symptoms associated with bacterial pneumonia and increasing antibiotic resistance makes bacterial pneumonia a major public health concern. Bacterial pneumonia can follow upper respiratory viral infection and complicate lower respiratory viral infection. Secondary bacterial pneumonia is a major cause of influenza-related deaths. In this review, we evaluate the following hypotheses: (i) respiratory viruses influence the etiology of pneumonia by altering bacterial community structure in the upper respiratory tract (URT) and (ii) respiratory viruses promote or inhibit colonization of the lower respiratory tract (LRT) by certain bacterial species residing in the URT. We conducted a systematic review of the literature to examine temporal associations between respiratory viruses and bacteria and a targeted review to identify potential mechanisms of interactions. We conclude that viruses both alter the bacterial community in the URT and promote bacterial colonization of the LRT. However, it is uncertain whether changes in the URT bacterial community play a substantial role in pneumonia etiology. The exception is Streptococcus pneumoniae where a strong link between viral co-infection, increased carriage and pneumococcal pneumonia has been established.
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Affiliation(s)
- Kyu Han Lee
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Betsy Foxman
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
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27
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Crotty MP, Meyers S, Hampton N, Bledsoe S, Ritchie DJ, Buller RS, Storch GA, Micek ST, Kollef MH. Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An Observational Cohort Study. Medicine (Baltimore) 2015; 94:e2332. [PMID: 26683973 PMCID: PMC5058945 DOI: 10.1097/md.0000000000002332] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Advanced technologies using polymerase-chain reaction have allowed for increased recognition of viral respiratory infections including pneumonia. Co-infections have been described for several respiratory viruses, especially with influenza. Outcomes of viral pneumonia, including cases with co-infections, have not been well described. This was observational cohort study conducted to describe hospitalized patients with viral pneumonia including co-infections, clinical outcomes, and predictors of mortality. Patients admitted from March 2013 to November 2014 with a positive respiratory virus panel (RVP) and radiographic findings of pneumonia within 48 h of the index RVP were included. Co-respiratory infection (CRI) was defined as any organism identification from a respiratory specimen within 3 days of the index RVP. Predictors of in-hospital mortality on univariate analysis were evaluated in a multivariate model. Of 284 patients with viral pneumonia, a majority (51.8%) were immunocompromised. A total of 84 patients (29.6%) were found to have a CRI with 48 (57.6%) having a bacterial CRI. Viral CRI with HSV, CMV, or both occurred in 28 patients (33.3%). Fungal (16.7%) and other CRIs (7.1%) were less common. Many patients required mechanical ventilation (54%) and vasopressor support (36%). Overall in-hospital mortality was high (23.2%) and readmissions were common with several patients re-hospitalized within 30 (21.1%) and 90 days (36.7%) of discharge. Predictors of in-hospital mortality on multivariate regression included severity of illness factors, stem-cell transplant, and identification of multiple respiratory viruses. In conclusion, hospital mortality is high among adult patients with viral pneumonia and patients with multiple respiratory viruses identified may be at a higher risk.
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Affiliation(s)
- Matthew P Crotty
- From the Pharmacy St. Louis College of Pharmacy (STLCOP) (MPC); STLCOP and Dept of Pharmacy, Barnes-Jewish Hospital (DJR); STLCOP (SM); STLCOP and Dept of Pharmacy, Barnes-Jewish Hospital (STM); Center for Clinical Excellence, BJC Healthcare (NH); Department of Pediatrics, Washington University School of Medicine (RSB, GAS); and Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine (MHK)
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28
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Crotty MP, Meyers S, Hampton N, Bledsoe S, Ritchie DJ, Buller RS, Storch GA, Kollef MH, Micek ST. Impact of antibacterials on subsequent resistance and clinical outcomes in adult patients with viral pneumonia: an opportunity for stewardship. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:404. [PMID: 26577540 PMCID: PMC4650137 DOI: 10.1186/s13054-015-1120-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 10/28/2015] [Indexed: 02/04/2023]
Abstract
Introduction Respiratory viruses are increasingly recognized as significant etiologies of pneumonia among hospitalized patients. Advanced technologies using multiplex molecular assays and polymerase-chain reaction increase the ability to identify viral pathogens and may ultimately impact antibacterial use. Method This was a single-center retrospective cohort study to evaluate the impact of antibacterials in viral pneumonia on clinical outcomes and subsequent multidrug-resistant organism (MDRO) infections/colonization. Patients admitted from March 2013 to November 2014 with positive respiratory viral panels (RVP) and radiographic findings of pneumonia were included. Patients transferred from an outside hospital or not still hospitalized 72 hours after the RVP report date were excluded. Patients were categorized based on exposure to systemic antibacterials: less than 3 days representing short-course therapy and 3 to 10 days being long-course therapy. Results A total of 174 patients (long-course, n = 67; short-course, n = 28; mixed bacterial-viral infection, n = 79) were included with most being immunocompromised (56.3 %) with active malignancy the primary etiology (69.4 %). Rhinovirus/Enterovirus (23 %), Influenza (19 %), and Parainfluenza (15.5 %) were the viruses most commonly identified. A total of 13 different systemic antibacterials were used as empiric therapy in the 95 patients with pure viral infection for a total of 466 days-of-therapy. Vancomycin (50.7 %), cefepime (40.3 %), azithromycin (40.3 %), meropenem (23.9 %), and linezolid (20.9 %) were most frequently used. In-hospital mortality did not differ between patients with viral pneumonia in the short-course and long-course groups. Subsequent infection/colonization with a MDRO was more frequent in the long-course group compared to the short-course group (53.2 vs 21.1 %; P = 0.027). Conclusion This study found that long-course antibacterial use in the setting of viral pneumonia had no impact on clinical outcomes but increased the incidence of subsequent MDRO infection/colonization.
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Affiliation(s)
- Matthew P Crotty
- Pharmacy Department, Barnes-Jewish Hospital, One Barnes Jewish Hospital Plaza, St. Louis, MO, 63110, USA.
| | - Shelby Meyers
- St. Louis College of Pharmacy, 4588 Parkview Place, St. Louis, MO, 63110, USA.
| | - Nicholas Hampton
- Center for Clinical Excellence, BJC Healthcare, 8300 Eager Road, St. Louis, MO, 63144, USA.
| | - Stephanie Bledsoe
- Department of Pediatrics, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8116, St. Louis, MO, 63110, USA.
| | - David J Ritchie
- Pharmacy Department, Barnes-Jewish Hospital, One Barnes Jewish Hospital Plaza, St. Louis, MO, 63110, USA. .,St. Louis College of Pharmacy, 4588 Parkview Place, St. Louis, MO, 63110, USA.
| | - Richard S Buller
- Department of Pediatrics, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8116, St. Louis, MO, 63110, USA.
| | - Gregory A Storch
- Department of Pediatrics, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8116, St. Louis, MO, 63110, USA.
| | - Marin H Kollef
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8052, St. Louis, MO, 63110, USA.
| | - Scott T Micek
- St. Louis College of Pharmacy, 4588 Parkview Place, St. Louis, MO, 63110, USA.
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Shrestha S, Foxman B, Berus J, van Panhuis WG, Steiner C, Viboud C, Rohani P. The role of influenza in the epidemiology of pneumonia. Sci Rep 2015; 5:15314. [PMID: 26486591 PMCID: PMC4614252 DOI: 10.1038/srep15314] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/15/2015] [Indexed: 12/25/2022] Open
Abstract
Interactions arising from sequential viral and bacterial infections play important roles in the epidemiological outcome of many respiratory pathogens. Influenza virus has been implicated in the pathogenesis of several respiratory bacterial pathogens commonly associated with pneumonia. Though clinical evidence supporting this interaction is unambiguous, its population-level effects-magnitude, epidemiological impact and variation during pandemic and seasonal outbreaks-remain unclear. To address these unknowns, we used longitudinal influenza and pneumonia incidence data, at different spatial resolutions and across different epidemiological periods, to infer the nature, timing and the intensity of influenza-pneumonia interaction. We used a mechanistic transmission model within a likelihood-based inference framework to carry out formal hypothesis testing. Irrespective of the source of data examined, we found that influenza infection increases the risk of pneumonia by ~100-fold. We found no support for enhanced transmission or severity impact of the interaction. For model-validation, we challenged our fitted model to make out-of-sample pneumonia predictions during pandemic and non-pandemic periods. The consistency in our inference tests carried out on several distinct datasets, and the predictive skill of our model increase confidence in our overall conclusion that influenza infection substantially enhances the risk of pneumonia, though only for a short period.
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Affiliation(s)
- Sourya Shrestha
- Department of Ecology & Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA
- Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
| | - Betsy Foxman
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Joshua Berus
- Undergraduate Research Opportunity Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Willem G. van Panhuis
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh PA 15261, USA
| | - Claudia Steiner
- Healthcare Cost and Utilization Project, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Rockville, MD 20850, USA
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, National Institutes of Health, Bethesda, MD 20892, USA
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA 30602, USA
- Department of Infectious Diseases, School of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
- Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA
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Immune Response to Human Metapneumovirus Infection: What We Have Learned from the Mouse Model. Pathogens 2015; 4:682-96. [PMID: 26393657 PMCID: PMC4584281 DOI: 10.3390/pathogens4030682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 09/09/2015] [Accepted: 09/15/2015] [Indexed: 01/17/2023] Open
Abstract
Human Metapneumovirus (hMPV) is a leading respiratory viral pathogen associated with bronchiolitis, pneumonia, and asthma exacerbation in young children, the elderly and immunocompromised individuals. The development of a potential vaccine against hMPV requires detailed understanding of the host immune system, which plays a significant role in hMPV pathogenesis, susceptibility and vaccine efficacy. As a result, animal models have been developed to better understand the mechanisms by which hMPV causes disease. Several animal models have been evaluated and established so far to study the host immune responses and pathophysiology of hMPV infection. However, inbred laboratory mouse strains have been one of the most used animal species for experimental modeling and therefore used for the studies of immunity and immunopathogenesis to hMPV. This review summarizes the contributions of the mouse model to our understanding of the immune response against hMPV infection.
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31
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Hraiech S, Papazian L, Rolain JM, Bregeon F. Animal models of polymicrobial pneumonia. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:3279-92. [PMID: 26170617 PMCID: PMC4492661 DOI: 10.2147/dddt.s70993] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Pneumonia is one of the leading causes of severe and occasionally life-threatening infections. The physiopathology of pneumonia has been extensively studied, providing information for the development of new treatments for this condition. In addition to in vitro research, animal models have been largely used in the field of pneumonia. Several models have been described and have provided a better understanding of pneumonia under different settings and with various pathogens. However, the concept of one pathogen leading to one infection has been challenged, and recent flu epidemics suggest that some pathogens exhibit highly virulent potential. Although "two hits" animal models have been used to study infectious diseases, few of these models have been described in pneumonia. Therefore the aims of this review were to provide an overview of the available literature in this field, to describe well-studied and uncommon pathogen associations, and to summarize the major insights obtained from this information.
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Affiliation(s)
- Sami Hraiech
- IHU Méditerranée infection, URMITE CNRS IRD INSERM UMR 7278, Marseille, France ; Réanimation - Détresses Respiratoires et infections Sévères, APHM, CHU Nord, Marseille, France
| | - Laurent Papazian
- IHU Méditerranée infection, URMITE CNRS IRD INSERM UMR 7278, Marseille, France ; Réanimation - Détresses Respiratoires et infections Sévères, APHM, CHU Nord, Marseille, France
| | - Jean-Marc Rolain
- IHU Méditerranée infection, URMITE CNRS IRD INSERM UMR 7278, Marseille, France
| | - Fabienne Bregeon
- IHU Méditerranée infection, URMITE CNRS IRD INSERM UMR 7278, Marseille, France ; Service d'explorations Fonctionnelles Respiratoires, APHM, CHU Nord, Marseille, France
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32
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Rhedin S, Lindstrand A, Hjelmgren A, Ryd-Rinder M, Öhrmalm L, Tolfvenstam T, Örtqvist Å, Rotzén-Östlund M, Zweygberg-Wirgart B, Henriques-Normark B, Broliden K, Naucler P. Respiratory viruses associated with community-acquired pneumonia in children: matched case-control study. Thorax 2015; 70:847-53. [PMID: 26077969 DOI: 10.1136/thoraxjnl-2015-206933] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/25/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND Community-acquired pneumonia (CAP) is the leading cause of death in children worldwide and a substantial proportion of childhood CAP is caused by viruses. A better understanding of the role of virus infections in this condition is needed to improve clinical management and preventive measures. The aim of the study was therefore to assess the association between specific respiratory viruses and childhood CAP. METHODS A case-control study was conducted during 3 years in Stockholm, Sweden. Cases were children aged ≤5 years with radiological CAP. Healthy controls were consecutively enrolled at child health units during routine visits and matched to cases on age and calendar time. Nasopharyngeal aspirates were obtained and analysed by real-time PCR for 15 viruses. Multivariate conditional logistic regression was used to account for coinfections with other viruses and baseline characteristics. RESULTS A total of 121 cases, of which 93 cases met the WHO criteria for radiological pneumonia, and 240 controls were included in the study. Viruses were detected in 81% of the cases (n=98) and 56% of the controls (n=134). Influenza virus, metapneumovirus and respiratory syncytial virus were detected in 60% of cases and were significantly associated with CAP with ORs >10. There was no association with parainfluenza virus, human enterovirus or rhinovirus and coronavirus and bocavirus were negatively associated with CAP. CONCLUSIONS Our study indicates viral CAP is an underestimated disease and points out hMPV as a new important target for the prevention of childhood CAP.
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Affiliation(s)
- Samuel Rhedin
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ann Lindstrand
- The Public Health Agency of Sweden, Stockholm, Sweden Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Annie Hjelmgren
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Malin Ryd-Rinder
- Department of Clinical Science and Education, Karolinska Institutet, Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden
| | - Lars Öhrmalm
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Tolfvenstam
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden The Public Health Agency of Sweden, Stockholm, Sweden
| | - Åke Örtqvist
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden Department of Communicable Disease and Control, Stockholm County Council, Stockholm, Sweden
| | - Maria Rotzén-Östlund
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Benita Zweygberg-Wirgart
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Broliden
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Pontus Naucler
- Department of Medicine Solna, Infectious Diseases Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Human monoclonal antibodies targeting the haemagglutinin glycoprotein can neutralize H7N9 influenza virus. Nat Commun 2015; 6:6714. [PMID: 25819694 DOI: 10.1038/ncomms7714] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 02/20/2015] [Indexed: 01/07/2023] Open
Abstract
The recently identified avian-originated influenza H7N9 virus causes severe pulmonary disease and may lead to death in humans. Currently, treatment options for the prevention and control of fatal H7N9 infections in humans remain limited. Here we characterize two human monoclonal antibodies (HuMAbs), HNIgGA6 and HNIgGB5, by screening a Fab antibody phage library derived from patients who recovered from H7N9 infection. Both antibodies exhibit high neutralizing activity against H7N9 virus in cells. Two amino acids in the receptor-binding site, 186V and 226L, are crucial for the binding of these two HuMAbs to viral haemagglutinin antigens. Prophylaxis with HNIgGA6 and HNIgGB5 confers significant immunity against H7N9 virus in a mouse model and significantly reduces the pulmonary virus titre. When administered post infection, therapeutic doses of the HuMAbs also provide robust protection against lethality. These antibodies might represent a potential alternative or adjunct to H7N9 pandemic interventions.
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Abstract
Acute respiratory tract infection (RTI) is a leading cause of morbidity and mortality worldwide and the majority of RTIs are caused by viruses, among which respiratory syncytial virus (RSV) and the closely related human metapneumovirus (hMPV) figure prominently. Host innate immune response has been implicated in recognition, protection and immune pathological mechanisms. Host-viral interactions are generally initiated via host recognition of pathogen-associated molecular patterns (PAMPs) of the virus. This recognition occurs through host pattern recognition receptors (PRRs) which are expressed on innate immune cells such as epithelial cells, dendritic cells, macrophages and neutrophils. Multiple PRR families, including Toll-like receptors (TLRs), RIG-I-like receptors (RLRs) and NOD-like receptors (NLRs), contribute significantly to viral detection, leading to induction of cytokines, chemokines and type I interferons (IFNs), which subsequently facilitate the eradication of the virus. This review focuses on the current literature on RSV and hMPV infection and the role of PRRs in establishing/mediating the infection in both in vitro and in vivo models. A better understanding of the complex interplay between these two viruses and host PRRs might lead to efficient prophylactic and therapeutic treatments, as well as the development of adequate vaccines.
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35
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Yoon YK, Yang KS, Sohn JW, Lee CK, Kim MJ. Impact of preceding respiratory viral infections on the clinical severity of patients with pneumococcal pneumonia. Influenza Other Respir Viruses 2014; 8:549-56. [PMID: 24962523 PMCID: PMC4181819 DOI: 10.1111/irv.12265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2014] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to investigate the impact of preceding respiratory viral infections (RVI) on the clinical severity of pneumococcal pneumonia patients. Methods A retrospective observational study was conducted at a university hospital from January 2009 to March 2013. Study subjects included adults (aged ≥18 years) with pneumococcal pneumonia who had undergone laboratory tests for RVI. Multivariate logistic regression analysis was performed to identify risk factors associated with severe pneumococcal pneumonia, defined as severity with the Pneumonia Severity Index (PSI) score ≥91. Results In total, 191 patients with pneumococcal pneumonia were included for analysis and stratified into 2 groups: the severe group with a PSI score ≥91 (n = 99) and the non-severe group with a PSI score <91 (n = 92). Preceding RVIs were detected in 48 patients, including influenza A virus (n = 20), influenza B virus (n = 4), parainfluenza viruses (n = 5), metapneumovirus (n = 4), rhinovirus (n = 4), respiratory syncytial viruses (n = 6), coronaviruses (n = 2), and mixed viral infections (n = 3). In the multivariate logistic regression analysis, preceding RVIs (odds ratio [OR], 2·49; 95% confidence interval [CI], 1·10–5·60), male sex (OR, 2·58; 95% CI, 1·24–5·38), old age (OR, 2·92; 95% CI, 1·37–6·24), hypoalbuminemia (OR, 3·26; 95% CI, 1·56–6·84)], and azotemia (OR, 2·24; 95% CI, 1·08–4·67) were significantly associated with severe pneumococcal pneumonia. Conclusion This study suggests that preceding RVIs might be one of the risk factors affecting the clinical severity of pneumococcal pneumonia.
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Affiliation(s)
- Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea; Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Korea
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Lai SH, Liao SL, Wong KS, Lin TY. Preceding human metapneumovirus infection increases adherence of Streptococcus pneumoniae and severity of murine pneumococcal pneumonia. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 49:216-24. [PMID: 24931548 DOI: 10.1016/j.jmii.2014.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 03/06/2014] [Accepted: 04/10/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Coinfection with respiratory virus and Streptococcus pneumoniae has been frequently reported in several epidemiologic studies. The aim of this study was to explore the effect of preceding human metapneumovirus (hMPV) inoculation on subsequent pneumococcal infection. METHODS Hep-2 and A549 cells were infected with hMPV then inoculated with S. pneumoniae. Bacterial adhesion was measured using colony forming unit and cytometric-fluorescence assays. In vivo bacterial adhesion was examined in hMPV-infected mice after inoculation of fluorescence-conjugated S. pneumoniae. Pulmonary inflammation (bacterial titers, cytokine levels, and histopathology) of hMPV-infected mice was investigated after inoculation with S. pneumoniae. RESULTS In vitro results of bacterial infection with S. pneumoniae on A549 and Hep-2 monolayer cells showed that even though cellular adherence was variable among different serotypes, there was significantly enhanced bacterial adherence in A549 cells with preceding hMPV infection. In addition, in vivo study of hMPV-infected mice showed increased adhesion of S. pneumoniae on the bronchial epithelium with delayed bacterial clearance and exacerbated histopathology. Furthermore, mice with preceding hMPV infection showed repressed recruitment of airway neutrophils with decreased expression of neutrophil chemoattractants during pneumococcal infection. CONCLUSION These results suggest that hMPV-infected airway cells, especially the lower airway epithelium, express increased adherence with S. pneumoniae. Furthermore, hMPV-infected mice showed impaired recruitment of airway neutrophils, possibly leading to delayed bacterial clearance and exacerbated pulmonary inflammation, after secondary infection with pneumococcal isolates.
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Affiliation(s)
- Shen-Hao Lai
- Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Sui-Ling Liao
- Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Keelung, Taiwan
| | - Kin-Sun Wong
- Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Tzou-Yien Lin
- Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
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Wei L, Zhu S, She R, Hu F, Wang J, Yan X, Zhang C, Liu S, Quan R, Li Z, Du F, Wei T, Liu J. Viral replication and lung lesions in BALB/c mice experimentally inoculated with avian metapneumovirus subgroup C isolated from chickens. PLoS One 2014; 9:e92136. [PMID: 24637582 PMCID: PMC3956885 DOI: 10.1371/journal.pone.0092136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 02/18/2014] [Indexed: 11/18/2022] Open
Abstract
Avian metapneumovirus (aMPV) emerged as an important respiratory pathogen causing acute respiratory tract infection in avian species. Here we used a chicken aMPV subgroup C (aMPV/C) isolate to inoculate experimentally BALB/c mice and found that the aMPV/C can efficiently replicate and persist in the lungs of mice for at least 21 days with a peak viral load at day 6 postinoculation. Lung pathological changes were characterized by increased inflammatory cells. Immunochemical assay showed the presence of viral antigens in the lungs and significant upregulation of pulmonary inflammatory cytokines and chemokines including MCP-1, MIP-1α, RANTES, IL-1β, IFN-γ, and TNF-α were detected following inoculation. These results indicate for the first time that chicken aMPV/C may replicate in the lung of mice. Whether aMPV/C has potential as zoonotic pathogen, further investigation will be required.
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Affiliation(s)
- Li Wei
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Shanshan Zhu
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Ruiping She
- College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Fengjiao Hu
- College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Jing Wang
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Xu Yan
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Chunyan Zhang
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Shuhang Liu
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Rong Quan
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Zixuan Li
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
| | - Fang Du
- College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Ting Wei
- Molecular Virology Laboratory, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Jue Liu
- Beijing Key Laboratory for Prevention and Control of Infectious Diseases in Livestock and Poultry, Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, People’s Republic of China
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Seki M, Yoshida H, Gotoh K, Hamada N, Motooka D, Nakamura S, Yamamoto N, Hamaguchi S, Akeda Y, Watanabe H, Iida T, Tomono K. Severe respiratory failure due to co-infection with human metapneumovirus and Streptococcus pneumoniae. Respir Med Case Rep 2014; 12:13-5. [PMID: 26029528 PMCID: PMC4061431 DOI: 10.1016/j.rmcr.2013.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 64-year-old male patient was admitted with respiratory failure, although chest X-rays revealed only mild bronchiolitis. Streptococcus pneumoniae, which usually presents as massive lobular pneumonia, was isolated from sputum, however, pan-pathogen screening using a next-generation sequencer also detected human metapneumovirus genome fragments.
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Affiliation(s)
- Masafumi Seki
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Kazuyoshi Gotoh
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Nobuyuki Hamada
- Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Shota Nakamura
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Shigeto Hamaguchi
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Yukihiro Akeda
- Laboratory for Clinical of Clinical Research on Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Hiroshi Watanabe
- Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuya Iida
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita City, Osaka, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
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Shrestha S, Foxman B, Dawid S, Aiello AE, Davis BM, Berus J, Rohani P. Time and dose-dependent risk of pneumococcal pneumonia following influenza: a model for within-host interaction between influenza and Streptococcus pneumoniae. J R Soc Interface 2013; 10:20130233. [PMID: 23825111 DOI: 10.1098/rsif.2013.0233] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A significant fraction of seasonal and in particular pandemic influenza deaths are attributed to secondary bacterial infections. In animal models, influenza virus predisposes hosts to severe infection with both Streptococcus pneumoniae and Staphylococcus aureus. Despite its importance, the mechanistic nature of the interaction between influenza and pneumococci, its dependence on the timing and sequence of infections as well as the clinical and epidemiological consequences remain unclear. We explore an immune-mediated model of the viral-bacterial interaction that quantifies the timing and the intensity of the interaction. Taking advantage of the wealth of knowledge gained from animal models, and the quantitative understanding of the kinetics of pathogen-specific immunological dynamics, we formulate a mathematical model for immune-mediated interaction between influenza virus and S. pneumoniae in the lungs. We use the model to examine the pathogenic effect of inoculum size and timing of pneumococcal invasion relative to influenza infection, as well as the efficacy of antivirals in preventing severe pneumococcal disease. We find that our model is able to capture the key features of the interaction observed in animal experiments. The model predicts that introduction of pneumococcal bacteria during a 4-6 day window following influenza infection results in invasive pneumonia at significantly lower inoculum size than in hosts not infected with influenza. Furthermore, we find that antiviral treatment administered later than 4 days after influenza infection was not able to prevent invasive pneumococcal disease. This work provides a quantitative framework to study interactions between influenza and pneumococci and has the potential to accurately quantify the interactions. Such quantitative understanding can form a basis for effective clinical care, public health policies and pandemic preparedness.
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Affiliation(s)
- Sourya Shrestha
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA.
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Shrestha S, Foxman B, Weinberger DM, Steiner C, Viboud C, Rohani P. Identifying the interaction between influenza and pneumococcal pneumonia using incidence data. Sci Transl Med 2013; 5:191ra84. [PMID: 23803706 PMCID: PMC4178309 DOI: 10.1126/scitranslmed.3005982] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The association between influenza virus and the bacterium Streptococcus pneumoniae (pneumococcus) has been proposed as a polymicrobial system, whereby transmission and pathogenicity of one pathogen (the bacterium) are affected by interactions with the other (the virus). However, studies focusing on different scales of resolution have painted an inconsistent picture: Individual-scale animal experiments have unequivocally demonstrated an association, whereas epidemiological support in human populations is, at best, inconclusive. We integrate weekly incidence reports and a mechanistic transmission model within a likelihood-based inference framework to characterize the nature, timing, and magnitude of this interaction. We find support for a strong but short-lived interaction, with influenza infection increasing susceptibility to pneumococcal pneumonia ~100-fold. We infer modest population-level impacts arising from strong processes at the level of an individual, thereby resolving the dichotomy in seemingly inconsistent observations across scales. An accurate characterization of the influenza-pneumococcal interaction can form a basis for more effective clinical care and public health measures for pneumococcal pneumonia.
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Affiliation(s)
- Sourya Shrestha
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA.
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Bousbia S, Raoult D, La Scola B. Pneumonia pathogen detection and microbial interactions in polymicrobial episodes. Future Microbiol 2013; 8:633-60. [DOI: 10.2217/fmb.13.26] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Recent reports show that microbial communities associated with respiratory infections, such as pneumonia and cystic fibrosis, are more complex than expected. Most of these communities are polymicrobial and might comprise microorganisms originating from several diverse biological and ecological sources. Moreover, unexpected bacteria in the etiology of these respiratory infections have been increasingly identified. These findings were established with the use of efficient microbiological diagnostic tools, particularly molecular tools based on common gene amplification, followed by cloning and sequencing approaches, which facilitated the identification of the polymicrobial flora. Similarly, recent investigations reported that microbial interactions might exist between species in polymicrobial communities, including typical pneumonia pathogens, such as Pseudomonas aeruginosa and Candida albicans. Here, we review recent tools for microbial diagnosis, in particular, of intensive care unit pneumonia and the reported interactions between microbial species that have primarily been identified in the etiology of these infections.
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Affiliation(s)
- Sabri Bousbia
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine, Marseille, France
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique – Hôpitaux de Marseille, Marseille, France
| | - Didier Raoult
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine, Marseille, France
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique – Hôpitaux de Marseille, Marseille, France
| | - Bernard La Scola
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique – Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine, Marseille, France.
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Kuri T, Sörensen AS, Thomas S, Karlsson Hedestam GB, Normark S, Henriques-Normark B, McInerney GM, Plant L. Influenza A virus-mediated priming enhances cytokine secretion by human dendritic cells infected with Streptococcus pneumoniae. Cell Microbiol 2013; 15:1385-400. [PMID: 23421931 PMCID: PMC3798092 DOI: 10.1111/cmi.12122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 01/23/2013] [Accepted: 02/04/2013] [Indexed: 12/22/2022]
Abstract
Secondary infections with Streptococcus pneumoniae (SP) are frequently observed following influenza A virus (IAV) infection and have a substantial impact on global health. Despite this, the basis for the disease progression is incompletely understood. To investigate the effect of co-infection on human monocyte-derived dendritic cells (MDDCs) we analysed the expression of clinically important pro-inflammatory and immune-modulatory cytokines. IAV infection or treatment with supernatants from IAV-infected cell cultures resulted in priming of the DCs which subsequently influenced the production of IL-12p70, as well as IL-6, following SP infection. Co-infection of the same cell was not required but this effect was dependent on the time, dose and duration of the infections, as well as pathogen viability, bacterial uptake and endosome acidification. Bacterially infected cells were characterized as the main producers of IL-12p70. Finally, we showed that type I interferons were primarily responsible for the priming of IL-12p70 that was observed by infection with IAV. These results provide a probable mechanism for the elevated levels of particular cytokines observed in IAV and SP co-infected cell cultures with implications for the pathogenic outcome observed during in vivo infection.
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Affiliation(s)
- Thomas Kuri
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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Moore DP, Dagan R, Madhi SA. Respiratory viral and pneumococcal coinfection of the respiratory tract: implications of pneumococcal vaccination. Expert Rev Respir Med 2013; 6:451-65. [PMID: 22971069 DOI: 10.1586/ers.12.32] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The interactions between Streptococcus pneumoniae and other respiratory pathogens have been studied in vitro, in animal models and in humans - including epidemiologic and vaccine probe studies. Interactions of pneumococcus with respiratory viruses are common, and many mechanisms have been suggested to explain this phenomenon. The aim of this review is to explore pneumococcal interactions with respiratory viruses and consider the potential role that the pneumococcal polysaccharide-protein conjugate vaccine may play in modifying pneumococcal-respiratory viral interactions.
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Affiliation(s)
- David Paul Moore
- Department of Science and Technology, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Bosch AATM, Biesbroek G, Trzcinski K, Sanders EAM, Bogaert D. Viral and bacterial interactions in the upper respiratory tract. PLoS Pathog 2013; 9:e1003057. [PMID: 23326226 PMCID: PMC3542149 DOI: 10.1371/journal.ppat.1003057] [Citation(s) in RCA: 416] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Respiratory infectious diseases are mainly caused by viruses or bacteria that often interact with one another. Although their presence is a prerequisite for subsequent infections, viruses and bacteria may be present in the nasopharynx without causing any respiratory symptoms. The upper respiratory tract hosts a vast range of commensals and potential pathogenic bacteria, which form a complex microbial community. This community is assumed to be constantly subject to synergistic and competitive interspecies interactions. Disturbances in the equilibrium, for instance due to the acquisition of new bacteria or viruses, may lead to overgrowth and invasion. A better understanding of the dynamics between commensals and pathogens in the upper respiratory tract may provide better insight into the pathogenesis of respiratory diseases. Here we review the current knowledge regarding specific bacterial–bacterial and viral–bacterial interactions that occur in the upper respiratory niche, and discuss mechanisms by which these interactions might be mediated. Finally, we propose a theoretical model to summarize and illustrate these mechanisms.
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Affiliation(s)
- Astrid A. T. M. Bosch
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Giske Biesbroek
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Krzysztof Trzcinski
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Elisabeth A. M. Sanders
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Debby Bogaert
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands
- * E-mail:
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Haas LEM, Thijsen SFT, van Elden L, Heemstra KA. Human metapneumovirus in adults. Viruses 2013; 5:87-110. [PMID: 23299785 PMCID: PMC3564111 DOI: 10.3390/v5010087] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 12/17/2012] [Accepted: 12/19/2012] [Indexed: 11/16/2022] Open
Abstract
Human metapneumovirus (HMPV) is a relative newly described virus. It was first isolated in 2001 and currently appears to be one of the most significant and common human viral infections. Retrospective serologic studies demonstrated the presence of HMPV antibodies in humans more than 50 years earlier. Although the virus was primarily known as causative agent of respiratory tract infections in children, HMPV is an important cause of respiratory infections in adults as well. Almost all children are infected by HMPV below the age of five; the repeated infections throughout life indicate transient immunity. HMPV infections usually are mild and self-limiting, but in the frail elderly and the immunocompromised patients, the clinical course can be complicated. Since culturing the virus is relatively difficult, diagnosis is mostly based on a nucleic acid amplification test, such as reverse transcriptase polymerase chain reaction. To date, no vaccine is available and treatment is supportive. However, ongoing research shows encouraging results. The aim of this paper is to review the current literature concerning HMPV infections in adults, and discuss recent development in treatment and vaccination.
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Affiliation(s)
- Lenneke E. M. Haas
- Department of Intensive Care Medicine, Diakonessenhuis, Utrecht, 3582 KE, The Netherlands
| | - Steven F. T. Thijsen
- Department of Microbiology, Diakonessenhuis, Utrecht, 3582 KE, The Netherlands; E-Mails: (S.F.T.T.); (K.A.H.)
| | - Leontine van Elden
- Department of Pulmonary Diseases, Diakonessenhuis, Utrecht, 3582 KE, The Netherlands; E-Mail:
| | - Karen A. Heemstra
- Department of Microbiology, Diakonessenhuis, Utrecht, 3582 KE, The Netherlands; E-Mails: (S.F.T.T.); (K.A.H.)
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Chung WJ, Kang SS, Bang KW, Chun YH, Yoon JS, Kim HH, Kim JT, Lee JS. Comparison of respiratory disease by human metapneumovirus and respiratory syncytial virus in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2013. [DOI: 10.4168/aard.2013.1.2.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Woo Jin Chung
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Shil Kang
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyong Won Bang
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yoon Hong Chun
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Hee Kim
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Tack Kim
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Joon Sung Lee
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
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McCullers JA. Do specific virus-bacteria pairings drive clinical outcomes of pneumonia? Clin Microbiol Infect 2012; 19:113-8. [PMID: 23231363 DOI: 10.1111/1469-0691.12093] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 10/27/2012] [Accepted: 10/30/2012] [Indexed: 12/01/2022]
Abstract
Bacterial pneumonia is a common contributor to severe outcomes of influenza. Epidemiological data suggest that the incidence, severity and associated bacterial pathogens differ between epidemics and by geographical location within epidemics. Data from animal models demonstrate that differences in both viral and bacterial strains alter the incidence and outcomes of pneumonia. For influenza viruses, evolutionary changes to specific virulence factors appear to alter the ability of viruses within particular lineages to prime the host for secondary bacterial infection. Although bacterial strains differ considerably in disease potential in the setting of viral co-infection, the bacterial virulence factors underlying this finding are currently unknown. The hypothesis that geographical variation exists in the prevalence of bacterial strains expressing factors that enable efficient disease potentiation during viral epidemics should be considered as one explanation for regional differences in severity. This would have implications for surveillance, vaccine development, and the conduct of clinical trials for the prevention or treatment of pneumonia.
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Affiliation(s)
- J A McCullers
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38103, USA.
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Papenburg J, Hamelin MÈ, Ouhoummane N, Carbonneau J, Ouakki M, Raymond F, Robitaille L, Corbeil J, Caouette G, Frenette L, De Serres G, Boivin G. Comparison of risk factors for human metapneumovirus and respiratory syncytial virus disease severity in young children. J Infect Dis 2012; 206:178-89. [PMID: 22551815 PMCID: PMC7114627 DOI: 10.1093/infdis/jis333] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background. Human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) are leading pediatric pathogens. However, risk factors for severe hMPV disease remain unknown. We comparatively assessed environmental, host, and viral determinants for severe hMPV and RSV infections. Methods. We studied a prospective cohort of >1000 children aged <3 years hospitalized in or presenting to a pediatric clinic for acute respiratory infection. We collected clinical data at enrollment and 1-month follow-up and tested nasopharyngeal secretions for respiratory viruses. Disease severity was defined as hospitalization and was also assessed with a severity score (1 point/variable) calculated on the basis of fraction of inhaled O2 ≥ 30%, hospitalization >5 days, and pediatric intensive care unit admission. Results. hMPV was identified in 58 of 305 outpatient children (19.0%) and 69 of 734 hospitalized children (9.4%), second only to RSV (48.2% and 63.6%, respectively). In multivariate regression analysis of hMPV cases, age <6 months and household crowding were associated with hospitalization. Among hospitalized patients, risk factors for severe hMPV disease were female sex, prematurity, and genotype B infection. Age <6 months, comorbidities, and household crowding were risk factors for RSV hospitalization; breast-feeding and viral coinfection were protective. Age <6 months and prematurity were associated with severe RSV cases among hospitalized children. Conclusions. hMPV and RSV severity risk factors may differ slightly. These findings will inform hMPV prevention strategies.
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Affiliation(s)
- Jesse Papenburg
- Centre de recherche en infectiologie de l'Université Laval, Centre de recherche du CHUQ, Quebec, Canada
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Verkaik NJ, Nguyen DT, de Vogel CP, Moll HA, Verbrugh HA, Jaddoe VWV, Hofman A, van Wamel WJB, van den Hoogen BG, Buijs-Offerman RMGB, Ludlow M, de Witte L, Osterhaus ADME, van Belkum A, de Swart RL. Streptococcus pneumoniae exposure is associated with human metapneumovirus seroconversion and increased susceptibility to in vitro HMPV infection. Clin Microbiol Infect 2011; 17:1840-4. [PMID: 21883660 DOI: 10.1111/j.1469-0691.2011.03480.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
It remains largely unknown which factors determine the clinical outcome of human metapneumovirus (HMPV) infections. The aim of the present study was to analyse whether exposure to bacterial pathogens can influence HMPV infections. From 57 children, serum samples and colonization data for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pneumoniae were collected at 1.5, 6, 14 and 24 months of age. Seroconversion rates to HMPV were determined and related to bacterial carriage. Frequent nasopharyngeal carriage (≥2 times in the first 2 years of life) of S. pneumoniae, but not of the other three pathogens, was associated with increased seroconversion rates of infants to HMPV at the age of 2 years (frequently vs. less exposed, 93% vs. 59%; p <0.05). Subsequently, the susceptibility of well-differentiated normal human bronchial epithelial cells (wd-NHBE) pre-incubated with bacterial pathogens to in vitro HMPV infection was evaluated. Pre-incubation of wd-NHBE with S. pneumoniae resulted in increased susceptibility to infection with HMPV-enhanced green fluorescent protein (EGFP), as determined by enumeration of EGFP-positive cells. This was not the case for cells pre-incubated with H. influenzae, M. catarrhalis on S. aureus. We conclude that exposure to S. pneumoniae can modulate HMPV infection.
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Affiliation(s)
- N J Verkaik
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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