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Gonzalez-Ferrer S, Peñaloza HF, van der Geest R, Xiong Z, Gheware A, Tabary M, Kochin M, Dalton K, Zou H, Lou D, Lockwood K, Zhang Y, Bain WG, Mallampalli RK, Ray A, Ray P, Van Tyne D, Chen K, Lee JS. STAT1 Employs Myeloid Cell-Extrinsic Mechanisms to Regulate the Neutrophil Response and Provide Protection against Invasive Klebsiella pneumoniae Lung Infection. Immunohorizons 2024; 8:122-135. [PMID: 38289252 PMCID: PMC10832384 DOI: 10.4049/immunohorizons.2300104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
Klebsiella pneumoniae (KP) is an extracellular Gram-negative bacterium that causes infections in the lower respiratory and urinary tracts and the bloodstream. STAT1 is a master transcription factor that acts to maintain T cell quiescence under homeostatic conditions. Although STAT1 helps defend against systemic spread of acute KP intrapulmonary infection, whether STAT1 regulation of T cell homeostasis impacts pulmonary host defense during acute bacterial infection and injury is less clear. Using a clinical KP respiratory isolate and a pneumonia mouse model, we found that STAT1 deficiency led to an early neutrophil-dominant transcriptional profile and neutrophil recruitment in the lung preceding widespread bacterial dissemination and lung injury development. Yet, myeloid cell STAT1 was dispensable for control of KP proliferation and dissemination, because myeloid cell-specific STAT1-deficient (LysMCre/WT;Stat1fl/fl) mice showed bacterial burden in the lung, liver, and kidney similar to that of their wild-type littermates. Surprisingly, IL-17-producing CD4+ T cells infiltrated Stat1-/- murine lungs early during KP infection. The increase in Th17 cells in the lung was not due to preexisting immunity against KP and was consistent with circulating rather than tissue-resident CD4+ T cells. However, blocking global IL-17 signaling with anti-IL-17RC administration led to increased proliferation and dissemination of KP, suggesting that IL-17 provided by other innate immune cells is essential in defense against KP. Contrastingly, depletion of CD4+ T cells reduced Stat1-/- murine lung bacterial burden, indicating that early CD4+ T cell activation in the setting of global STAT1 deficiency is pathogenic. Altogether, our findings suggest that STAT1 employs myeloid cell-extrinsic mechanisms to regulate neutrophil responses and provides protection against invasive KP by restricting nonspecific CD4+ T cell activation and immunopathology in the lung.
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Affiliation(s)
- Shekina Gonzalez-Ferrer
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Hernán F. Peñaloza
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Rick van der Geest
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Zeyu Xiong
- Division of Pulmonary and Critical Care Medicine, The John T. Milliken Department of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Atish Gheware
- Division of Pulmonary and Critical Care Medicine, The John T. Milliken Department of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Mohammadreza Tabary
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Megan Kochin
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Kathryn Dalton
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Henry Zou
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Dequan Lou
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Karina Lockwood
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Yingze Zhang
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - William G. Bain
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA
| | - Rama K. Mallampalli
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ohio State University, Columbus, OH
| | - Anuradha Ray
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Prabir Ray
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Daria Van Tyne
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Kong Chen
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Janet S. Lee
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Acute Lung Injury Center of Excellence, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Division of Pulmonary and Critical Care Medicine, The John T. Milliken Department of Medicine, Washington University in St. Louis, St. Louis, MO
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Lund TC, Liegel J, Bejanyan N, Orchard PJ, Cao Q, Tolar J, Brunstein C, Wagner JE, Verneris MR, Weisdorf D. Second allogeneic hematopoietic cell transplantation for graft failure: poor outcomes for neutropenic graft failure. Am J Hematol 2015; 90:892-6. [PMID: 26149534 DOI: 10.1002/ajh.24111] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/16/2015] [Accepted: 07/02/2015] [Indexed: 12/12/2022]
Abstract
Graft failure (GF) after hematopoietic cell transplant (HCT) occurs in 5-30% of patients. GF can be accompanied by neutropenia (NGF) or can result with adequate neutrophils, but loss of donor chimerism (non-neutropenic graft failure, NNGF). In this report, we describe the outcomes of 95 patients treated with a second HCT for GF at the University of Minnesota; 62 with NGF and 33 with NNGF. The cumulative incidence of neutrophil recovery at 42 days after second HCT was 45% for NGF and 88% for NNGF. A second GF occurred in 34 NGF (55%) and in 9 NNGF (27%) patients. The incidence of Grade III-IV acute graft versus host disease (GVHD) was 8% (95% confidence interval (CI), 1-16%) and 12% (95% CI, 1-23%) for NGF and NNGF, respectively. From the 2nd HCT, 1-year overall survival (OS) was 44% (95% CI, 34-54%), [NNGF: 76% (95% CI, 57-87%) and NGF: 27% (95% CI, 17-39%)]. The most common cause of death after second HCT was infection (52%). In summary, the outcomes of second HCT after NGF and NNGF are different with much worse outcomes for NGF necessitating new approaches for this complication.
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Affiliation(s)
- Troy C. Lund
- Division of Pediatric Blood and Marrow Transplant, Department of Pediatrics; University of Minnesota; Minneapolis Minnesota
| | - Jessica Liegel
- Blood and Marrow Transplant Program, Department of Medicine; University of Minnesota; Minneapolis Minnesota
| | - Nelli Bejanyan
- Blood and Marrow Transplant Program, Department of Medicine; University of Minnesota; Minneapolis Minnesota
| | - Paul J. Orchard
- Division of Pediatric Blood and Marrow Transplant, Department of Pediatrics; University of Minnesota; Minneapolis Minnesota
| | - Qing Cao
- Biostatistics Core, Masonic Cancer Center; University of Minnesota; Minneapolis Minnesota
| | - Jakub Tolar
- Division of Pediatric Blood and Marrow Transplant, Department of Pediatrics; University of Minnesota; Minneapolis Minnesota
| | - Claudio Brunstein
- Blood and Marrow Transplant Program, Department of Medicine; University of Minnesota; Minneapolis Minnesota
| | - John E. Wagner
- Division of Pediatric Blood and Marrow Transplant, Department of Pediatrics; University of Minnesota; Minneapolis Minnesota
| | - Michael R. Verneris
- Division of Pediatric Blood and Marrow Transplant, Department of Pediatrics; University of Minnesota; Minneapolis Minnesota
| | - Daniel Weisdorf
- Blood and Marrow Transplant Program, Department of Medicine; University of Minnesota; Minneapolis Minnesota
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