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Radhouani M, Starkl P. Adjuvant-independent airway sensitization and infection mouse models leading to allergic asthma. FRONTIERS IN ALLERGY 2024; 5:1423938. [PMID: 39157265 PMCID: PMC11327155 DOI: 10.3389/falgy.2024.1423938] [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: 04/26/2024] [Accepted: 07/05/2024] [Indexed: 08/20/2024] Open
Abstract
Asthma is a chronic respiratory disease of global importance. Mouse models of allergic asthma have been instrumental in advancing research and novel therapeutic strategies for patients. The application of relevant allergens and physiological routes of exposure in such models has led to valuable insights into the complexities of asthma onset and development as well as key disease mechanisms. Furthermore, environmental microbial exposures and infections have been shown to play a fundamental part in asthma pathogenesis and alter disease outcome. In this review, we delve into physiological mouse models of allergic asthma and explore literature reports on most significant interplays between microbial infections and asthma development with relevance to human disease.
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Affiliation(s)
- Mariem Radhouani
- Research Division of Infection Biology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Philipp Starkl
- Research Division of Infection Biology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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Nemet M, Vukoja M. Obstructive Sleep Apnea and Acute Lower Respiratory Tract Infections: A Narrative Literature Review. Antibiotics (Basel) 2024; 13:532. [PMID: 38927198 PMCID: PMC11200551 DOI: 10.3390/antibiotics13060532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/27/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Both obstructive sleep apnea (OSA) and acute lower respiratory tract infections (LRTIs) are important global health issues. The pathophysiological links between OSA and LRTIs include altered immune responses due to chronic intermittent hypoxia and sleep fragmentation, increased aspiration risk, and a high burden of comorbidities. In this narrative review, we evaluated the current evidence on the association between OSA and the incidence and outcomes of acute LRTIs in adults, specifically community-acquired pneumonia and viral pneumonia caused by influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Studies have demonstrated that OSA patients are more likely to develop bacterial pneumonia and exhibit a higher risk of invasive pneumococcal disease. The risk intensifies with the severity of OSA, influencing hospitalization rates and the need for intensive care. OSA is also associated with an increased risk of contracting influenza and suffering more severe disease, potentially necessitating hospitalization. Similarly, OSA contributes to increased COVID-19 disease severity, reflected by higher rates of hospitalization, longer hospital stays, and a higher incidence of acute respiratory failure. The effect of OSA on mortality rates from these infections is, however, somewhat ambiguous. Finally, we explored antibiotic therapy for OSA patients with LRTIs, addressing care settings, empirical regimens, risks, and pharmacokinetic considerations. Given the substantial burden of OSA and its significant interplay with acute LRTIs, enhanced screening, targeted vaccinations, and optimized management strategies for OSA patients should be prioritized.
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Affiliation(s)
- Marko Nemet
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Marija Vukoja
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
- The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, 21204 Novi Sad, Serbia
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Schaunaman N, Cervantes D, Nichols T, Numata M, Ledford JG, Kraft M, Chu HW. Cooperation of immune regulators Tollip and surfactant protein A inhibits influenza A virus infection in mice. Respir Res 2024; 25:193. [PMID: 38702733 PMCID: PMC11068576 DOI: 10.1186/s12931-024-02820-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Influenza A virus (IAV) infection is a significant risk factor for respiratory diseases, but the host defense mechanisms against IAV remain to be defined. Immune regulators such as surfactant protein A (SP-A) and Toll-interacting protein (Tollip) have been shown to be involved in IAV infection, but whether SP-A and Tollip cooperate in more effective host defense against IAV infection has not been investigated. METHODS Wild-type (WT), Tollip knockout (KO), SP-A KO, and Tollip/SP-A double KO (dKO) mice were infected with IAV for four days. Lung macrophages were isolated for bulk RNA sequencing. Precision-cut lung slices (PCLS) from WT and dKO mice were pre-treated with SP-A and then infected with IAV for 48 h. RESULTS Viral load was significantly increased in bronchoalveolar lavage (BAL) fluid of dKO mice compared to all other strains of mice. dKO mice had significantly less recruitment of neutrophils into the lung compared to Tollip KO mice. SP-A treatment of PCLS enhanced expression of TNF and reduced viral load in dKO mouse lung tissue. Pathway analysis of bulk RNA sequencing data suggests that macrophages from IAV-infected dKO mice reduced expression of genes involved in neutrophil recruitment, IL-17 signaling, and Toll-like receptor signaling. CONCLUSIONS Our data suggests that both Tollip and SP-A are essential for the lung to exert more effective innate defense against IAV infection.
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Affiliation(s)
- Niccolette Schaunaman
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Room A639, Denver, CO, 80206, USA
| | - Diana Cervantes
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Room A639, Denver, CO, 80206, USA
| | - Taylor Nichols
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Room A639, Denver, CO, 80206, USA
| | - Mari Numata
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Room A639, Denver, CO, 80206, USA
| | | | - Monica Kraft
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hong Wei Chu
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Room A639, Denver, CO, 80206, USA.
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Cole J, Cąpała-Szczurko I, Roseti S, Chen C, Caveney S, Aksyuk AA, Streicher K, Ponnarambil S, Colice G. Effect of Tezepelumab on the Humoral Immune Response to Seasonal Quadrivalent Influenza Vaccination in Patients with Moderate to Severe Asthma: The Phase 3b VECTOR Study. Pulm Ther 2024; 10:53-67. [PMID: 38064153 PMCID: PMC10881940 DOI: 10.1007/s41030-023-00245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/06/2023] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Annual influenza vaccinations are recommended for adolescents and adults with moderate to severe asthma. This study investigated the effect of tezepelumab, a human monoclonal antibody that blocks the activity of thymic stromal lymphopoietin, on the humoral immune response to the quadrivalent seasonal influenza vaccine in patients with moderate to severe asthma. METHODS VECTOR was a phase 3b, randomized, multicenter, double-blind, parallel-group, placebo-controlled study. Adolescents (aged 12-17 years) and young adults (aged 18-21 years) with moderate to severe asthma were enrolled across 15 centers in the USA. Patients received tezepelumab 210 mg or placebo subcutaneously at weeks 0, 4, 8, and 12, and a single dose of inactivated quadrivalent seasonal influenza vaccine at week 12 before receiving study treatment. Immediately before vaccination and at 4 weeks postvaccination (week 16), strain-specific antibody responses were assessed for four influenza antigens by hemagglutination inhibition (HAI) and microneutralization (MN) assays. Safety was assessed. RESULTS Seventy patients were randomized to tezepelumab (n = 35) or placebo (n = 35). There were no meaningful differences in HAI or MN antibody responses between treatment groups at week 16. HAI assay geometric mean fold rises (GMFRs) for influenza strains were 1.76-7.34 for tezepelumab and 1.46-4.75 for placebo. MN assay GMFRs were 4.00-14.56 for tezepelumab and 3.56-10.62 for placebo. In the HAI assay, a fourfold or larger rise in antibody titer from weeks 12 to 16 occurred in 15.2-78.8% and 15.2-51.5% of tezepelumab and placebo recipients, respectively, and 97.0-100% of patients in both treatment groups achieved an antibody titer of at least 40 at week 16. No unexpected safety findings occurred. CONCLUSION There was no observed suppression of the humoral immune response after influenza vaccination in adolescents and young adults with moderate to severe asthma treated with tezepelumab. Therefore, the influenza vaccine can be administered to this patient population during tezepelumab treatment. CLINICALTRIALS GOV IDENTIFIER NCT05062759.
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Affiliation(s)
| | - Iwona Cąpała-Szczurko
- Late-Stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Warsaw, Poland
| | - Stephanie Roseti
- Late-Stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Claudia Chen
- Biometrics, Late-Stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Scott Caveney
- Global Development, Inflammation, R&D, Amgen, Thousand Oaks, CA, USA
| | - Anastasia A Aksyuk
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Katie Streicher
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Sandhia Ponnarambil
- Late-Stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
- AstraZeneca BioPharmaceuticals R&D, 136 Hills Road, Cambridge, CB2 8PA, UK.
| | - Gene Colice
- Late-Stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
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Pereira LA, Lapinscki BA, Santos JS, Debur MC, Petterle RR, Nogueira MB, Vidal LRR, De Almeida SM, Raboni SM. Influenza A infections: predictors of disease severity. Braz J Microbiol 2024; 55:75-86. [PMID: 38049661 PMCID: PMC10920610 DOI: 10.1007/s42770-023-01186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
Influenza affects approximately 10% of the world's population annually. It is associated with high morbidity and mortality rates due to its propensity to progress to severe acute respiratory infection, leading to 10-40% of hospitalized patients needing intensive care. Characterizing the multifactorial predictors of poor prognosis is essential for developing strategies against this disease. This study aimed to identify predictors of disease severity in influenza A-infected (IFA-infected) patients and to propose a prognostic score. A retrospective cross-sectional study was conducted with 142 IFA-infected out- and inpatients treated at a tertiary hospital between 2010 and 2018. The viral subtypes, hemagglutinin mutations, viral load, IL-28B SNPs, and clinical risk factors were evaluated according to the patient's ICU admission. Multivariate analysis identified the following risk factors for disease severity: neuromuscular diseases (OR = 7.02; 95% CI = 1.18-41.75; p = 0.032), cardiovascular diseases (OR = 5.47; 95% CI = 1.96-15.27; p = 0.001), subtype (H1N1) pdm09 infection (OR = 2.29; 95% CI = 1.02-5.15; p = 0.046), and viral load (OR = 1.43; 95% CI = 1.09-1.88; p = 0.009). The prognosis score for ICU admission is based on these predictors of severity presented and ROC curve AUC = 0.812 (p < 0.0001). Our results identified viral and host predictors of disease severity in IFA-infected patients, yielding a prognostic score that had a high performance in predicting the IFA patients' ICU admission and better results than a viral load value alone. However, its implementation in health services needs to be validated in a broader population.
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Affiliation(s)
- L A Pereira
- Graduate Program in Internal Medicine and Health Science, Federal University of Paraná, Curitiba, 82060-240, Brazil
| | - B A Lapinscki
- Graduate Program in Internal Medicine and Health Science, Federal University of Paraná, Curitiba, 82060-240, Brazil
| | - J S Santos
- Public Health Laboratory (LACEN-PR), Curitiba, Brazil
| | - M C Debur
- Public Health Laboratory (LACEN-PR), Curitiba, Brazil
| | - R R Petterle
- Medical School, Sector of Health Sciences, Federal University of Paraná, Curitiba, 82060-240, Brazil
| | - M B Nogueira
- Clinical Analysis Department, Federal University of Parana, Curitiba, 82060-240, Brazil
| | - L R R Vidal
- Virology Laboratory, Federal University of Paraná, Curitiba, 82060-240, Brazil
- Virology Laboratory, Complexo Hospital de Clínicas, Federal University of Paraná, Curitiba, 82060-240, Brazil
| | - S M De Almeida
- Department of Medical Pathology, Federal University of Paraná, Curitiba, 82060-240, Brazil
| | - S M Raboni
- Virology Laboratory, Complexo Hospital de Clínicas, Federal University of Paraná, Curitiba, 82060-240, Brazil.
- Division of Infectious Diseases, Federal University of Paraná, Curitiba, 82060-240, Brazil.
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Djeddi S, Fernandez-Salinas D, Huang GX, Aguiar VRC, Mohanty C, Kendziorski C, Gazal S, Boyce J, Ober C, Gern J, Barrett N, Gutierrez-Arcelus M. Rhinovirus infection of airway epithelial cells uncovers the non-ciliated subset as a likely driver of genetic susceptibility to childhood-onset asthma. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.02.24302068. [PMID: 38370648 PMCID: PMC10871459 DOI: 10.1101/2024.02.02.24302068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Asthma is a complex disease caused by genetic and environmental factors. Epidemiological studies have shown that in children, wheezing during rhinovirus infection (a cause of the common cold) is associated with asthma development during childhood. This has led scientists to hypothesize there could be a causal relationship between rhinovirus infection and asthma or that RV-induced wheezing identifies individuals at increased risk for asthma development. However, not all children who wheeze when they have a cold develop asthma. Genome-wide association studies (GWAS) have identified hundreds of genetic variants contributing to asthma susceptibility, with the vast majority of likely causal variants being non-coding. Integrative analyses with transcriptomic and epigenomic datasets have indicated that T cells drive asthma risk, which has been supported by mouse studies. However, the datasets ascertained in these integrative analyses lack airway epithelial cells. Furthermore, large-scale transcriptomic T cell studies have not identified the regulatory effects of most non-coding risk variants in asthma GWAS, indicating there could be additional cell types harboring these "missing regulatory effects". Given that airway epithelial cells are the first line of defense against rhinovirus, we hypothesized they could be mediators of genetic susceptibility to asthma. Here we integrate GWAS data with transcriptomic datasets of airway epithelial cells subject to stimuli that could induce activation states relevant to asthma. We demonstrate that epithelial cultures infected with rhinovirus significantly upregulate childhood-onset asthma-associated genes. We show that this upregulation occurs specifically in non-ciliated epithelial cells. This enrichment for genes in asthma risk loci, or 'asthma heritability enrichment' is also significant for epithelial genes upregulated with influenza infection, but not with SARS-CoV-2 infection or cytokine activation. Additionally, cells from patients with asthma showed a stronger heritability enrichment compared to cells from healthy individuals. Overall, our results suggest that rhinovirus infection is an environmental factor that interacts with genetic risk factors through non-ciliated airway epithelial cells to drive childhood-onset asthma.
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Vanders RL, Gomez HM, Hsu AC, Daly K, Wark PAB, Horvat JC, Hansbro PM. Inflammatory and antiviral responses to influenza A virus infection are dysregulated in pregnant mice with allergic airway disease. Am J Physiol Lung Cell Mol Physiol 2023; 325:L385-L398. [PMID: 37463835 DOI: 10.1152/ajplung.00232.2022] [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: 07/24/2022] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
Influenza A virus (IAV) infections are increased during pregnancy especially with asthma as a comorbidity, leading to asthma exacerbations, secondary bacterial infections, intensive care unit admissions, and mortality. We aimed to define the processes involved in increased susceptibility and severity of IAV infections during pregnancy, especially with asthma. We sensitized mice to house dust mite (HDM), induced pregnancy, and challenged with HDM to induce allergic airway disease (AAD). At midpregnancy, we induced IAV infection. We assessed viral titers, airway inflammation, lung antiviral responses, mucus hypersecretion, and airway hyperresponsiveness (AHR). During early IAV infection, pregnant mice with AAD had increased mRNA expression of the inflammatory markers Il13 and IL17 and reduced mRNA expression of the neutrophil chemoattractant marker Kc. These mice had increased mucous hyperplasia and increased AHR. miR155, miR574, miR223, and miR1187 were also reduced during early infection, as was mRNA expression of the antiviral β-defensins, Bd1, Bd2, and Spd and IFNs, Ifnα, Ifnβ, and Ifnλ. During late infection, Il17 was still increased as was eosinophil infiltration in the lungs. mRNA expression of Kc was reduced, as was neutrophil infiltration and mRNA expression of the antiviral markers Ifnβ, Ifnλ, and Ifnγ and Ip10, Tlr3, Tlr9, Pkr, and Mx1. Mucous hyperplasia was still significantly increased as was AHR. Early phase IAV infection in pregnancy with asthma heightens underlying inflammatory asthmatic phenotype and reduces antiviral responses.NEW & NOTEWORTHY Influenza A virus (IAV) infection during pregnancy with asthma is a major health concern leading to increased morbidity for both mother and baby. Using murine models, we show that IAV infection in pregnancy with allergic airway disease is associated with impaired global antiviral and antimicrobial responses, increased lung inflammation, mucus hypersecretion, and airway hyperresponsiveness (AHR). Targeting specific β-defensins or microRNAs (miRNAs) may prove useful in future treatments for IAV infection during pregnancy.
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Affiliation(s)
- Rebecca L Vanders
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Henry M Gomez
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Alan C Hsu
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Katie Daly
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Peter A B Wark
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jay C Horvat
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Philip M Hansbro
- Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia
- Vaccines, Infection, Viruses and Asthma Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute and University of Technology Sydney, Sydney, New South Wales, Australia
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Chang LA, Choi A, Rathnasinghe R, Warang P, Noureddine M, Jangra S, Chen Y, De Geest BG, Schotsaert M. Influenza breakthrough infection in vaccinated mice is characterized by non-pathological lung eosinophilia. Front Immunol 2023; 14:1217181. [PMID: 37600776 PMCID: PMC10437116 DOI: 10.3389/fimmu.2023.1217181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Eosinophils are important mediators of mucosal tissue homeostasis, anti-helminth responses, and allergy. Lung eosinophilia has previously been linked to aberrant Type 2-skewed T cell responses to respiratory viral infection and may also be a consequence of vaccine-associated enhanced respiratory disease (VAERD), particularly in the case of respiratory syncytial virus (RSV) and the formalin-inactivated RSV vaccine. We previously reported a dose-dependent recruitment of eosinophils to the lungs of mice vaccinated with alum-adjuvanted trivalent inactivated influenza vaccine (TIV) following a sublethal, vaccine-matched H1N1 (A/New Caledonia/20/1999; NC99) influenza challenge. Given the differential role of eosinophil subset on immune function, we conducted the investigations herein to phenotype the lung eosinophils observed in our model of influenza breakthrough infection. Here, we demonstrate that eosinophil influx into the lungs of vaccinated mice is adjuvant- and sex-independent, and only present after vaccine-matched sublethal influenza challenge but not in mock-challenged mice. Furthermore, vaccinated and challenged mice had a compositional shift towards more inflammatory eosinophils (iEos) compared to resident eosinophils (rEos), resembling the shift observed in ovalbumin (OVA)-sensitized allergic control mice, however without any evidence of enhanced morbidity or aberrant inflammation in lung cytokine/chemokine signatures. Furthermore, we saw a lung eosinophil influx in the context of a vaccine-mismatched challenge. Additional layers of heterogeneity in the eosinophil compartment were observed via unsupervised clustering analysis of flow cytometry data. Our collective findings are a starting point for more in-depth phenotypic and functional characterization of lung eosinophil subsets in the context of vaccine- and infection-induced immunity.
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Affiliation(s)
- Lauren A. Chang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Angela Choi
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Raveen Rathnasinghe
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Prajakta Warang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Moataz Noureddine
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Sonia Jangra
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yong Chen
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | | | - Michael Schotsaert
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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9
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Elsabour Kinawy SA, Assalahi AA, Elnour Elshikh Ahmed G, Taha A, Abd Elgafar Hassan K, Wahdan Alrifai A, Helmy Elsaied M. COVID-19 and H1N1 Influenza: Are They 2 Sides of the Same Coin? Med J Islam Repub Iran 2023; 37:71. [PMID: 37600633 PMCID: PMC10436672 DOI: 10.47176/mjiri.37.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Indexed: 08/22/2023] Open
Abstract
Background Swine flu (H1N1) and Coronavirus diseases (COVID-19) have been compared in the past few months. Both pandemics sparked a worldwide major panic. Although both have some common symptoms and diagnoses, they are quite different in many aspects. The current study aimed to investigate the differences in clinical and viral behaviors between H1N1 Influenza and COVID-19 pneumonia. Methods This was a retrospective study of adult patients hospitalized with H1N1 influenza pneumonia between January 2019 and February 2020, and patients hospitalized with COVID-19 during the outbreak. A demographic and clinical characteristic of H1N1 influenza and COVID-19 patients were recorded. Both groups were compared-using an independent samples student t test for continuous variables and a chi-square test for categorical data-to identify significantly different parameters between the 2 diseases. Results A total of 78 patients were included and divided into 2 groups: 33 patients (42.3%) with H1N1 and 45 patients (57.7%) with COVID-19. The mean age of the patients was 43.3 ± 10.6 years. Bronchial asthma was significantly higher among patients with H1N1, while diabetes mellitus was significantly higher among patients with COVID-19. Right lower lobe affection was significantly present among those with H1N1 than those with COVID (100% vs 0%). The monocytic count was significantly higher among those with H1N1 than COVID-19 (11.63 ± 1.50 vs 7.76 ± 1.68; P < 0.001). Respiratory rates of more than 22 c/min significantly increased in patients with HINI than in those with COVID-19 (18.2% vs 4.4%; P = 0.05). Mortality increased in patients with HINI than in those with COVID-19 (18.2% vs 6.7%). However, the difference did not reach statistical significance (P = 0.15). Conclusion Clinically, it is difficult to distinguish between H1N1 and COVID-19. Thus, a polymerase chain reaction is recommended for all patients suffering from influenza-like symptoms to rule out influenza A subtype H1N1 and/or SARS-CoV2.
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Affiliation(s)
- Sayed Abd Elsabour Kinawy
- Chest Diseases Department, Faculty of Medicine, Aswan University, Egypt,
Intensive Care Unit Consultant New Najran General Hospital, KSA
| | | | | | - Ahmed Taha
- Department of Chest Disease, Faculty of Medicine, Al-Azhar University, Cairo,
Egypt
| | - Kamel Abd Elgafar Hassan
- Department of Chest Disease, Damietta Faculty of Medicine (DFM), Al-Azhar
University, Damietta, Egypt
| | - Atef Wahdan Alrifai
- Department of Chest Disease, Damietta Faculty of Medicine (DFM), Al-Azhar
University, Damietta, Egypt
| | - Mahmoud Helmy Elsaied
- Department of Forensic Medicine and Clinical Toxicology, DFM, Al-Azhar
University, Damietta, Egypt
- Medical Education, Alexandria University, Egypt
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10
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Kim SH, Park HY, Jung H, Zo S, Kim S, Park DW, Park TS, Moon JY, Kim SH, Kim TH, Sohn JW, Yoon HJ, Lee H, Shin SH. Trends and factors associated with influenza vaccination in subjects with asthma: analysis of the Korea National Health and Nutrition Examination Survey between 2010 and 2019. Ther Adv Chronic Dis 2022; 13:20406223221123979. [PMID: 36213169 PMCID: PMC9537498 DOI: 10.1177/20406223221123979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/18/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite the importance of influenza vaccination, its rates in subjects with asthma are suboptimal, especially in the young population. METHODS Among 72,843 adults aged ⩾18 years from the Korea National Health and Nutrition Examination Survey conducted between 2010 and 2019, 1643 with asthma were included. The yearly trends and factors associated with influenza vaccination were analyzed in subjects with asthma. In addition, stratified analyses were performed by age group (<65 versus ⩾65 years). RESULTS During the study period, the overall influenza vaccination rate among subjects with asthma fluctuated from 51.0% to 64.3%, with a consistently higher vaccination rate in elderly subjects than in young subjects. Among young subjects with asthma, factors positively associated with influenza vaccination were female sex [adjusted odds ratio (aOR) = 1.66, 95% confidence interval (CI) = 1.11-2.49], current asthma being treated (aOR = 1.69, 95% CI = 1.14-2.50), history of pulmonary tuberculosis (aOR = 2.01, 95% CI = 1.04-3.87), and dyslipidemia (aOR = 1.86, 95% CI = 1.05-3.30). However, unmarried subjects showed an inverse relationship (aOR = 0.50, 95% CI = 0.34-0.75). In elderly subjects, unmarried status (aOR = 0.52, 95% CI = 0.29-0.94), being underweight (aOR = 0.29, 95% CI = 0.09-0.97), and having a low income (aOR = 0.42, 95% CI = 0.18-0.97) were factors negatively associated with influenza vaccination. CONCLUSION In the last 10 years, influenza vaccination rates have still been insufficient in subjects with asthma, particularly in young subjects. Considering the factors that are influencing the vaccination rates of young subjects, public policies to increase influenza vaccination rates in subjects with asthma need to be established urgently.
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Affiliation(s)
| | | | - Hwasik Jung
- Division of Pulmonary and Critical Care
Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, Korea
| | - Sungmin Zo
- Division of Pulmonary and Critical Care
Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, Korea
| | - Saerom Kim
- Division of Pulmonary and Critical Care
Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
| | - Tai Sun Park
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
| | - Sang-Heon Kim
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
| | - Tae-Hyung Kim
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
| | - Jang Won Sohn
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
| | - Ho Joo Yoon
- Division of Pulmonary Medicine and Allergy,
Department of Internal Medicine, Hanyang University College of Medicine,
Seoul, Korea
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11
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Kimura S, Yasudo H, Oga A, Fukano R, Matsushige T, Hamano H, Hasegawa H, Nakajima N, Ainai A, Itoh H, Shirabe K, Toda S, Atsuta R, Hasegawa S. Histological characteristics of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 in asthmatic murine model during A(H1N1)pdm09 infection. Pathol Int 2022; 72:506-518. [PMID: 36066006 DOI: 10.1111/pin.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/09/2022] [Indexed: 11/27/2022]
Abstract
Pandemic influenza virus A(H1N1)pdm09 infection occurred in healthy children and young adults, but asthmatic patients presented more rapid progression of respiratory distress and plastic bronchitis. To investigate the pathogenesis of worsening respiratory symptoms after A(H1N1)pdm09 infection, we focused on matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1). MMP-9 and TIMP-1 levels in bronchoalveolar lavage fluid and serum from mice with and without asthma were evaluated after A(H1N1)pdm09 or seasonal A(H1N1) infection. MMP-9 levels were more elevated in Asthma/A(H1N1)pdm09-infected mice than in non-Asthma/A(H1N1)pdm09-infected mice on both 3 and 7 days post-infection. Immunohistochemical findings in this pneumonia model showed that MMP-9 and TIMP-1 positive cells were observed in blood vessels and bronchus of lung tissue in severe pathological findings of pneumonia with asthma. Microscopically, shedding cells and secretions were conspicuous in the trachea on days 3 and 7 post-infection, in the A(H1N1)pdm09-infected mice with asthma. Our results suggest that MMP-9 and TIMP-1 expressions are related to severe pneumonia in the A(H1N1)pdm09 infection with asthma, leading to cause epithelial cell shedding.
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Affiliation(s)
- Sasagu Kimura
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroki Yasudo
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Atsunori Oga
- Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takeshi Matsushige
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroki Hamano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hideki Hasegawa
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Hiroshi Itoh
- Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Komei Shirabe
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Shoichi Toda
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Ryo Atsuta
- Akihabara Atsuta Clinic, Chiyoda-ku, Japan
| | - Shunji Hasegawa
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
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12
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Flores-Torres AS, Samarasinghe AE. Impact of Therapeutics on Unified Immunity During Allergic Asthma and Respiratory Infections. FRONTIERS IN ALLERGY 2022; 3:852067. [PMID: 35386652 PMCID: PMC8974821 DOI: 10.3389/falgy.2022.852067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/21/2022] [Indexed: 11/04/2022] Open
Abstract
Asthma is a common chronic respiratory disease that affects millions of people worldwide. Patients with allergic asthma, the most prevalent asthma endotype, are widely considered to possess a defective immune response against some respiratory infectious agents, including viruses, bacteria and fungi. Furthermore, respiratory pathogens are associated with asthma development and exacerbations. However, growing data suggest that the immune milieu in allergic asthma may be beneficial during certain respiratory infections. Immunomodulatory asthma treatments, although beneficial, should then be carefully prescribed to avoid misuse and overuse as they can also alter the host microbiome. In this review, we summarize and discuss recent evidence of the correlations between allergic asthma and the most significant respiratory infectious agents that have a role in asthma pathogenesis. We also discuss the implications of current asthma therapeutics beyond symptom prevention.
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Affiliation(s)
- Armando S. Flores-Torres
- Division of Pulmonology, Allergy-Immunology, and Sleep, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - Amali E. Samarasinghe
- Division of Pulmonology, Allergy-Immunology, and Sleep, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, United States,*Correspondence: Amali E. Samarasinghe
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13
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Persson C. Early humoral defense under the radar: microvascular-epithelial cooperation at airways infection in asthma and health. Am J Physiol Lung Cell Mol Physiol 2022; 322:L503-L506. [PMID: 35263205 PMCID: PMC8917927 DOI: 10.1152/ajplung.00470.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Carl Persson
- Laboratory Medicine, University Hospital of Lund, Lund, Sweden
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14
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Protein Disulfide Isomerase A3 Regulates Influenza Neuraminidase Activity and Influenza Burden in the Lung. Int J Mol Sci 2022; 23:ijms23031078. [PMID: 35162999 PMCID: PMC8834910 DOI: 10.3390/ijms23031078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/02/2022] Open
Abstract
Influenza (IAV) neuraminidase (NA) is a glycoprotein required for the viral exit from the cell. NA requires disulfide bonds for proper function. We have recently demonstrated that protein disulfide isomerase (PDI)A3 is required for oxidative folding of IAV hemagglutinin (HA), and viral propagation. However, it not known whether PDIs are required for NA maturation or if these interactions represent a putative target for the treatment of influenza infection. We sought to determine whether PDIA3 is required for disulfide bonds of NA, its activity, and propagation of the virus. Requirement of disulfides for NA oligomerization and activity were determined using biotin switch and redox assays in WT and PDIA3−/− in A549 cells. A PDI specific inhibitor (LOC14) was utilized to determine the requirement of PDIs in NA activity, IAV burden, and inflammatory response in A549 and primary mouse tracheal epithelial cells. Mice were treated with the inhibitor LOC14 and subsequently examined for IAV burden, NA activity, cytokine, and immune response. IAV-NA interacts with PDIA3 and this interaction is required for NA activity. PDIA3 ablation or inhibition decreased NA activity, viral burden, and inflammatory response in lung epithelial cells. LOC14 treatment significantly attenuated the influenza-induced inflammatory response in mice including the overall viral burden. These results provide evidence for PDIA3 inhibition suppressing NA activity, potentially providing a novel platform for host-targeted antiviral therapies.
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15
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Drăgănescu AC, Miron VD, Streinu-Cercel A, Florea D, Vlaicu O, Bilaşco A, Oţelea D, Luminos ML, Piţigoi D, Streinu-Cercel A, Săndulescu O. Circulation of influenza A viruses among patients hospitalized for severe acute respiratory infection in a tertiary care hospital in Romania in the 2018/19 season: Results from an observational descriptive epidemiological study. Medicine (Baltimore) 2021; 100:e28460. [PMID: 34967388 PMCID: PMC8718231 DOI: 10.1097/md.0000000000028460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 12/09/2021] [Indexed: 01/05/2023] Open
Abstract
The seasonal circulation of influenza viruses and the impact that this infection has on the population varies from year to year. We have prospectively captured hospital-based surveillance data describing the circulation of influenza viruses and characterizing patients with influenza admitted to a tertiary hospital in Bucharest, Romania in the 2018/19 season.We have conducted an observational descriptive epidemiological study analyzing all consecutive patients hospitalized for influenza like illness or severe acute respiratory infection at the National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania, from November 2018 to April 2019. For all patients we actively collected standardized clinical information and performed real-time reverse transcription polymerase chain reaction testing of respiratory samples to identify the presence of influenza viruses and to determine the subtype/lineage.A total of 1128 hospitalized patients were tested in this study, with an influenza positivity rate of 41.2% (n = 465). We identified an exclusive circulation of influenza A viruses (A/H1 - 57.2%, A/H3 - 29.3%, A not subtyped - 13.3%), with only 1 case of influenza B detected at the end of the season (week 18/2019). Children under 5 years of age accounted for the majority of cases (40%, n = 186), and all cases had a favorable evolution. Females were more likely to test positive for influenza (53.3%) compared to males (46.7%), P = .048, and presence of asthma or chronic obstructive pulmonary disease increased the risk of influenza 4.4-fold and 2-fold, respectively (P < .001 and P = .034). Thirteen influenza patients required hospitalization in intensive care and 5 deaths were recorded (1.1%). The vaccination rate for all patients included in the study was low (4.6%). The existence of chronic conditions or age over 65 years prolonged the hospitalization period with 2 days (P < .001 each).In the 2018/19 season, we identified an important circulation of influenza A viruses among patients hospitalized for influenza like illness/severe acute respiratory infection in a tertiary care hospital in Romania, with a higher likelihood of affecting females and patients with pre-existing lung conditions. Monitoring of the clinical and epidemiological characteristics of influenza virus infection is of great interest and should be done carefully each season to better inform on the necessary measures to limit the impact that this infection may have on risk groups.
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Affiliation(s)
| | | | - Anca Streinu-Cercel
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Dragoş Florea
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ovidiu Vlaicu
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
| | - Anuţa Bilaşco
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
| | - Dan Oţelea
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
| | - Monica Luminiţa Luminos
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Daniela Piţigoi
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adrian Streinu-Cercel
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Oana Săndulescu
- National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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16
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Could Interleukin-33 (IL-33) Govern the Outcome of an Equine Influenza Virus Infection? Learning from Other Species. Viruses 2021; 13:v13122519. [PMID: 34960788 PMCID: PMC8704309 DOI: 10.3390/v13122519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/04/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Influenza A viruses (IAVs) are important respiratory pathogens of horses and humans. Infected individuals develop typical respiratory disorders associated with the death of airway epithelial cells (AECs) in infected areas. Virulence and risk of secondary bacterial infections vary among IAV strains. The IAV non-structural proteins, NS1, PB1-F2, and PA-X are important virulence factors controlling AEC death and host immune responses to viral and bacterial infection. Polymorphism in these proteins impacts their function. Evidence from human and mouse studies indicates that upon IAV infection, the manner of AEC death impacts disease severity. Indeed, while apoptosis is considered anti-inflammatory, necrosis is thought to cause pulmonary damage with the release of damage-associated molecular patterns (DAMPs), such as interleukin-33 (IL-33). IL-33 is a potent inflammatory mediator released by necrotic cells, playing a crucial role in anti-viral and anti-bacterial immunity. Here, we discuss studies in human and murine models which investigate how viral determinants and host immune responses control AEC death and subsequent lung IL-33 release, impacting IAV disease severity. Confirming such data in horses and improving our understanding of early immunologic responses initiated by AEC death during IAV infection will better inform the development of novel therapeutic or vaccine strategies designed to protect life-long lung health in horses and humans, following a One Health approach.
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17
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Murillo-Zamora E, Trujillo X, Huerta M, Ríos-Silva M, Guzmán-Esquivel J, Benites-Godínez V, Mendoza-Cano O. Survival in influenza virus-related pneumonia by viral subtype: 2016-2020. Int J Infect Dis 2021; 112:288-293. [PMID: 34547495 DOI: 10.1016/j.ijid.2021.09.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/11/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Influenza remains a common cause of morbidity and mortality worldwide, and viral subtype-related differences in disease outcomes have been documented. OBJECTIVE To characterize the survival experience of adult inpatients with influenza virus-associated pneumonia by viral subtype during five consecutive flu seasons. METHOD We performed a retrospective cohort study; data from 4,678 adults were analyzed using the Kaplan-Meier method. A multivariate Cox proportional hazard regression model was fitted. RESULTS The overall in-hospital mortality rate was 25.0 per 1,000 hospital days. The survival probabilities from pneumonia patients went from 93.4% (95% CI 92.6-94.1%) by day three to 43.3% (95% CI 39.2-47.4%) by day 30 from hospital admission. In general, the lowest survival rates were observed in patients with AH1N1 infection. In multiple models, after adjusting for comorbidities and when compared with A non-subtyped virus, pneumonia patients with AH3N2 or B strains had a significantly decreased risk of a non-favorable disease outcome. The association of other strains was not significant. CONCLUSIONS Our findings suggest that the survival of inpatients with influenza virus-associated pneumonia varies according to the pathogenic viral subtype; the lowest survival rates were observed in patients with AH1N1 infection. This effect was independent of the patients' gender, age, and the analyzed underlying health conditions.
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Affiliation(s)
- Efrén Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Av. Javier Mina 301, Col. Centro, C.P. 28000, Colima, Colima, México; Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. L as Víboras, C.P. 28040, Colima, Colima, México.
| | - Xóchitl Trujillo
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de julio 965, Col. Villas San Sebastián, C.P. 28045 Colima, México.
| | - Miguel Huerta
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de julio 965, Col. Villas San Sebastián, C.P. 28045 Colima, México.
| | - Mónica Ríos-Silva
- Universidad de Colima - CONACyT, Centro Universitario de Investigaciones Biomédicas, Av. 25 de julio 965, Col. Villas San Sebastián, C.P. 28045 Colima, México
| | - José Guzmán-Esquivel
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. L as Víboras, C.P. 28040, Colima, Colima, México; Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. de los Maestros 149, Col. Centro, CP 28000, Colima, México.
| | - Verónica Benites-Godínez
- Coordinación de Educación en Salud, Instituto Mexicano del Seguro Social, Calzada del Ejercito Nacional 14, Col. Fray Junípero Serra, C.P. 63160, Tepic, Nayarit; Unidad Académica de Medicina, Universidad Autónoma de Nayarit, Ciudad de la Cultura Amado Nervo, C.P. 631555, Tepic, Nayarit , México Tel +523112118800.
| | - Oliver Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 carretera Colima-Coquimatlán, Coquimatlán, C.P. 28400, Colima, México..
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18
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Flores-Torres AS, Rendon A, Salinas-Carmona MC, Salinas E, Rosas-Taraco AG. Human Eosinophils Reduce Viral Titer, Secrete IL-8, and Increase RIG-I Expression in Response to Influenza A H1N1 pdm09. Viral Immunol 2021; 34:573-578. [PMID: 34415814 DOI: 10.1089/vim.2021.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Eosinophils participate in the immune response against many pathogens, including viruses. Since mouse eosinophils are susceptible to influenza A virus infection and possess antiviral activity, we evaluated the expression of sialic acid residues in human eosinophils and their response against influenza virus in vitro. We demonstrated that human eosinophils express α2,6- and α2,3-linked sialic acid, and drastically reduced influenza virus titer. After influenza virus exposure, eosinophils upregulated retinoic acid-inducible gene I (RIG-I) mRNA expression, but no other pattern recognition receptors. Finally, high concentrations of interleukin-8 (IL-8) were found in influenza virus-exposed eosinophil cultures. These data suggest that human eosinophils possess antiviral activity and may play a role in the innate immune response to influenza virus.
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Affiliation(s)
- Armando S Flores-Torres
- Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Adrian Rendon
- Center of Research, Prevention and Treatment of Respiratory Diseases (CIPTIR), University Hospital, Universidad Autónoma de Nuevo León Monterrey, Mexico
| | - Mario C Salinas-Carmona
- Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Eva Salinas
- Department of Microbiology, Center of Basic Science, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
| | - Adrian G Rosas-Taraco
- Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
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Mthembu N, Ikwegbue P, Brombacher F, Hadebe S. Respiratory Viral and Bacterial Factors That Influence Early Childhood Asthma. FRONTIERS IN ALLERGY 2021; 2:692841. [PMID: 35387053 PMCID: PMC8974778 DOI: 10.3389/falgy.2021.692841] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
Asthma is a chronic respiratory condition characterised by episodes of shortness of breath due to reduced airway flow. The disease is triggered by a hyperreactive immune response to innocuous allergens, leading to hyper inflammation, mucus production, changes in structural cells lining the airways, and airway hyperresponsiveness. Asthma, although present in adults, is considered as a childhood condition, with a total of about 6.2 million children aged 18 and below affected globally. There has been progress in understanding asthma heterogeneity in adults, which has led to better patient stratification and characterisation of multiple asthma endotypes with distinct, but overlapping inflammatory features. The asthma inflammatory profile in children is not well-defined and heterogeneity of the disease is less described. Although many factors such as genetics, food allergies, antibiotic usage, type of birth, and cigarette smoke exposure can influence asthma development particularly in children, respiratory infections are thought to be the major contributing factor in poor lung function and onset of the disease. In this review, we focus on viral and bacterial respiratory infections in the first 10 years of life that could influence development of asthma in children. We also review literature on inflammatory immune heterogeneity in asthmatic children and how this overlaps with early lung development, poor lung function and respiratory infections. Finally, we review animal studies that model early development of asthma and how these studies could inform future therapies and better understanding of this complex disease.
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Affiliation(s)
- Nontobeko Mthembu
- Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Paul Ikwegbue
- Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Frank Brombacher
- Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Division of Immunology, Health Science Faculty, International Centre for Genetic Engineering and Biotechnology (ICGEB) and Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Faculty of Health Sciences, Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Sabelo Hadebe
- Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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20
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Laura G, Liu Y, Fernandes K, Willis-Owen SAG, Ito K, Cookson WO, Moffatt MF, Zhang Y. ORMDL3 regulates poly I:C induced inflammatory responses in airway epithelial cells. BMC Pulm Med 2021; 21:167. [PMID: 34001091 PMCID: PMC8127224 DOI: 10.1186/s12890-021-01496-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Oroscomucoid 3 (ORMDL3) has been linked to susceptibility of childhood asthma and respiratory viral infection. Polyinosinic-polycytidylic acid (poly I:C) is a synthetic analog of viral double-stranded RNA, a toll-like receptor 3 (TLR3) ligand and mimic of viral infection. METHODS To investigate the functional role of ORMDL3 in the poly I:C-induced inflammatory response in airway epithelial cells, ORMDL3 knockdown and over-expression models were established in human A549 epithelial cells and primary normal human bronchial epithelial (NHBE) cells. The cells were stimulated with poly I:C or the Th17 cytokine IL-17A. IL-6 and IL-8 levels in supernatants, mRNA levels of genes in the TLR3 pathway and inflammatory response from cell pellets were measured. ORMDL3 knockdown models in A549 and BEAS-2B epithelial cells were then infected with live human rhinovirus (HRV16) followed by IL-6 and IL-8 measurement. RESULTS ORMDL3 knockdown and over-expression had little influence on the transcript levels of TLR3 in airway epithelial cells. Time course studies showed that ORMDL3-deficient A549 and NHBE cells had an attenuated IL-6 and IL-8 response to poly I:C stimulation. A549 and NHBE cells over-expressing ORMDL3 released relatively more IL-6 and IL-8 following poly I:C stimulation. IL-17A exhibited a similar inflammatory response in ORMDL3 knockdown and over-expressing cells, but co-stimulation of poly I:C and IL-17A did not significantly enhance the IL-6 and IL-8 response. Transcript abundance of IFNB following poly I:C stimulation was not significantly altered by ORMDL3 knockdown or over-expression. Dampening of the IL-6 response by ORMDL3 knockdown was confirmed in HRV16 infected BEAS-2B and A549 cells. CONCLUSIONS ORMDL3 regulates the viral inflammatory response in airway epithelial cells via mechanisms independent of the TLR3 pathway.
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Affiliation(s)
- Gemma Laura
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Yi Liu
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Kieran Fernandes
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | | | - Kazuhiro Ito
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK.,Pulmocide Ltd., London, WC2A 1AP, UK
| | - William O Cookson
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Miriam F Moffatt
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Youming Zhang
- National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK.
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21
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The microbiome in atopic patients and potential modifications in the context of the severe acute respiratory syndrome coronavirus 2 pandemic. Curr Opin Allergy Clin Immunol 2021; 21:245-251. [PMID: 33769313 DOI: 10.1097/aci.0000000000000738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Data regarding the effects of coronavirus disease 2019 (COVID-19) on host-microbiome alteration and subsequent effects on susceptibility and clinical course of COVID-19, especially in atopic patients, are currently limited. Here, we review the studies regarding the microbiome of atopic patients with other respiratory infections and discuss the potential role of probiotics as therapeutic targets for COVID-19 to decrease its susceptibility and severity of COVID-19. RECENT FINDINGS Respiratory tract virus infection affects the gut and airway microbiome structures and host's immune function. Diverse factors in atopic diseases affect the airway and gut microbiome structures, which are expected to negatively influence host health. However, response to respiratory virus infection in atopic hosts depends on the preexisting microbiome and immune responses. This may explain the inconclusiveness of the effects of COVID-19 on the susceptibility, morbidity, and mortality of patients with atopic diseases. Beneficial probiotics may be a therapeutic adjuvant in COVID-19 infection as the beneficial microbiome can decrease the viral load in the early phase of respiratory virus infection and improve the morbidity and mortality. SUMMARY Application of probiotics can be a potential adjuvant treatment in respiratory virus infection to improve host immune responses and disturbed microbiome structures in atopic patients. Further related studies involving COVID-19 are warranted in near future.
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Song D, Iverson E, Kaler L, Bader S, Scull MA, Duncan GA. Modeling Airway Dysfunction in Asthma Using Synthetic Mucus Biomaterials. ACS Biomater Sci Eng 2021; 7:2723-2733. [PMID: 33871978 DOI: 10.1021/acsbiomaterials.0c01728] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
As asthma worsens, occlusion of airways with mucus significantly contributes to airflow obstruction and reduced lung function. Recent evidence from clinical studies has shown mucus obtained from adults and children with asthma possesses altered mucin composition. However, how these changes alter the functional properties of the mucus gel is not yet fully understood. To study this, we have engineered a synthetic mucus biomaterial to closely mimic the properties of native mucus in health and disease. We demonstrate that this model possesses comparable biophysical and transport properties to native mucus ex vivo collected from human subjects and in vitro isolated from human airway epithelial (HAE) tissue cultures. We found by systematically varying mucin composition that mucus gel viscoelasticity is enhanced when predominantly composed of mucin 5AC (MUC5AC), as is observed in asthma. As a result, asthma-like synthetic mucus gels are more slowly transported on the surface of HAE tissue cultures and at a similar rate to native mucus produced by HAE cultures stimulated with type 2 cytokine IL-13, known to contribute to airway inflammation and MUC5AC hypersecretion in asthma. We also discovered that the barrier function of asthma-like synthetic mucus toward influenza A virus was impaired as evidenced by the increased frequency of infection in MUC5AC-rich hydrogel-coated HAE cultures. Together, this work establishes a biomaterial-based approach to understand airway dysfunction in asthma and related muco-obstructive lung diseases.
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Affiliation(s)
- Daniel Song
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
| | - Ethan Iverson
- Department of Cell Biology & Molecular Genetics, University of Maryland, College Park, Maryland 20742, United States
| | - Logan Kaler
- Biophysics Program, University of Maryland, College Park, Maryland 20742, United States
| | - Shahed Bader
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
| | - Margaret A Scull
- Department of Cell Biology & Molecular Genetics, University of Maryland, College Park, Maryland 20742, United States
| | - Gregg A Duncan
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States.,Biophysics Program, University of Maryland, College Park, Maryland 20742, United States
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23
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Eosinophil Responses at the Airway Epithelial Barrier during the Early Phase of Influenza A Virus Infection in C57BL/6 Mice. Cells 2021; 10:cells10030509. [PMID: 33673645 PMCID: PMC7997358 DOI: 10.3390/cells10030509] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 02/07/2023] Open
Abstract
Eosinophils, previously considered terminally differentiated effector cells, have multifaceted functions in tissues. We previously found that allergic mice with eosinophil-rich inflammation were protected from severe influenza and discovered specialized antiviral effector functions for eosinophils including promoting cellular immunity during influenza. In this study, we hypothesized that eosinophil responses during the early phase of influenza contribute to host protection. Using in vitro and in vivo models, we found that eosinophils were rapidly and dynamically regulated upon influenza A virus (IAV) exposure to gain migratory capabilities to traffic to lymphoid organs after pulmonary infection. Eosinophils were capable of neutralizing virus upon contact and combinations of eosinophil granule proteins reduced virus infectivity through hemagglutinin inactivation. Bi-directional crosstalk between IAV-exposed epithelial cells and eosinophils occurred after IAV infection and cross-regulation promoted barrier responses to improve antiviral defenses in airway epithelial cells. Direct interactions between eosinophils and airway epithelial cells after IAV infection prevented virus-induced cytopathology in airway epithelial cells in vitro, and eosinophil recipient IAV-infected mice also maintained normal airway epithelial cell morphology. Our data suggest that eosinophils are important in the early phase of IAV infection providing immediate protection to the epithelial barrier until adaptive immune responses are deployed during influenza.
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24
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Murillo-Zamora E, Mendoza-Cano O, Delgado-Enciso I, Guzmán-Esquivel J. National retrospective cohort study to identify risk factors for in-hospital 30-day lethality in laboratory-confirmed cases of influenza. Rev Clin Esp 2021; 221:76-85. [PMID: 32674849 DOI: 10.1016/j.rce.2020.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify factors associated with the risk of death in adolescent and adult inpatients with laboratory-positive (reverse-transcription polymerase chain reaction) influenza in Mexico during consecutive influenza seasons (2018-2020). PATIENTS AND METHODS A retrospective cohort study used national surveillance system data, enrolling 3422 individuals. The association between various risk factors and 30-day in-hospital lethality were evaluated through risk ratios (RR) and 95% confidence intervals (CI). RESULTS The lethality rate was 18.1%. Flu vaccination history (RR = 0.56, 95% CI 0.42-0.78), early antiviral drug administration (≤ two days from symptom onset [reference ≥ 5 days], RR = 0.68, 95% CI 0.58-0.81), and a history of asthma (RR = 0.66, 95% CI 0.47-0.95) showed protective effects against influenza-attributable death. Mechanical ventilator support produced the highest increase in death risk (RR = 3.31, 95% CI 2.89-3.79). Male sex, older age, AH1N1 subtype, and other chronic diseases were also associated with fatal in-hospital influenza-related outcomes. CONCLUSIONS Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.
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Affiliation(s)
- E Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Colima, México
| | - O Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, Colima, México
| | | | - J Guzmán-Esquivel
- Facultad de Medicina, Universidad de Colima, Colima, México; Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, México.
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25
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Li Y, Wang D, Zhi L, Zhu Y, Qiao L, Zhu Y, Hu X, Wang Q, Cao Y, Gao Y, Chen Y, Zhang Z, Bi F, Yan G. Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season. Sci Rep 2021; 11:2083. [PMID: 33483566 PMCID: PMC7822879 DOI: 10.1038/s41598-021-81558-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/17/2020] [Indexed: 01/07/2023] Open
Abstract
To describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.
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Affiliation(s)
- Yuyun Li
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Dongming Wang
- People's Hospital of Huantai County, No. 2198, Huantai Street, Zibo City, 256400, Shandong Province, China
| | - Lili Zhi
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China. .,Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, 250013, China.
| | - Yunmei Zhu
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Lan Qiao
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Yan Zhu
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Xin Hu
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Qian Wang
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Yuan Cao
- Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Yan Gao
- Zhangdian District Center for Disease Control and Prevention, No. 184, Xincun West Road, Zibo, 255000, Shandong Province, China
| | - Yousheng Chen
- Respiratory Medicine Department, Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Zeng Zhang
- Department of ENT, Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Fangjie Bi
- Internal Cardiovascular Department, Zibo Central Hospital, No. 54, Gongqingtuan West Road, Zibo, 255036, Shandong Province, People's Republic of China
| | - Guangxing Yan
- Pediatrics, Zibo Municipal Hospital, No. 139, Huangong Road, Zibo, 255400, Shandong Province, China
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26
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Eosinophils and COVID-19: diagnosis, prognosis, and vaccination strategies. Semin Immunopathol 2021; 43:383-392. [PMID: 33728484 PMCID: PMC7962927 DOI: 10.1007/s00281-021-00850-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
The unprecedented impact of the coronavirus disease 2019 (COVID-19) pandemic has resulted in global challenges to our health-care systems and our economic security. As such, there has been significant research into all aspects of the disease, including diagnostic biomarkers, associated risk factors, and strategies that might be used for its treatment and prevention. Toward this end, eosinopenia has been identified as one of many factors that might facilitate the diagnosis and prognosis of severe COVID-19. However, this finding is neither definitive nor pathognomonic for COVID-19. While eosinophil-associated conditions have been misdiagnosed as COVID-19 and others are among its reported complications, patients with pre-existing eosinophil-associated disorders (e.g., asthma, eosinophilic gastrointestinal disorders) do not appear to be at increased risk for severe disease; interestingly, several recent studies suggest that a diagnosis of asthma may be associated with some degree of protection. Finally, although vaccine-associated aberrant inflammatory responses, including eosinophil accumulation in the respiratory tract, were observed in preclinical immunization studies targeting the related SARS-CoV and MERS-CoV pathogens, no similar complications have been reported clinically in response to the widespread dissemination of either of the two encapsulated mRNA-based vaccines for COVID-19.
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27
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Murillo-Zamora E, Mendoza-Cano O, Delgado-Enciso I, Guzmán-Esquivel J. National retrospective cohort study to identify risk factors for in-hospital 30-day lethality in laboratory-confirmed cases of influenza. Rev Clin Esp 2020; 221:76-85. [PMID: 33998492 DOI: 10.1016/j.rceng.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/15/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To identify factors associated with the risk of death in adolescent and adult inpatients with laboratory-positive (reverse-transcription polymerase chain reaction) influenza in Mexico during consecutive influenza seasons (2018-2020). METHODS A retrospective cohort study used national surveillance system data, enrolling 3.422 individuals. The association between various risk factors and 30-day in-hospital lethality were evaluated through risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS The lethality rate was 18.1%. Flu vaccination history (RR=0.56, 95% CI 0.42-0.78), early antiviral drug administration (≤2 days from symptom onset [reference ≥5 days], RR=0.68, 95% CI 0.58-0.81), and a history of asthma (RR=0.66, 95% CI 0.47-0.95) showed protective effects against influenza-attributable death. Mechanical ventilator support produced the highest increase in death risk (RR=3.31, 95% CI 2.89-3.79). Male sex, older age, AH1N1 subtype, and other chronic diseases were also associated with fatal in-hospital influenza-related outcomes. CONCLUSIONS Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.
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Affiliation(s)
- E Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro, Colima, Colima, Mexico
| | - O Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 carretera Colima-Coquimatlán, Colima, Mexico
| | - I Delgado-Enciso
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Colima, Mexico
| | - J Guzmán-Esquivel
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Colima, Mexico; Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, Mexico.
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28
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Isaac BTJ, Kirupakaran H, Barney AM, Christopher DJ. Lessons from healthcare personnel screening and management during H1N1 pandemic in preparation for the impending COVID-19 pandemic in a tertiary care hospital in India. Indian J Tuberc 2020; 67:S122-S127. [PMID: 33308657 PMCID: PMC7388779 DOI: 10.1016/j.ijtb.2020.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/13/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Abstract
Background In the wake of the COVID-19 pandemic caused by a novel corona virus, health care personnel are at increased risk of acquiring the infection. In preparation for the management of health care personnel that are likely to be infected, we looked in to the data collected during the Influenza pandemic in 2009, caused by a novel strain of H1N1 influenza called swine flu. The care of healthcare personnel in our institution, who had an acute febrile respiratory illness (AFRI) during that period was routed through a single channel using a uniform protocol. We retrospectively analysed the available data, during the initial four months of the pandemic, to draw lessons from it. Objective To study the prevalence, clinical profile and risk factors of swine flu among health care personnel during the pandemic of 2009 in a tertiary care hospital in South India. Methodology This retrospective study enrolled all the health care personnel including students of a tertiary care institution in South India, who presented with an AFRI between June to August, the initial four months of the swine flu pandemic of 2009. The clinical profile and risk factors were extracted. The results of the RT PCR for swine flu was obtained. Prevalence in each demographic group was calculated and compared. Characteristics of those with swine flu were compared with those who turned negative for the swine flu. Results The prevalence of all AFRI and only swine flu among health care personnel during the study period was 18 per thousand and 8.7 per thousand respectively. Highest prevalence of swine flu was found among students and office staff. After adjusting for confounding factors, hyperthermia at presentation was significantly higher {OR = 1.97; 95% CI (1.01–3.76)} among those who tested positive for swine flu as compared with those with other AFRI's. Only 2.5% of the entire AFRI group required admission and there was no mortality. Conclusion Health care personnel are at increased risk of acquiring infection. Our study demonstrated that students and office staff were the most susceptible. Unprotected exposure to unknown infectious patients and relatives is likely to have been an important factor. Though the mode of transmission is similar, compared to H1N1, COVID-19 is associated with different comorbidities and has significantly higher mortality. Therefore, in preparation for the COVID-19 pandemic, the personal protective equipment of the healthcare personnel need to be escalated. During a pandemic, health care personnel are at increased risk of acquiring infection. Unprotected exposure to unknown infectious patients is an important factor for transmission. Compared to H1N1, COVID-19 is associated with different comorbidities and has significantly higher mortality. In preparation for the COVID-19 pandemic, the personal protective equipment of the healthcare personnel need to be escalated.
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Affiliation(s)
- Barney T J Isaac
- Department of Pulmonary Medicine, Christian Medical College, Vellore, 632004, India.
| | - Henry Kirupakaran
- Department of Student and Staff Health Service, Christian Medical College, Vellore, India
| | - Anitha M Barney
- Department of Clinical Genetics, Christian Medical College, Vellore, India
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29
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Wu Q, Jorde I, Kershaw O, Jeron A, Bruder D, Schreiber J, Stegemann-Koniszewski S. Resolved Influenza A Virus Infection Has Extended Effects on Lung Homeostasis and Attenuates Allergic Airway Inflammation in a Mouse Model. Microorganisms 2020; 8:microorganisms8121878. [PMID: 33260910 PMCID: PMC7761027 DOI: 10.3390/microorganisms8121878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022] Open
Abstract
Allergic airway inflammation (AAI) involves T helper cell type 2 (Th2) and pro-inflammatory responses to aeroallergens and many predisposing factors remain elusive. Influenza A virus (IAV) is a major human pathogen that causes acute respiratory infections and induces specific immune responses essential for viral clearance and resolution of the infection. Beyond acute infection, IAV has been shown to persistently affect lung homeostasis and respiratory immunity. Here we asked how resolved IAV infection affects subsequently induced AAI. Mice infected with a sublethal dose of IAV were sensitized and challenged in an ovalbumin mediated mouse model for AAI after resolution of the acute viral infection. Histological changes, respiratory leukocytes, cytokines and airway hyperreactivity were analyzed in resolved IAV infection alone and in AAI with and without previous IAV infection. More than five weeks after infection, we detected persistent pneumonia with increased activated CD4+ and CD8+ lymphocytes as well as dendritic cells and MHCII expressing macrophages in the lung. Resolved IAV infection significantly affected subsequently induced AAI on different levels including morphological changes, respiratory leukocytes and lymphocytes as well as the pro-inflammatory cytokine responses, which was clearly diminished. We conclude that IAV has exceptional persisting effects on respiratory immunity with substantial consequences for subsequently induced AAI.
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Affiliation(s)
- Qingyu Wu
- Experimental Pneumology, Department of Pneumology, Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (Q.W.); (I.J.); (J.S.)
| | - Ilka Jorde
- Experimental Pneumology, Department of Pneumology, Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (Q.W.); (I.J.); (J.S.)
| | - Olivia Kershaw
- Institute of Veterinary Pathology, Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany;
| | - Andreas Jeron
- Infection Immunology Group, Institute of Medical Microbiology, Infection Control and Prevention, Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (A.J.); (D.B.)
- Immune Regulation Group, Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany
| | - Dunja Bruder
- Infection Immunology Group, Institute of Medical Microbiology, Infection Control and Prevention, Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (A.J.); (D.B.)
- Immune Regulation Group, Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany
| | - Jens Schreiber
- Experimental Pneumology, Department of Pneumology, Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (Q.W.); (I.J.); (J.S.)
| | - Sabine Stegemann-Koniszewski
- Experimental Pneumology, Department of Pneumology, Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (Q.W.); (I.J.); (J.S.)
- Correspondence:
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30
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van Zyl-Smit R, Feldman C, Richards G, Abdool-Gaffar S, Lalloo U, Kalla I, Koegelenberg CFN, Dheda K. South African Thoracic Society statement on obstructive airways disease and COVID-19. Afr J Thorac Crit Care Med 2020; 26:10.7196/AJTCCM.2020.v26i3.111. [PMID: 34476396 PMCID: PMC8397166 DOI: 10.7196/ajtccm.2020.v26i3.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Asthmatics do not appear to have increased susceptibility to COVID-19.Uncontrolled severe asthma may be associated with worsened COVID-19 outcomes, especially in asthmatics managed with oral corticosteroids. Risk mitigation measures such as hand hygiene, social distancing and wearing of face masks must be observed at all times. Asthma should be managed as outlined in local and international guidelines.Ensure an adequate supply of medication, and inhaled corticosteroids should not be withdrawnChronic obstructive pulmonary disease (COPD) is associated with severe COVID-19 disease and poor outcomes. Maintenance of background medication is important to avoid exacerbations of COPD.Vaccination against influenza is strongly advised for all patients with asthma and COPDVaccination against pneumococcal infection is advisable for patients with COPD. Patients with obstructive airway disease on oral corticosteroids and/or with impaired lung function should take stringent safety precautions. This statement will be updated when more data become available Asthma and COPD occur commonly in South Africa. SARS-CoV-2 is a novel coronavirus, which can result in COVID-19-associated severe respiratory infection with respiratory failure and the need for mechanical ventilation. The South African Thoracic Society has prepared a guidance statement to assist clinicians and patients with asthma and COPD during the current epidemic.
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Affiliation(s)
- R van Zyl-Smit
- Division of Pulmonology, Department of Medicine and UCT Lung Institute, Faculty of Health Sciences, University of Cape Town, South Africa
| | - C Feldman
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - G Richards
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - U Lalloo
- Durban University of Technology, Enhancing Care Foundation and Busamed Gateway Private Hospital, Durban, South Africa
| | - I Kalla
- Durban University of Technology, Enhancing Care Foundation and Busamed Gateway Private Hospital, Durban, South Africa
| | - C F N Koegelenberg
- Division of Pulmonology, Faculty of Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - K Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute, University of Cape Town, South Africa
- South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, South Africa
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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31
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Montoya-Alonso JA, Morchón R, Matos JI, Falcón-Cordón Y, Costa-Rodriguez N, Carretón E. Dirofilaria immitis Could Be a Risk Factor for the Development of Allergic Diseases in Humans. Animals (Basel) 2020; 10:ani10101847. [PMID: 33050570 PMCID: PMC7601753 DOI: 10.3390/ani10101847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Heartworm is a parasitic infection transmitted by mosquitoes to animals and humans. The risk of human infections is high in those areas with high canine prevalence, such as the Canary Islands. In these islands, there is also a high number of allergic inhabitants. Since some studies have shown a relationship between parasite infections and development of allergies, the aim of this study was to evaluate whether exposure to heartworm may contribute to the development of allergies. A survey carried out on dog owners in the Canary Islands showed that 51.3% of allergic owners had a heartworm-positive dog, and significant differences were found between allergic or not-allergic owners, according to whether the dog was negative or positive to heartworm. Furthermore, 66 serum samples from inhabitants of the Canary Islands were analyzed for the presence of unspecific allergy markers (Immunoglobulin E or IgE) and specific for heartworm (IgE against Dirofilaria immitis and Wolbachia) and the results show that people who were in contact with heartworm showed total IgE and specific IgE against heartworm more frequently. Contact with heartworm may be a risk factor for the development of allergic diseases, although further studies to elucidate the relationship between heartworm and allergies should be carried out. Abstract The Canary Islands are hyperendemic for canine heartworm and the risk of zoonotic infection is high. Additionally, there is evidence of development of allergies due to nematode infections in animals and humans. Since the population of the Canary Islands presents high prevalence of allergic comorbidities, and previous studies have shown a possible relationship between allergies and seropositivity to heartworm, the aim was to evaluate whether exposure to heartworm may contribute to the development of allergies in the human population. First, an epidemiological study was conducted on 248 owners of dogs with/without heartworm infection in the Canary Islands. Secondly, a serological analysis of the presence of total IgE and specific IgE against heartworm was conducted in 66 samples of inhabitants of the Canary Islands. The survey showed that allergic owners had heartworm-positive dogs more frequently (p < 0.01). Of the analyzed human samples, 43.9% were seropositive to heartworm and Wolbachia. Total IgE concentrations were increased in 34.5% seropositive samples and 8.1% seronegative samples. Specific IgE against heartworm was only found in human seropositive samples (17.2%). Contact with heartworm may be a risk factor for the development of allergic diseases, although further studies to elucidate the relationship between heartworm and allergies should be carried out.
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Affiliation(s)
- José Alberto Montoya-Alonso
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (J.A.M.-A.); (J.I.M.); (Y.F.-C.); (N.C.-R.)
| | - Rodrigo Morchón
- Animal and Human Dirofilariosis Group, Laboratory of Parasitology, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain;
| | - Jorge Isidoro Matos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (J.A.M.-A.); (J.I.M.); (Y.F.-C.); (N.C.-R.)
| | - Yaiza Falcón-Cordón
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (J.A.M.-A.); (J.I.M.); (Y.F.-C.); (N.C.-R.)
| | - Noelia Costa-Rodriguez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (J.A.M.-A.); (J.I.M.); (Y.F.-C.); (N.C.-R.)
| | - Elena Carretón
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (J.A.M.-A.); (J.I.M.); (Y.F.-C.); (N.C.-R.)
- Correspondence:
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Macias AE, McElhaney JE, Chaves SS, Nealon J, Nunes MC, Samson SI, Seet BT, Weinke T, Yu H. The disease burden of influenza beyond respiratory illness. Vaccine 2020; 39 Suppl 1:A6-A14. [PMID: 33041103 PMCID: PMC7545338 DOI: 10.1016/j.vaccine.2020.09.048] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/10/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023]
Abstract
Although influenza is primarily considered a respiratory infection and causes significant respiratory mortality, evidence suggests that influenza has an additional burden due to broader consequences of the illness. Some of these broader consequences include cardiovascular events, exacerbations of chronic underlying conditions, increased susceptibility to secondary bacterial infections, functional decline, and poor pregnancy outcomes, all of which may lead to an increased risk for hospitalization and death. Although it is methodologically difficult to measure these impacts, epidemiological and interventional study designs have evolved over recent decades to better take them into account. Recognizing these broader consequences of influenza virus infection is essential to determine the full burden of influenza among different subpopulations and the value of preventive approaches. In this review, we outline the main influenza complications and societal impacts beyond the classical respiratory symptoms of the disease.
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Affiliation(s)
- Alejandro E Macias
- Department of Medicine and Nutrition, University of Guanajuato, Guanajuato, Mexico.
| | | | | | | | - Marta C Nunes
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | | | - Bruce T Seet
- Sanofi Pasteur, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada.
| | | | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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33
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Rich HE, Antos D, Melton NR, Alcorn JF, Manni ML. Insights Into Type I and III Interferons in Asthma and Exacerbations. Front Immunol 2020; 11:574027. [PMID: 33101299 PMCID: PMC7546400 DOI: 10.3389/fimmu.2020.574027] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/25/2020] [Indexed: 01/16/2023] Open
Abstract
Asthma is a highly prevalent, chronic respiratory disease that impacts millions of people worldwide and causes thousands of deaths every year. Asthmatics display different phenotypes with distinct genetic components, environmental causes, and immunopathologic signatures, and are broadly characterized into type 2-high or type 2-low (non-type 2) endotypes by linking clinical characteristics, steroid responsiveness, and molecular pathways. Regardless of asthma severity and adequate disease management, patients may experience acute exacerbations of symptoms and a loss of disease control, often triggered by respiratory infections. The interferon (IFN) family represents a group of cytokines that play a central role in the protection against and exacerbation of various infections and pathologies, including asthma. Type I and III IFNs in particular play an indispensable role in the host immune system to fight off pathogens, which seems to be altered in both pediatric and adult asthmatics. Impaired IFN production leaves asthmatics susceptible to infection and with uncontrolled type 2 immunity, promotes airway hyperresponsiveness (AHR), and inflammation which can lead to asthma exacerbations. However, IFN deficiency is not observed in all asthmatics, and alterations in IFN expression may be independent of type 2 immunity. In this review, we discuss the link between type I and III IFNs and asthma both in general and in specific contexts, including during viral infection, co-infection, and bacterial/fungal infection. We also highlight several studies which examine the potential role for type I and III IFNs as asthma-related therapies.
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Affiliation(s)
- Helen E Rich
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Danielle Antos
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Natalie R Melton
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - John F Alcorn
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Michelle L Manni
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
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34
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Velasco-Medina AA, García-León ML, Velázquez-Sámano G, Wong-Chew RM. The cellular and humoral immune response to influenza vaccination is comparable in asthmatic and healthy subjects. Hum Vaccin Immunother 2020; 17:98-105. [PMID: 32437230 DOI: 10.1080/21645515.2020.1759995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Annual influenza vaccination is recommended as a preventive measure for all patients with asthma since asthma exacerbations in children and adults are associated to viral infections including influenza. There is concern about the adequate immune response in asthmatics with ICS treatment. The production of antibodies to influenza in asthmatics has been demonstrated. However, cellular immunity is poorly understood. The aim of the study was to compare the humoral and cellular immune responses to influenza vaccine in asthmatic and healthy subjects. Twenty-five asthmatic patients attending the Allergy and Clinical Immunology Service at the Hospital General de Mexico and 25 healthy adults were included. Blood samples were obtained before, 4 and 12 months after immunization with influenza vaccine, influenza-specific antibodies were determined by the hemagglutination inhibition test and influenza-specific memory B, TCD4+, and TCD8 + lymphocytes were determined by flow cytometry. All the asthmatic patients received ICS treatment. The Geometric Mean titers for all influenza serotypes were similar in both groups; seropositivity and the cellular immune response increased in both groups over time and was comparable. Influenza vaccination in asthmatic patients with immunotherapy and ICS achieved protective antibody levels and cellular immunity over time comparable to healthy subjects.
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Affiliation(s)
- Andrea Aida Velasco-Medina
- Allergy and Clinical Immunology Department, Hospital General de México "Dr Eduardo Liceaga" , Mexico City, Mexico
| | | | - Guillermo Velázquez-Sámano
- Allergy and Clinical Immunology Department, Hospital General de México "Dr Eduardo Liceaga" , Mexico City, Mexico
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35
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LeMessurier KS, Rooney R, Ghoneim HE, Liu B, Li K, Smallwood HS, Samarasinghe AE. Influenza A virus directly modulates mouse eosinophil responses. J Leukoc Biol 2020; 108:151-168. [PMID: 32386457 DOI: 10.1002/jlb.4ma0320-343r] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 12/14/2022] Open
Abstract
Allergic asthma and influenza are common respiratory diseases with a high probability of co-occurrence. During the 2009 influenza pandemic, hospitalized patients with influenza experienced lower morbidity if asthma was an underlying condition. We have previously demonstrated that acute allergic asthma protects mice from severe influenza and have implicated eosinophils in the airways of mice with allergic asthma as participants in the antiviral response. However, very little is known about how eosinophils respond to direct exposure to influenza A virus (IAV) or the microenvironment in which the viral burden is high. We hypothesized that eosinophils would dynamically respond to the presence of IAV through phenotypic, transcriptomic, and physiologic changes. Using our mouse model of acute fungal asthma and influenza, we showed that eosinophils in lymphoid tissues were responsive to IAV infection in the lungs and altered surface expression of various markers necessary for cell activation in a niche-specific manner. Siglec-F expression was altered in a subset of eosinophils after virus exposure, and those expressing high Siglec-F were more active (IL-5Rαhi CD62Llo ). While eosinophils exposed to IAV decreased their overall transcriptional activity and mitochondrial oxygen consumption, transcription of genes encoding viral recognition proteins, Ddx58 (RIG-I), Tlr3, and Ifih1 (MDA5), were up-regulated. CD8+ T cells from IAV-infected mice expanded in response to IAV PB1 peptide-pulsed eosinophils, and CpG methylation in the Tbx21 promoter was reduced in these T cells. These data offer insight into how eosinophils respond to IAV and help elucidate alternative mechanisms by which they regulate antiviral immune responses during IAV infection.
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Affiliation(s)
- Kim S LeMessurier
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Children's Foundation Research Institute, Memphis, Tennessee, USA
| | - Robert Rooney
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Genetics, Genomics & Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Children's Foundation Research Institute, Memphis, Tennessee, USA
| | - Hazem E Ghoneim
- Department of Immunology, St Jude Children's Research Hospital, Memphis, Tennessee, USA.,Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, Ohio, USA
| | - Baoming Liu
- Department of Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kui Li
- Department of Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Heather S Smallwood
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Children's Foundation Research Institute, Memphis, Tennessee, USA
| | - Amali E Samarasinghe
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Children's Foundation Research Institute, Memphis, Tennessee, USA
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36
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Salvator H, Grassin-Delyle S, Naline E, Brollo M, Fournier C, Couderc LJ, Devillier P. Contrasting Effects of Adipokines on the Cytokine Production by Primary Human Bronchial Epithelial Cells: Inhibitory Effects of Adiponectin. Front Pharmacol 2020; 11:56. [PMID: 32132922 PMCID: PMC7040162 DOI: 10.3389/fphar.2020.00056] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/22/2020] [Indexed: 12/15/2022] Open
Abstract
Background Obesity is associated with an elevated risk of respiratory infections and inflammatory lung diseases. The objective was to investigate (i) the effects of adipokines (adiponectin (APN), leptin, chemerin, and visfatin) on the production of cytokines by unstimulated and poly(I:C)- and TNF-α-activated human primary bronchial epithelial cells (hBECs), (ii) the cells’ expression of the APN receptors (AdipoR1 and AdipoR2), and (iii) the cells' production of APN. Methods The hBECs were isolated from patients undergoing surgery for lung carcinoma. The cells were then cultured with human recombinant adipokines in the absence or presence of TNF-α or poly(I:C) for 24 h. Supernatant levels of cytokines (IL-6, CCL2, CCL5, CCL20, CXCL1, CXCL8) and APN were measured using ELISAs. The mRNA levels of AdipoR1 and AdipoR2 in hBECs were determined using a real-time quantitative PCR. Results Of the four adipokines tested, only APN significantly influenced the basal production and the TNF-α poly(I:C)-induced production of cytokines by hBECs. APN (3-30 µg.ml-1) was associated with greater basal production of IL-6, CCL20, and CXCL8, lower basal production of CCL2 and CXCL1 and no difference in CCL5 production. APN inhibited the poly(I:C)-induced production of these five cytokines and the TNF-α-induced production of CCL2 and CXCL1. AdipoR1 and AdipoR2 were both expressed in hBECs. In contrast to human bronchial explants, isolated hBECs did not produce APN. Conclusions The APN concentrations are abnormally low in obese individuals, and this fall may contribute to the susceptibility to viral lung infections and the severity of these infections in obese individuals.
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Affiliation(s)
- Hélène Salvator
- Laboratory of Research in Respiratory Pharmacology-UPRES EA220, UFR Sciences de la Santé Simone Veil, Université Paris-Saclay, Suresnes, France.,Department of Respiratory Diseases, Hôpital Foch, Suresnes, France
| | - Stanislas Grassin-Delyle
- Department of Respiratory Diseases, Hôpital Foch, Suresnes, France.,Mass Spectrometry Platform & INSERM UMR1173, UFR Sciences de la Santé Simone Veil, Université Versailles Saint Quentin en Yvelines, Université Paris-Saclay, Montigny-le-Bretonneux, France
| | - Emmanuel Naline
- Laboratory of Research in Respiratory Pharmacology-UPRES EA220, UFR Sciences de la Santé Simone Veil, Université Paris-Saclay, Suresnes, France.,Department of Respiratory Diseases, Hôpital Foch, Suresnes, France
| | - Marion Brollo
- Laboratory of Research in Respiratory Pharmacology-UPRES EA220, UFR Sciences de la Santé Simone Veil, Université Paris-Saclay, Suresnes, France
| | - Caroline Fournier
- Laboratory of Research in Respiratory Pharmacology-UPRES EA220, UFR Sciences de la Santé Simone Veil, Université Paris-Saclay, Suresnes, France
| | - Louis-Jean Couderc
- Laboratory of Research in Respiratory Pharmacology-UPRES EA220, UFR Sciences de la Santé Simone Veil, Université Paris-Saclay, Suresnes, France.,Department of Respiratory Diseases, Hôpital Foch, Suresnes, France
| | - Philippe Devillier
- Laboratory of Research in Respiratory Pharmacology-UPRES EA220, UFR Sciences de la Santé Simone Veil, Université Paris-Saclay, Suresnes, France.,Department of Respiratory Diseases, Hôpital Foch, Suresnes, France
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37
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LeMessurier KS, Iverson AR, Chang TC, Palipane M, Vogel P, Rosch JW, Samarasinghe AE. Allergic inflammation alters the lung microbiome and hinders synergistic co-infection with H1N1 influenza virus and Streptococcus pneumoniae in C57BL/6 mice. Sci Rep 2019; 9:19360. [PMID: 31852944 PMCID: PMC6920369 DOI: 10.1038/s41598-019-55712-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/28/2019] [Indexed: 12/12/2022] Open
Abstract
Asthma is a chronic airways condition that can be exacerbated during respiratory infections. Our previous work, together with epidemiologic findings that asthmatics were less likely to suffer from severe influenza during the 2009 pandemic, suggest that additional complications of influenza such as increased susceptibility to bacterial superinfection, may be mitigated in allergic hosts. To test this hypothesis, we developed a murine model of 'triple-disease' in which mice rendered allergic to Aspergillus fumigatus were co-infected with influenza A virus and Streptococcus pneumoniae seven days apart. Significant alterations to known synergistic effects of co-infection were noted in the allergic mice including reduced morbidity and mortality, bacterial burden, maintenance of alveolar macrophages, and reduced lung inflammation and damage. The lung microbiome of allergic mice differed from that of non-allergic mice during co-infection and antibiotic-induced perturbation to the microbiome rendered allergic animals susceptible to severe morbidity. Our data suggest that responses to co-infection in allergic hosts likely depends on the immune and microbiome states and that antibiotics should be used with caution in individuals with underlying chronic lung disease.
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Affiliation(s)
- Kim S LeMessurier
- Department of Paediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, 38103, USA
- Children's Foundation Research Institute, Memphis, TN, 38103, USA
| | - Amy R Iverson
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Ti-Cheng Chang
- Center for Applied Bioinformatics, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Maneesha Palipane
- Department of Paediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, 38103, USA
- Children's Foundation Research Institute, Memphis, TN, 38103, USA
| | - Peter Vogel
- Department of Veterinary Pathology at St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Jason W Rosch
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Amali E Samarasinghe
- Department of Paediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, 38103, USA.
- Children's Foundation Research Institute, Memphis, TN, 38103, USA.
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38
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Allergic Airway Disease Prevents Lethal Synergy of Influenza A Virus-Streptococcus pneumoniae Coinfection. mBio 2019; 10:mBio.01335-19. [PMID: 31266877 PMCID: PMC6606812 DOI: 10.1128/mbio.01335-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Asthma has become one of the most common chronic diseases and has been identified as a risk factor for developing influenza. However, the impact of asthma on postinfluenza secondary bacterial infection is currently not known. Here, we developed a novel triple-challenge model of allergic airway disease, primary influenza infection, and secondary Streptococcus pneumoniae infection to investigate the impact of asthma on susceptibility to viral-bacterial coinfections. We report for the first time that mice recovering from acute allergic airway disease are highly resistant to influenza-pneumococcal coinfection and that this resistance is due to inhibition of influenza virus-mediated impairment of bacterial clearance. Further characterization of allergic airway disease-associated resistance against postinfluenza secondary bacterial infection may aid in the development of prophylactic and/or therapeutic treatment against coinfection. Fatal outcomes following influenza infection are often associated with secondary bacterial infections. Allergic airway disease (AAD) is known to influence severe complications from respiratory infections, and yet the mechanistic effect of AAD on influenza virus-Streptococcus pneumoniae coinfection has not been investigated previously. We examined the impact of AAD on host susceptibility to viral-bacterial coinfections. We report that AAD improved survival during coinfection when viral-bacterial challenge occurred 1 week after AAD. Counterintuitively, mice with AAD had significantly deceased proinflammatory responses during infection. Specifically, both CD4+ and CD8+ T cell interferon gamma (IFN-γ) responses were suppressed following AAD. Resistance to coinfection was also associated with strong transforming growth factor β1 (TGF-β1) expression and increased bacterial clearance. Treatment of AAD mice with IFN-γ or genetic deletion of TGF-β receptor II expression reversed the protective effects of AAD. Using a novel triple-challenge model system, we show for the first time that AAD can provide protection against influenza virus-S. pneumoniae coinfection through the production of TGF-β that suppresses the influenza virus-induced IFN-γ response, thereby preserving antibacterial immunity.
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39
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Flores-Torres AS, Salinas-Carmona MC, Salinas E, Rosas-Taraco AG. Eosinophils and Respiratory Viruses. Viral Immunol 2019; 32:198-207. [PMID: 31140942 DOI: 10.1089/vim.2018.0150] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Eosinophils have been mainly associated with parasitic infection and pathologies such as asthma. Some patients with asthma present a high number of eosinophils in their airways. Since respiratory viruses are associated with asthma exacerbations, several studies have evaluated the role of eosinophils against respiratory viruses. Eosinophils contain and produce molecules with antiviral activity, including RNases and reactive nitrogen species. They can also participate in adaptive immunity, serving as antigen-presenting cells. Eosinophil antiviral response has been demonstrated against some respiratory viruses in vitro and in vivo, including respiratory syncytial virus and influenza. Given the implication of respiratory viruses in asthma, the eosinophil antiviral role might be an important factor to consider in this pathology.
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Affiliation(s)
- Armando S Flores-Torres
- 1 Department of Immunology, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose E. Gonzalez," Monterrey, Nuevo León, Mexico
| | - Mario C Salinas-Carmona
- 1 Department of Immunology, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose E. Gonzalez," Monterrey, Nuevo León, Mexico
| | - Eva Salinas
- 2 Department of Microbiology, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, Mexico
| | - Adrian G Rosas-Taraco
- 1 Department of Immunology, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose E. Gonzalez," Monterrey, Nuevo León, Mexico
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40
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Coverstone AM, Wang L, Sumino K. Beyond Respiratory Syncytial Virus and Rhinovirus in the Pathogenesis and Exacerbation of Asthma: The Role of Metapneumovirus, Bocavirus and Influenza Virus. Immunol Allergy Clin North Am 2019; 39:391-401. [PMID: 31284928 PMCID: PMC7127190 DOI: 10.1016/j.iac.2019.03.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Respiratory viruses other than rhinovirus or respiratory syncytial virus, including human metapneumovirus, influenza virus, and human bocavirus, are important pathogens in acute wheezing illness and asthma exacerbations in young children. Whether infection with these viruses in early life is associated with recurrent wheezing and/or asthma is not fully investigated, although there are data to suggest children with human metapneumovirus lower respiratory tract infection may have a higher likelihood of subsequent and recurrent wheezing several years after initial infection.
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Affiliation(s)
- Andrea M Coverstone
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, 1 Children's Place, Campus Box 8116, Saint Louis, MO 63110, USA
| | - Leyao Wang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, 425 S. Euclid Avenue, CB 8052, Saint Louis, MO 63110, USA
| | - Kaharu Sumino
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, 660 Euclid Avenue, Campus Box 8052, Saint Louis, MO 63110, USA.
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41
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Dutot M, Grassin-Delyle S, Salvator H, Brollo M, Rat P, Fagon R, Naline E, Devillier P. A marine-sourced fucoidan solution inhibits Toll-like-receptor-3-induced cytokine release by human bronchial epithelial cells. Int J Biol Macromol 2019; 130:429-436. [PMID: 30797011 PMCID: PMC7112488 DOI: 10.1016/j.ijbiomac.2019.02.113] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/08/2019] [Accepted: 02/19/2019] [Indexed: 12/28/2022]
Abstract
Fucoidans are sulfated polysaccharides from brown algae, known to have immunomodulatory activity. Their effects on the response of airway epithelial cells to Toll-like receptor 3 (TLR3) stimulation have not been characterized. Our objective was to evaluate the effects of a marine-sourced fucoidan solution (MFS) on the TLR3-induced expression and/or production of cytokines and prostaglandin by human primary bronchial epithelial cells as a model of the airway epithelium. The cells were incubated with MFS in the presence or absence of Poly(I:C) (a TLR3 agonist that mimics viral RNA). Cytokine expression and production were assessed using RT-qPCR and ELISA. The expression of cyclooxygenase-2 and the production of prostaglandin E2 were also measured. Relative to control, exposure to MFS was associated with lower Poly(I:C)-induced mRNA expression of various cytokines and chemokines, and lower COX-2 production. The MFS inhibited the production of some cytokines (IL-1α, IL-1β, TNFα, and IL-6), chemokines (CCL5, CCL22, CXCL1, CXCL5 and CXCL8) and prostaglandin E2 but did not alter the production of IL-12/25, CCL2 and CCL20. At clinically relevant concentrations, the MFS inhibited the TLR3-mediated production of inflammatory mediators by human primary bronchial epithelial cells - suggesting that locally applied MFS might help to reduce airway inflammation in viral infections.
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Affiliation(s)
- M Dutot
- Yslab, F-29000 Quimper, France; CNRS UMR 8038, Laboratoire de Chimie-Toxicologie Analytique et Cellulaire, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Pharmacie de Paris, F-75006 Paris, France.
| | - S Grassin-Delyle
- INSERM UMR 1173 et Plateforme de spectrométrie de masse MasSpecLab, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint Quentin, Université Paris Saclay, Montigny-le-Bretonneux, France; Département des Maladies Respiratoires, Hôpital Foch, F-92150 Suresnes, France
| | - H Salvator
- Département des Maladies Respiratoires, Hôpital Foch, F-92150 Suresnes, France; Laboratoire de Pharmacologie Respiratoire, UPRES EA 220, UFR Sciences de la Santé Simone Veil, Université Versailles Saint Quentin en Yvelines, Université Paris-Saclay, F-92150 Suresnes, France
| | - M Brollo
- Département des Maladies Respiratoires, Hôpital Foch, F-92150 Suresnes, France
| | - P Rat
- CNRS UMR 8038, Laboratoire de Chimie-Toxicologie Analytique et Cellulaire, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Pharmacie de Paris, F-75006 Paris, France
| | - R Fagon
- Yslab, F-29000 Quimper, France
| | - E Naline
- Département des Maladies Respiratoires, Hôpital Foch, F-92150 Suresnes, France; Laboratoire de Pharmacologie Respiratoire, UPRES EA 220, UFR Sciences de la Santé Simone Veil, Université Versailles Saint Quentin en Yvelines, Université Paris-Saclay, F-92150 Suresnes, France
| | - P Devillier
- Département des Maladies Respiratoires, Hôpital Foch, F-92150 Suresnes, France; Laboratoire de Pharmacologie Respiratoire, UPRES EA 220, UFR Sciences de la Santé Simone Veil, Université Versailles Saint Quentin en Yvelines, Université Paris-Saclay, F-92150 Suresnes, France
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42
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Palipane M, Snyder JD, LeMessurier KS, Schofield AK, Woolard SN, Samarasinghe AE. Macrophage CD14 impacts immune defenses against influenza virus in allergic hosts. Microb Pathog 2018; 127:212-219. [PMID: 30529429 DOI: 10.1016/j.micpath.2018.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/15/2018] [Accepted: 12/04/2018] [Indexed: 12/13/2022]
Abstract
Asthma and influenza are leading causes of worldwide morbidity and mortality. Although these two conditions can co-exist in the same patient, the immune parameters that impact disease outcomes are not fully elucidated. The importance of macrophages to both conditions suggested a role for CD14, a co-receptor for endotoxin, as a regulatory mechanism for innate immune responses during asthma and influenza co-morbidity. Herein, we hypothesized that parameters of influenza morbidity will be reduced in the absence of CD14. Age and gender matched wild-type (WT) and CD14 knock-out (KO) mice were subjected to our validated model of Aspergillus-induced model of asthma and/or influenza. Characteristics of disease pathogenesis were investigated using standard methods in weight loss, flow cytometry, airway resistance, histology, quantitative real-time PCR, and viral titer quantification. The absence of CD14 did not have an impact on morbidity as these mice were equally susceptible to disease with similar airway resistance. Peribronchovascular inflammation and goblet cell content were equivalent between WT and KO mice in asthma alone and asthma and influenza co-morbidity. Co-morbid KO mice had less lymphocytes and eosinophils in the airways although their lung viral burden was equivalent to WT. Inflammatory gene signatures were altered in co-morbid mice in each genotype. CD14 expression on macrophages is necessary for airway inflammation but not for viral pathogenesis in allergic hosts.
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Affiliation(s)
- Maneesha Palipane
- Children's Foundation Research Institute, Memphis, TN, 38103, United States; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, 38103, United States
| | - John D Snyder
- Children's Foundation Research Institute, Memphis, TN, 38103, United States; College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, 38103, United States
| | - Kim S LeMessurier
- Children's Foundation Research Institute, Memphis, TN, 38103, United States; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, 38103, United States
| | - Anna K Schofield
- Children's Foundation Research Institute, Memphis, TN, 38103, United States; Colorado State University, Fort Collins, CO 80523, United States
| | - Stacie N Woolard
- Department of Flow Cytometry, St Jude Children's Research Hospital, Memphis, TN, 38105, United States
| | - Amali E Samarasinghe
- Children's Foundation Research Institute, Memphis, TN, 38103, United States; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, 38103, United States.
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Jankauskaitė L, Misevičienė V, Vaidelienė L, Kėvalas R. Lower Airway Virology in Health and Disease-From Invaders to Symbionts. MEDICINA (KAUNAS, LITHUANIA) 2018; 54:E72. [PMID: 30344303 PMCID: PMC6262431 DOI: 10.3390/medicina54050072] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 12/13/2022]
Abstract
Studies of human airway virome are relatively recent and still very limited. Culture-independent microbial techniques showed growing evidence of numerous viral communities in the respiratory microbial ecosystem. The significance of different acute respiratory viruses is already known in the pathogenesis of chronic conditions, such as asthma, cystic fibrosis (CF), or chronic obstructive lung disease (COPD), and their exacerbations. Viral pathogens, such as influenza, metapneumovirus, parainfluenza, respiratory syncytial virus, or rhinovirus, have been associated with impaired immune response, acute exacerbations, and decrease in lung function in chronic lung diseases. However, more data have attributed a role to Herpes family viruses or the newly identified Anelloviridae family of viruses in chronic diseases, such as asthma, idiopathic pulmonary fibrosis (IPF), or CF. Impaired antiviral immunity, bacterial colonization, or used medication, such as glucocorticoids or antibiotics, contribute to the imbalance of airway microbiome and may shape the local viral ecosystem. A specific part of virome, bacteriophages, frames lung microbial communities through direct contact with its host, the specific bacteria known as Pseudomonas aeruginosa or their biofilm formation. Moreover, antibiotic resistance is induced through phages via horizontal transfer and leads to more severe exacerbations of chronic airway conditions. Morbidity and mortality of asthma, COPD, CF, and IPF remains high, despite an increased understanding and knowledge about the impact of respiratory virome in the pathogenesis of these conditions. Thus, more studies focus on new prophylactic methods or therapeutic agents directed toward viral⁻host interaction, microbial metabolic function, or lung microbial composition rearrangement.
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Affiliation(s)
- Lina Jankauskaitė
- Department of Paediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
| | - Valdonė Misevičienė
- Department of Paediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
| | - Laimutė Vaidelienė
- Department of Paediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
| | - Rimantas Kėvalas
- Department of Paediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
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