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Koch CM, Prigge AD, Anekalla KR, Shukla A, Do Umehara HC, Setar L, Chavez J, Abdala-Valencia H, Politanska Y, Markov NS, Hahn GR, Heald-Sargent T, Sanchez-Pinto LN, Muller WJ, Singer BD, Misharin AV, Ridge KM, Coates BM. Age-related Differences in the Nasal Mucosal Immune Response to SARS-CoV-2. Am J Respir Cell Mol Biol 2021; 66:206-222. [PMID: 34731594 PMCID: PMC8845137 DOI: 10.1165/rcmb.2021-0292oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 180 million people since the onset of the pandemic. Despite similar viral load and infectivity rates between children and adults, children rarely develop severe illness. Differences in the host response to the virus at the primary infection site are among the mechanisms proposed to account for this disparity. Our objective was to investigate the host response to SARS-CoV-2 in the nasal mucosa in children and adults and compare it with the host response to respiratory syncytial virus (RSV) and influenza virus. We analyzed clinical outcomes and gene expression in the nasal mucosa of 36 children with SARS-CoV-2, 24 children with RSV, 9 children with influenza virus, 16 adults with SARS-CoV-2, and 7 healthy pediatric and 13 healthy adult controls. In both children and adults, infection with SARS-CoV-2 led to an IFN response in the nasal mucosa. The magnitude of the IFN response correlated with the abundance of viral reads, not the severity of illness, and was comparable between children and adults infected with SARS-CoV-2 and children with severe RSV infection. Expression of ACE2 and TMPRSS2 did not correlate with age or presence of viral infection. SARS-CoV-2–infected adults had increased expression of genes involved in neutrophil activation and T-cell receptor signaling pathways compared with SARS-CoV-2–infected children, despite similar severity of illness and viral reads. Age-related differences in the immune response to SARS-CoV-2 may place adults at increased risk of developing severe illness.
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Affiliation(s)
- Clarissa M Koch
- Northwestern University, Medicine , Chicago, Illinois, United States
| | - Andrew D Prigge
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Pediatrics, Chicago, Illinois, United States
| | - Kishore R Anekalla
- Northwestern University Feinberg School of Medicine, Division of Pulmonary and Critical Care Medicine, Chicago, Illinois, United States
| | - Avani Shukla
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Chicago, Illinois, United States
| | | | - Leah Setar
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Pediatrics, Chicago, Illinois, United States
| | - Jairo Chavez
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Chicago, Illinois, United States
| | - Hiam Abdala-Valencia
- Northwestern University Feinberg School of Medicine, Division of Pulmonary and Critical Care Medicine, Chicago, Illinois, United States
| | - Yuliya Politanska
- Northwestern University, Medicine , Chicago, Illinois, United States
| | - Nikolay S Markov
- Northwestern University, Medicine , Chicago, Illinois, United States
| | - Grant R Hahn
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Pediatrics, Chicago, Illinois, United States
| | - Taylor Heald-Sargent
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Pediatrics, Chicago, Illinois, United States
| | - L Nelson Sanchez-Pinto
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Critical Care Medicine, Chicago, Illinois, United States.,Northwestern University Feinberg School of Medicine, 12244, Pediatrics, Chicago, Illinois, United States
| | - William J Muller
- Ann and Robert H Lurie Children's Hospital of Chicago, 2429, Pediatrics, Chicago, Illinois, United States
| | - Benjamin D Singer
- Northwestern University Feinberg School of Medicine, 12244, Medicine and Biochemistry & Molecular Genetics, Chicago, Illinois, United States
| | - Alexander V Misharin
- Northwestern University, Rheumatology/Medicine, Chicago, Illinois, United States
| | - Karen M Ridge
- Northwestern University, Pulmonary and Critical Care, Chicago, Illinois, United States
| | - Bria M Coates
- Northwestern University, Division of Pulmonary and Critical Care Medicine, Chicago, Illinois, United States;
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