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Ferolla FM, Toledano A, Caratozzolo A, Talarico LB, Acosta PL, Theiler G, Yfran EW, Matute J, Mascardi N, Neira P, Contrini MM, López EL. 2157. Low Interferon-γ and Interleukin-13 Levels in the Respiratory Tract are Related to Life-threatening Respiratory Syncytial Virus Infection in Previously Healthy Infants. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
The mechanisms of interindividual susceptibility to respiratory syncytial virus (RSV) are not clearly understood. Viral load (VL), an exaggerated immune response or T-helper 2 (Th2) bias were postulated as playing a role in the severity of RSV infection. We aimed to analyze VL, cytokine profiles and their association with life-threatening disease (LTD).
Methods
Prospective cohort study including previously healthy full-term infants < 12 months old, hospitalized with a first RSV infection in 2017-2019. Nasopharyngeal aspirates were performed on admission to assess VL (by qRT-PCR) and cytokines levels (using a Bioplex panel). Cytokines were grouped according to their functional classification: proinflammatory (TNF-α), regulatory (interleukin [IL]-10), Th1 (interfereron-γ [IFN-γ]), Th2 (IL-4, IL-5, IL-9, IL-13) and Th17 (IL-17a). Patients were defined to have LTD when required admittance to the intensive care units and ventilatory support.
Results
One hundred and nineteen patients were studied, 68 (57%) were male; median age was 3 months. Nineteen (16%) infants developed LTD, with no significant differences in socioeconomic, pregnancy and infant variables compared with other RSV cases. Virus subtypes were not related to LTD (p= 0.77). VL was not associated with LTD (p= 0.51). Patients with LTD had significantly lower levels of IFN-γ (mean 0.08 pg/ml [standard deviation -SD- 0.06] vs. 0.32 pg/ml [SD 0.4]; p= 0.001) and IL-13 (mean 0.03 pg/ml [SD 0.04] vs. 0.05 pg/ml [SD 0.07]; p= 0.02), fig 1. IFN-γ and IL-13 inversely correlated with days of hypoxemia (p< 0.001 and p= 0.002, respectively). VL, IFN-γ and IL-13 did not correlate with duration of symptoms before admission. No relationship was observed between IFN-γ, IL-13 and age, sex or breastfeeding. In 102 (86%) samples, IL-4 was under the limit of quantitation. TNF-α, IL-5, IL-9, IL-10 e IL-17a were not related to LTD.
IFN-γ and interleukin-13 levels according to clinical outcome.
Conclusion
To our knowledge, this is the first study to relate low IL-13 levels to LTD in previously healthy infants. Patients with LTD had 4-fold lower levels of IFN-γ. The severity of RSV infection may be the result of a deficient immune response rather than a higher viral load or an overactive immune response. These findings provide additional evidence for the development of preventive and therapeutic strategies.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Fausto M Ferolla
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Analía Toledano
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Ana Caratozzolo
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Laura B Talarico
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Patricio L Acosta
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Graciela Theiler
- Hospital de Clinicas "Jose de San Martin", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Eduardo W Yfran
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Javier Matute
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Normando Mascardi
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Pablo Neira
- Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - María M Contrini
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Eduardo L López
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
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Bonnin FA, Talarico LB, Phung E, Kumar A, Ferolla FM, Byrne AB, Acosta PL, Toledano A, Caratozzolo A, Contrini MM, Graham BS, Ruckwardt T, López EL. 487. Analysis of the Association between Specific Antibody Response against Respiratory Syncytial Virus Fusion Protein Conformations and Life-Threatening Infection in Previously Healthy Infants. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Specific humoral response against pre-fusion (pre-F) conformation of respiratory syncytial virus (RSV) F protein has been proposed to play a role against severe infection. We aimed to analyze the association between serum IgG titers against pre-F and post-fusion (post-F) conformations of RSV F protein and life-threatening RSV disease (LTD) in previously healthy infants.
Methods
Prospective cohort study including previously healthy infants < 12 months, hospitalized with a first RSV infection, in 2017-2019. Patients were defined to have LTD when required intensive care and ventilatory support. Pre-F exclusive and post-F-specific antibody responses were determined by post-F competition and non-competitive immunoassays, respectively, and neutralizing activity was measured by plaque reduction neutralization test. Viral load (VL) was assessed by qRT-PCR from nasopharyngeal aspirates collected on admission. Serum samples were collected within 72 h from admission and in convalescence (between 14 to 60 days).
Results
Seventy-five patients were included, median age 3 months, 60% (n=45) were males; 21 patients developed LTD. Importantly, acute and convalescent post-F and pre-F exclusive IgG titers did not associate with LTD (Fig 1). There was a positive correlation between neutralizing antibody titers and pre-F exclusive IgG titers (p=0.016). Post-F and pre-F exclusive IgG titers negatively correlated with age in acute phase (p< 0.0001 and p= 0.0009). In acute phase, post-F and pre-F exclusive IgG titers were higher in patients ≤ 2 months (Fig 2). Patients > 2 months increased post-F and pre-F exclusive IgG titers in convalescence. Additionally, post-F and pre-F exclusive titers did not correlate with VL, and VL was not related to LTD.
Conclusion
-Pre-F exclusive and post-F IgG titers did not associate with LTD, even though pre-F exclusive IgG correlated with neutralizing antibody titers.
-Infants under two months of age developed a lower humoral response, likely due to an interference by maternal antibodies and/or immunological immaturity.
-These findings highlight the importance of fully characterizing the immune response against RSV and its association with disease severity for the development of preventive strategies.
Disclosures
Barney S. Graham, MD, PhD, BSG: BSG is an inventor on patents for the stabilization of the RSV F protein (WO2014160463A1, Prefusion RSV F proteins and their use).|National Institutes of Health: Inventor on patents for RSV vaccines|National Institutes of Health: inventor on patents for measles and other paramyxovirus vaccines.
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Affiliation(s)
- Florencia A Bonnin
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Laura B Talarico
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Emily Phung
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, Maryland
| | - Azad Kumar
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, Maryland
| | - Fausto M Ferolla
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Alana B Byrne
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Patricio L Acosta
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Analía Toledano
- Pediatric Infectious Diseases Program, Hospital de Niños "Dr. Ricardo Gutiérrez", Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - Ana Caratozzolo
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | - María M Contrini
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
| | | | | | - Eduardo L López
- Pediatric Infectious Disease Program, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires , Buenos Aires, Ciudad Autonoma de Buenos Aires , Argentina
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3
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Ofman G, Pradarelli B, Caballero MT, Bianchi A, Grimaldi LA, Sancilio A, Duenas K, Rodriguez A, Ferrero F, Ferretti A, Coviello S, Ferolla FM, Acosta PL, Bergel E, Libster R, Polack FP. Respiratory Failure and Death in Vulnerable Premature Children With Lower Respiratory Tract Illness. J Infect Dis 2021; 222:1129-1137. [PMID: 32006428 PMCID: PMC7459133 DOI: 10.1093/infdis/jiaa046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/24/2020] [Indexed: 01/14/2023] Open
Abstract
Background Efforts to better understand the risk factors associated with respiratory failure (RF) and fatal lower respiratory tract infection (LRTI) in premature children in developing countries are necessary to elaborate evidenced-based preventive interventions. We aim to characterize the burden of respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) LRTI in premature children and determine risk factors for RF and fatal illness in a vulnerable population. Methods This is a prospective, population-based, cross-sectional study. Subjects with severe LRTI were enrolled during respiratory season. Risk factors for RF and death in premature infants were investigated. Results A total of 664 premature children participated. Infant’s hospitalization rate due to LRTI was 82.6/1000 (95% confidence interval [CI], 68.6–96.7/1000). Infant’s RSV and hMPV rates were 40.9/1000 (95% CI, 36.3–45.6/1000) and 6.6/1000 (95% CI, 3.9–9.2/1000), respectively. The RF rate was 8.2/1000 (95% CI, 4.9–11.5/1000). The LRTI mortality was 2.2/1000 (95% CI, 0.7–3.7/1000); for RSV, the rate was 0.8/1000 (95% CI, 0–1.7/1000) with a case-fatality ratio of 1.8%. Never breastfeeding, malnutrition, younger than 6 months, congenital heart disease, and lower hematocrit were risk factors for RF. Experiencing pneumonia, pneumothorax, sepsis, or apnea were clinical determinants of poor outcomes. Conclusions Premature children under 2 years old in vulnerable environments experience RF and death more often than term counterparts. Modifiable risk factors associated with poor outcomes should prompt evidence-based interventions.
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Affiliation(s)
| | | | - Mauricio T Caballero
- Fundación INFANT, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | | | - Andrea Sancilio
- Hospital Interzonal General de Agudos "Evita" de Lanus, Buenos Aires, Argentina
| | - Karina Duenas
- Hospital Interzonal General de Agudos "Evita" de Lanus, Buenos Aires, Argentina
| | - Andrea Rodriguez
- Hospital Zonal General de Agudos Descentralizado "Evita Pueblo" de Berazategui, Buenos Aires, Argentina
| | - Fernando Ferrero
- Hospital General de Niños "Pedro de Elizalde", Buenos Aires, Argentina
| | | | | | | | | | | | - Romina Libster
- Fundación INFANT, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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4
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Libster R, Esteban I, Bianchi A, Alva Grimaldi L, Dueñas K, Sancillo A, Rodriguez A, Ferrero F, Stein K, Acosta PL, Ferolla FM, Bergel E, Caballero MT, Polack FP. Role for Maternal Asthma in Severe Human Metapneumovirus Lung Disease Susceptibility in Children. J Infect Dis 2020; 223:2072-2079. [PMID: 31965186 PMCID: PMC7107446 DOI: 10.1093/infdis/jiaa019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/20/2020] [Indexed: 11/22/2022] Open
Abstract
Background Severity of human metapneumovirus (hMPV) lower respiratory illness (LRTI) is considered similar to that observed for respiratory syncytial virus (RSV). However, differences in severity between these pathogens have been noted, suggesting the degree of illness may vary in different populations. Moreover, a potential association between hMPV and asthma also suggests that hMPV may preferentially affect asthmatic subjects. Methods In a population-based surveillance study in children aged <2 years admitted for severe LRTI in Argentina, nasopharyngeal aspirates were tested by RT-PCR for hMPV, RSV, influenza A, and human rhinovirus. Results Of 3947 children, 383 (10%) were infected with hMPV. The hospitalization rate for hMPV LRTI was 2.26 per 1000 children (95% confidence interval [CI], 2.04–2.49). Thirty-nine (10.2%) patients infected with hMPV experienced life-threatening disease (LTD; 0.23 per 1000 children; 95% CI, .16–.31/1000), and 2 died (mortality rate 0.024 per 1000; 95% CI, .003–.086). In hMPV-infected children birth to an asthmatic mother was an increased risk for LTD (odds ratio, 4.72; 95% CI, 1.39–16.01). We observed a specific interaction between maternal asthma and hMPV infection affecting risk for LTD. Conclusions Maternal asthma increases the risk for LTD in children <2 years old hospitalized for severe hMPV LRTI.
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Affiliation(s)
- Romina Libster
- Fundación INFANT, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Ignacio Esteban
- Fundación INFANT, Buenos Aires, Argentina.,Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | | | | | - Karina Dueñas
- Hospital Interzonal General de Agudos "Evita," Lanus, Argentina
| | - Andrea Sancillo
- Hospital Interzonal General de Agudos "Evita," Lanus, Argentina
| | - Andrea Rodriguez
- Hospital Zonal General de Agudos Descentralizado "Evita Pueblo," Berazategui, Argentina
| | - Fernando Ferrero
- Hospital General de Niños "Pedro de Elizalde," Buenos Aires, Argentina
| | | | - Patricio L Acosta
- Fundación INFANT, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | | | | | - Mauricio T Caballero
- Fundación INFANT, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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5
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Rajan D, O'Keefe EL, Travers C, McCracken C, Geoghegan S, Caballero MT, Acosta PL, Polack F, Anderson LJ. MUC5AC Levels Associated With Respiratory Syncytial Virus Disease Severity. Clin Infect Dis 2019; 67:1441-1444. [PMID: 29878077 DOI: 10.1093/cid/ciy340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/28/2018] [Indexed: 02/05/2023] Open
Abstract
To assess MUC5AC as a biomarker for respiratory syncytial virus (RSV) disease severity, we tested nasal aspirates from RSV+ children with mild, moderate, and severe disease. Levels were significantly higher in those in the severe and moderate groups compared to mild group, indicating MUC5AC may be a useful biomarker for RSV disease severity.
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Affiliation(s)
- Devi Rajan
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Georgia
| | - Evan L O'Keefe
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Georgia
| | - Curtis Travers
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Georgia
| | - Courtney McCracken
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Georgia
| | | | | | - Patricio L Acosta
- Consejo Nacional de Investigaciones Cientificas y Tecnicas, Buenos Aires, Argentina
| | | | - Larry J Anderson
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Georgia
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6
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Caballero MT, Hijano DR, Acosta PL, Mateu CG, Marcone DN, Linder JE, Talarico LB, Elder JM, Echavarria M, Miller EK, Polack FP. Interleukin-13 associates with life-threatening rhinovirus infections in infants and young children. Pediatr Pulmonol 2018; 53:787-795. [PMID: 29665312 DOI: 10.1002/ppul.23998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 03/03/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Delineate risk factors associated with severe hypoxemia (O2 sat ≤87%) in infants and children younger than 2 years hospitalized with single pathogen HRV infection. STUDY DESIGN Prospective study in a yearly catchment population of 56 560 children <2 years old between 2011 and 2013 in Argentina. All children with respiratory signs and O2 sat <93% on admission were included. HRV infections were identified by reverse transcriptase-polymerase chain reaction. Epidemiologic, clinical, viral, and immunological risk factors were assessed. RESULTS Among 5012 hospitalized patients, HRV was detected as a single pathogen in 347 (6.92%) subjects. Thirty-two (9.2%) had life-threatening disease. Traditional risk factors for severe bronchiolitis did not affect severity of illness. HRV viral load, HRV groups, and type II and III interferons did not associate with severe hypoxemia. Interleukin-13 Levels in respiratory secretions at the time of admission (OR = 7.43 (3-18.4); P < 0.001 for IL-13 >10 pg/mL) predisposed to life-threatening disease. CONCLUSIONS Targeted interventions against IL-13 should be evaluated to decrease severity of HRV illness in infancy and early childhood.
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Affiliation(s)
| | - Diego R Hijano
- Fundación INFANT, Ciudad de Buenos Aires, Argentina.,St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Patricio L Acosta
- Fundación INFANT, Ciudad de Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad de Buenos Aires, Argentina
| | | | - Débora N Marcone
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad de Buenos Aires, Argentina.,Virology Unit and Clinical Virology Laboratory, Centro de Educación Médica e Investigaciones Clínicas "CEMIC", Ciudad de Buenos Aires, Argentina
| | | | - Laura B Talarico
- Fundación INFANT, Ciudad de Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad de Buenos Aires, Argentina
| | | | - Marcela Echavarria
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad de Buenos Aires, Argentina.,Virology Unit and Clinical Virology Laboratory, Centro de Educación Médica e Investigaciones Clínicas "CEMIC", Ciudad de Buenos Aires, Argentina
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7
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Soto AS, Fenoy IM, Sanchez VR, March F, Perrone Sibilia MD, Aldirico MDLA, Picchio MS, Arcon N, Acosta PL, Polack FP, Martin V, Goldman A. Toxoplasma gondii serine-protease inhibitor-1: A new adjuvant candidate for asthma therapy. PLoS One 2017; 12:e0187002. [PMID: 29073215 PMCID: PMC5658115 DOI: 10.1371/journal.pone.0187002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/11/2017] [Indexed: 11/25/2022] Open
Abstract
Serine-proteases are important players in the pathogenesis of asthma, promoting inflammation and tissue remodeling. It’s also known that many serine protease inhibitors display immunomodulatory properties. TgPI-1 is a Toxoplasma gondii protein that exhibits broad spectrum inhibitory activity against serine proteases. In view of the increased prevalence of atopic disorders and the need to develop new treatment strategies we sought to investigate the potential of TgPI-1 for treating respiratory allergies. For this purpose, we developed a therapeutic experimental model. BALB/c mice were rendered allergic by intraperitoneal ovalbumin-alum sensitization and airway-challenged. Once the asthmatic phenotype was achieved, mice were intranasally treated with rTgPI-1 alone or with a mixture of rTgPI-1 and ovalbumin (OVA). A week later mice were given a secondary aerosol challenge. Treatment with rTgPI-1 alone or co-administered with OVA diminished bronchoalveolar eosinophilia, mucus production and peribronchial lung infiltration. This effect was accompanied by a lung resistance reduction of 26.3% and 50.3% respectively. Both treatments resulted in the production of lower levels of IL-4, IL-5, IFN-γ and regulatory IL-10 by thoracic lymph node cells stimulated with OVA. Interestingly, significant decreases in OVA specific IgE and T cell proliferation, and increases in FoxP3+ T cells at local and systemic levels were only detected when the inhibitor was administered along with OVA. These results show that both rTgPI-1 treatments reduced asthma hallmarks. However, co-administration of the inhibitor with the allergen was more effective. Hence, rTgPI-1 emerges as a novel adjuvant candidate for asthma treatment.
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Affiliation(s)
- Ariadna S. Soto
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Ignacio M. Fenoy
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Vanesa R. Sanchez
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Florencia March
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Matías D. Perrone Sibilia
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - María de los Angeles Aldirico
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Mariano S. Picchio
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Nadia Arcon
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Patricio L. Acosta
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Fundación Infant, Buenos Aires, Argentina
| | | | - Valentina Martin
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Alejandra Goldman
- Laboratorio de Inmunología, Vacunas y Alergia, CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- * E-mail:
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8
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Talarico LB, Byrne AB, Amarilla S, Lovera D, Vázquez C, Chamorro G, Acosta PL, Ferretti A, Caballero MT, Arbo A, Polack FP. Characterization of type I interferon responses in dengue and severe dengue in children in Paraguay. J Clin Virol 2017; 97:10-17. [PMID: 29078078 DOI: 10.1016/j.jcv.2017.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/11/2017] [Accepted: 10/18/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Infection with dengue virus (DENV) produces a wide spectrum of clinical illness ranging from asymptomatic infection to mild febrile illness, and to severe forms of the disease. Type I interferons (IFNs) represent an initial and essential host defense response against viruses. DENV has been reported to trigger a robust type I IFN response; however, IFN-α/β profile in the progression of disease is not well characterized. OBJECTIVES AND STUDY DESIGN In this context, we conducted a retrospective study assessing the circulating serum levels of type I IFNs and related cytokines at different phases of illness in children during the 2011 outbreak of DENV in Paraguay. Demographic, clinical, laboratory and virological data were analyzed. RESULTS During defervescence, significantly higher levels of IFN-β, IL-6 and MIP-1β, were detected in severe vs. non-severe dengue patients. Additionally, a significant positive correlation between INF-α and viremia was detected in children with severe dengue. A significant positive correlation was also observed between IFN-β serum levels and hematocrit during the febrile phase, whereas IFN-α levels negatively correlated with white blood cells during defervescence in severe dengue patients. Furthermore, previous serologic status of patients to DENV did not influence type I IFN production. CONCLUSIONS The distinct type I IFN profile in children with dengue and severe dengue, as well as its association with viral load, cytokine production and laboratory manifestations indicate differences in innate and adaptive immune responses that should be investigated further in order to unveil the association of immunological and physiological pathways that underlie in DENV infection.
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Affiliation(s)
- Laura B Talarico
- Fundación INFANT, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.
| | - Alana B Byrne
- Fundación INFANT, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Sara Amarilla
- Department of Pediatrics, Instituto de Medicina Tropical, Asunción, Paraguay; National University of Asunción, Asunción, Paraguay
| | - Dolores Lovera
- Department of Pediatrics, Instituto de Medicina Tropical, Asunción, Paraguay; National University of Asunción, Asunción, Paraguay
| | | | | | - Patricio L Acosta
- Fundación INFANT, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | | | | | - Antonio Arbo
- Department of Pediatrics, Instituto de Medicina Tropical, Asunción, Paraguay; National University of Asunción, Asunción, Paraguay
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9
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Geoghegan S, Erviti A, Caballero MT, Vallone F, Zanone SM, Losada JV, Bianchi A, Acosta PL, Talarico LB, Ferretti A, Grimaldi LA, Sancilio A, Dueñas K, Sastre G, Rodriguez A, Ferrero F, Barboza E, Gago GF, Nocito C, Flamenco E, Perez AR, Rebec B, Ferolla FM, Libster R, Karron RA, Bergel E, Polack FP. Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors. Am J Respir Crit Care Med 2017; 195:96-103. [PMID: 27331632 DOI: 10.1164/rccm.201603-0658oc] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
RATIONALE Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear. OBJECTIVES To determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants. METHODS This was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model. MEASUREMENTS AND MAIN RESULTS A total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes. CONCLUSIONS RSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes.
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Affiliation(s)
| | | | | | | | | | - Juan Ves Losada
- 3 Hospital de Alta Complejidad El Cruce "Dr. Néstor Kirchner," Florencio Varela, Argentina
| | | | | | | | | | | | - Andrea Sancilio
- 5 Hospital Interzonal General de Agudos "Evita," Lanús, Argentina
| | - Karina Dueñas
- 5 Hospital Interzonal General de Agudos "Evita," Lanús, Argentina
| | - Gustavo Sastre
- 6 Hospital Zonal General de Agudos Descentralizado "Evita Pueblo," Berazategui, Argentina
| | - Andrea Rodriguez
- 6 Hospital Zonal General de Agudos Descentralizado "Evita Pueblo," Berazategui, Argentina
| | - Fernando Ferrero
- 7 Hospital General de Niños "Pedro de Elizalde," Buenos Aires, Argentina
| | - Edgar Barboza
- 8 Hospital Zonal General de Agudos "Dr. Narciso López," Lanús, Argentina
| | - Guadalupe Fernández Gago
- 9 Institute for Development and Research in Pediatrics "Prof. Dr. Fernando E. Viteri," Children's Hospital of La Plata (Min Sal/CIC-PBA), La Plata, Argentina
| | - Celina Nocito
- 10 Hospital Interzonal General de Agudos "Dr. Pedro Fiorito," Avellaneda, Argentina
| | - Edgardo Flamenco
- 11 Hospital Zonal General de Agudos "Dr. Arturo Oñativia," Rafael Calzada, Argentina
| | | | - Beatriz Rebec
- 13 Hospital Interzonal General de Agudos "Presidente Perón," Avellaneda, Argentina
| | | | | | - Ruth A Karron
- 14 Johns Hopkins University, Baltimore, Maryland; and
| | | | - Fernando P Polack
- 1 Fundación INFANT, Buenos Aires, Argentina.,15 Vanderbilt University, Nashville, Tennessee
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10
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High M, Cho HY, Marzec J, Wiltshire T, Verhein KC, Caballero MT, Acosta PL, Ciencewicki J, McCaw ZR, Kobzik L, Miller-DeGraff L, Gladwell W, Peden DB, Serra ME, Shi M, Weinberg C, Suzuki O, Wang X, Bell DA, Polack FP, Kleeberger SR. Determinants of host susceptibility to murine respiratory syncytial virus (RSV) disease identify a role for the innate immunity scavenger receptor MARCO gene in human infants. EBioMedicine 2016; 11:73-84. [PMID: 27554839 PMCID: PMC5049919 DOI: 10.1016/j.ebiom.2016.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 08/02/2016] [Accepted: 08/05/2016] [Indexed: 11/29/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is the global leading cause of lower respiratory tract infection in infants. Nearly 30% of all infected infants develop severe disease including bronchiolitis, but susceptibility mechanisms remain unclear. Methods We infected a panel of 30 inbred strains of mice with RSV and measured changes in lung disease parameters 1 and 5 days post-infection and they were used in genome-wide association (GWA) studies to identify quantitative trait loci (QTL) and susceptibility gene candidates. Findings GWA identified QTLs for RSV disease phenotypes, and the innate immunity scavenger receptor Marco was a candidate susceptibility gene; targeted deletion of Marco worsened murine RSV disease. We characterized a human MARCO promoter SNP that caused loss of gene expression, increased in vitro cellular response to RSV infection, and associated with increased risk of disease severity in two independent populations of children infected with RSV. Interpretation Translational integration of a genetic animal model and in vitro human studies identified a role for MARCO in human RSV disease severity. Because no RSV vaccines are approved for clinical use, genetic studies have implications for diagnosing individuals who are at risk for severe RSV disease, and disease prevention strategies (e.g. RSV antibodies). In a panel of inbred strains of mice, RSV disease phenotypes were characterized that resemble those in human disease. We identified Marco as a susceptibility gene, and a human MARCO mutation increased risk of disease severity in children. These studies have implications for diagnosing individuals who are at risk for severe RSV disease and prevent disease.
RSV disease is the primary global cause for hospitalization one year after birth but the causes of differential RSV disease severity are not understood. We show that RSV disease phenotypes vary significantly between inbred strains of mice, and resemble those in human disease. We used genetic approaches to identify and validate the innate immunity gene Marco as a host susceptibility determinant for murine RSV disease. We then characterized a loss of function polymorphism in human MARCO that increases risk of severe RSV disease risk in infants. Results have important implications for identifying genetic risk factors for severe RSV disease.
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Affiliation(s)
- Monica High
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Hye-Youn Cho
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Jacqui Marzec
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Tim Wiltshire
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Kirsten C Verhein
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Patricio L Acosta
- Fundación INFANT, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Buenos Aires, Argentina
| | - Jonathan Ciencewicki
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Zackary R McCaw
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lester Kobzik
- Department of Environmental Health, Harvard University School of Public Health, Boston, MA, USA
| | - Laura Miller-DeGraff
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Wes Gladwell
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - David B Peden
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Min Shi
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Clarice Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Oscar Suzuki
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Xuting Wang
- Genome Integrity & Structural Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Douglas A Bell
- Genome Integrity & Structural Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Fernando P Polack
- Fundación INFANT, Buenos Aires, Argentina; Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
| | - Steven R Kleeberger
- Immunity, Inflammation, and Diseases Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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11
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Abstract
In 1967, infants and toddlers immunized with a formalin-inactivated vaccine against respiratory syncytial virus (RSV) experienced an enhanced form of RSV disease characterized by high fever, bronchopneumonia, and wheezing when they became infected with wild-type virus in the community. Hospitalizations were frequent, and two immunized toddlers died upon infection with wild-type RSV. The enhanced disease was initially characterized as a "peribronchiolar monocytic infiltration with some excess in eosinophils." Decades of research defined enhanced RSV disease (ERD) as the result of immunization with antigens not processed in the cytoplasm, resulting in a nonprotective antibody response and CD4(+) T helper priming in the absence of cytotoxic T lymphocytes. This response to vaccination led to a pathogenic Th2 memory response with eosinophil and immune complex deposition in the lungs after RSV infection. In recent years, the field of RSV experienced significant changes. Numerous vaccine candidates with novel designs and formulations are approaching clinical trials, defying our previous understanding of favorable parameters for ERD. This review provides a succinct analysis of these parameters and explores criteria for assessing the risk of ERD in new vaccine candidates.
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Affiliation(s)
- Patricio L Acosta
- Fundacion INFANT, Buenos Aires, Argentina Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | | | - Fernando P Polack
- Fundacion INFANT, Buenos Aires, Argentina Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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12
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Libster R, M. Ferolla F, Hijano DR, Acosta PL, Erviti A, Polack FP. Alcohol during pregnancy worsens acute respiratory infections in children. Acta Paediatr 2015; 104:e494-9. [PMID: 26249835 DOI: 10.1111/apa.13148] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 03/27/2015] [Accepted: 08/03/2015] [Indexed: 11/29/2022]
Abstract
AIM This study explored whether alcohol consumption during pregnancy increased the risk of life-threatening respiratory infections in children. METHODS We prospectively evaluated children under the age of two years admitted to hospitals in Buenos Aires, Argentina, with severe acute respiratory infections during the winters of 2011 and 2012. Information on maternal alcohol consumption during the third trimester of pregnancy was collected using standardised questionnaires and categorised as never, low if it was once a week and high if it was equal or more than once a week. RESULTS Of the 3423 children hospitalised with acute respiratory infection, 2089 (63.7%) had respiratory syncytial virus (RSV). Alcohol consumption during the last trimester was reported by 398 mothers (12.4%) and categorised as low (n = 210, 6.5%) or high (n = 188, 5.9%). A greater effect on life-threatening respiratory infection, defined as oxygen saturation of or up to 87%, was observed with higher alcohol intake due to all viruses and specifically RSV in the logistic regression analyses. Alcohol consumption was strongly associated with life-threatening disease, particularly in boys whose adjusted odds ratio rose from 3.67 to 13.52 when their mothers drank alcohol. CONCLUSION Alcohol consumption during pregnancy was associated with life-threatening respiratory infections in boys.
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Affiliation(s)
- Romina Libster
- Fundación INFANT; Ciudad de Buenos Aires; Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); CABA Argentina
- Vanderbilt University; Nashville TN USA
| | - Fausto M. Ferolla
- Fundación INFANT; Ciudad de Buenos Aires; Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); CABA Argentina
| | - Diego R. Hijano
- Fundación INFANT; Ciudad de Buenos Aires; Argentina
- Vanderbilt University; Nashville TN USA
| | - Patricio L. Acosta
- Fundación INFANT; Ciudad de Buenos Aires; Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); CABA Argentina
| | | | - Fernando P. Polack
- Fundación INFANT; Ciudad de Buenos Aires; Argentina
- Vanderbilt University; Nashville TN USA
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13
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Caballero MT, Serra ME, Acosta PL, Marzec J, Gibbons L, Salim M, Rodriguez A, Reynaldi A, Garcia A, Bado D, Buchholz UJ, Hijano DR, Coviello S, Newcomb D, Bellabarba M, Ferolla FM, Libster R, Berenstein A, Siniawaski S, Blumetti V, Echavarria M, Pinto L, Lawrence A, Ossorio MF, Grosman A, Mateu CG, Bayle C, Dericco A, Pellegrini M, Igarza I, Repetto HA, Grimaldi LA, Gudapati P, Polack NR, Althabe F, Shi M, Ferrero F, Bergel E, Stein RT, Peebles RS, Boothby M, Kleeberger SR, Polack FP. TLR4 genotype and environmental LPS mediate RSV bronchiolitis through Th2 polarization. J Clin Invest 2015; 125:571-82. [PMID: 25555213 DOI: 10.1172/jci75183] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 11/13/2014] [Indexed: 01/14/2023] Open
Abstract
While 30%-70% of RSV-infected infants develop bronchiolitis, 2% require hospitalization. It is not clear why disease severity differs among healthy, full-term infants; however, virus titers, inflammation, and Th2 bias are proposed explanations. While TLR4 is associated with these disease phenotypes, the role of this receptor in respiratory syncytial virus (RSV) pathogenesis is controversial. Here, we evaluated the interaction between TLR4 and environmental factors in RSV disease and defined the immune mediators associated with severe illness. Two independent populations of infants with RSV bronchiolitis revealed that the severity of RSV infection is determined by the TLR4 genotype of the individual and by environmental exposure to LPS. RSV-infected infants with severe disease exhibited a high GATA3/T-bet ratio, which manifested as a high IL-4/IFN-γ ratio in respiratory secretions. The IL-4/IFN-γ ratio present in infants with severe RSV is indicative of Th2 polarization. Murine models of RSV infection confirmed that LPS exposure, Tlr4 genotype, and Th2 polarization influence disease phenotypes. Together, the results of this study identify environmental and genetic factors that influence RSV pathogenesis and reveal that a high IL-4/IFN-γ ratio is associated with severe disease. Moreover, these molecules should be explored as potential targets for therapeutic intervention.
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14
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García LN, Leimgruber C, Uribe Echevarría EM, Acosta PL, Brahamian JM, Polack FP, Miró MS, Quintar AA, Sotomayor CE, Maldonado CA. Protective phenotypes of club cells and alveolar macrophages are favored as part of endotoxin-mediated prevention of asthma. Exp Biol Med (Maywood) 2014; 240:904-16. [PMID: 25504013 DOI: 10.1177/1535370214562338] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/20/2014] [Indexed: 12/31/2022] Open
Abstract
Atopic asthma is a chronic allergic disease that involves T-helper type 2 (Th2)-inflammation and airway remodeling. Bronchiolar club cells (CC) and alveolar macrophages (AM) are sentinel cells of airway barrier against inhaled injuries, where allergy induces mucous metaplasia of CC and the alternative activation of AM, which compromise host defense mechanisms and amplify Th2-inflammation. As there is evidence that high levels of environmental endotoxin modulates asthma, the goal of this study was to evaluate if the activation of local host defenses by Lipopolysaccharide (LPS) previous to allergy development can contribute to preserving CC and AM protective phenotypes. Endotoxin stimulus before allergen exposition reduced hallmarks of allergic inflammation including eosinophil influx, Interleukin-4 and airway hyperreactivity, while the T-helper type 1 related cytokines IL-12 and Interferon-γ were enhanced. This response was accompanied by the preservation of the normal CC phenotype and the anti-allergic proteins Club Cell Secretory Protein (CCSP) and Surfactant-D, thereby leading to lower levels of CC metaplasia and preventing the increase of the pro-Th2 cytokine Thymic stromal lymphopoietin. In addition, classically activated alveolar macrophages expressing nitric oxide were promoted over the alternatively activated ones that expressed arginase-1. We verified that LPS induced a long-term overexpression of CCSP and the innate immune markers Toll-like receptor 4, and Tumor Necrosis Factor-α, changes that were preserved in spite of the allergen challenge. These results demonstrate that LPS pre-exposition modifies the local bronchioalveolar microenvironment by inducing natural anti-allergic mechanisms while reducing local factors that drive Th2 type responses, thus modulating allergic inflammation.
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Affiliation(s)
- Luciana N García
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET and Centro de Microscopía Electrónica- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros esq. Enfermera Gordillo, Ciudad Universitaria X5000HRA, Córdoba, Argentina
| | - Carolina Leimgruber
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET and Centro de Microscopía Electrónica- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros esq. Enfermera Gordillo, Ciudad Universitaria X5000HRA, Córdoba, Argentina
| | - Elisa M Uribe Echevarría
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET and Centro de Microscopía Electrónica- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros esq. Enfermera Gordillo, Ciudad Universitaria X5000HRA, Córdoba, Argentina
| | - Patricio L Acosta
- Fundación INFANT, Gavilan 94 C1406ABC, Capital Federal, Buenos Aires, Argentina
| | - Jorge M Brahamian
- Fundación INFANT, Gavilan 94 C1406ABC, Capital Federal, Buenos Aires, Argentina
| | - Fernando P Polack
- Fundación INFANT, Gavilan 94 C1406ABC, Capital Federal, Buenos Aires, Argentina Department of Pediatrics, Vanderbilt University, MCN, Vanderbilt University, Nashville, TN 37232, USA
| | - María S Miró
- Centro de Investigación en Bioquímica Clínica e Inmunología (CIBICI), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre y Medina Allende (X5000HRA), Ciudad Universitaria, Córdoba, Argentina
| | - Amado A Quintar
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET and Centro de Microscopía Electrónica- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros esq. Enfermera Gordillo, Ciudad Universitaria X5000HRA, Córdoba, Argentina
| | - Claudia E Sotomayor
- Centro de Investigación en Bioquímica Clínica e Inmunología (CIBICI), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre y Medina Allende (X5000HRA), Ciudad Universitaria, Córdoba, Argentina
| | - Cristina A Maldonado
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET and Centro de Microscopía Electrónica- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros esq. Enfermera Gordillo, Ciudad Universitaria X5000HRA, Córdoba, Argentina
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15
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Talarico LB, Bugna J, Wimmenauer V, Espinoza MA, Quipildor MO, Hijano DR, Beccaria M, Wurster V, Cavagnaro LE, Martinez D, Fattore G, Batalle JP, Acosta PL, Reynoso N, Melendi GA, Rey FA, Libster R, Polack FP. T helper type 2 bias and type 17 suppression in primary dengue virus infection in infants and young children. Trans R Soc Trop Med Hyg 2013; 107:411-9. [PMID: 23764739 DOI: 10.1093/trstmh/trt044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The immune response to dengue virus (DENV) primary infection in infants and young children is not well characterized. In Northern Argentina, >90% of the population was DENV-naïve before the 2009 outbreak, allowing evaluation of age-dependent primary responses to infection. METHODS We conducted a comparative study of the immune response to DENV in 27 infected infants, young children and their mothers. Lymphocyte T helper (Th) 1, Th2, Th17 and inflammatory responses were assayed in blood during the 2009 DENV-1 epidemic. RESULTS The immune response to DENV-1 was significantly biased to Th2 in infected infants and young children, compared to infants with other febrile illnesses (for IL-4 p < 0.001) and to their infected mothers (for IL-4 p < 0.01). In addition, IL-17 suppression was observed in the memory response to DENV-1 in infected infants (p < 0.01 vs placebo). CONCLUSION Age-related differences in the primary response to DENV, characterized by an immature Th2 polarization and Th17 suppression in infants, should be studied further in order to expand our understanding of the mechanism of dengue pathogenesis.
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16
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Ferolla FM, Hijano DR, Acosta PL, Rodríguez A, Dueñas K, Sancilio A, Barboza E, Caría A, Gago GF, Almeida RE, Castro L, Pozzolo C, Martínez MV, Grimaldi LA, Rebec B, Calvo M, Henrichsen J, Nocito C, González M, Barbero G, Losada JV, Caballero MT, Zurankovas V, Raggio M, Schavlovsky G, Kobylarz A, Wimmenauer V, Bugna J, Williams JV, Sastre G, Flamenco E, Pérez AR, Ferrero F, Libster R, Grijalva CG, Polack FP. Macronutrients during Pregnancy and Life-Threatening Respiratory Syncytial Virus Infections in Children. Am J Respir Crit Care Med 2013; 187:983-90. [DOI: 10.1164/rccm.201301-0016oc] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Miller EK, Bugna J, Libster R, Shepherd BE, Scalzo PM, Acosta PL, Hijano D, Reynoso N, Batalle JP, Coviello S, Klein MI, Bauer G, Benitez A, Kleeberger SR, Polack FP. Human rhinoviruses in severe respiratory disease in very low birth weight infants. Pediatrics 2012; 129:e60-7. [PMID: 22201153 PMCID: PMC3255465 DOI: 10.1542/peds.2011-0583] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To assess incidence, burden of illness, and risk factors for human rhinoviruses (HRVs) in a cohort of very low birth weight (VLBW) infants. METHODS A 2-year prospective cohort study was conducted among VLBW premature infants in Buenos Aires, Argentina. Infants were enrolled in the NICU from June 1, 2003, to May 31, 2005, and managed monthly and with every acute respiratory illness (ARI) during the first year of life. Nasal wash samples were obtained during every respiratory episode and tested for HRV, respiratory syncytial virus (RSV), human parainfluenza viruses, influenza viruses, and human metapneumovirus using reverse transcriptase-polymerase chain reaction. RESULTS Of 119 patients, 66 (55%) had HRV-associated ARIs. The incidence of HRV-associated ARI was 123 events per 100 child-years of follow-up. Of those infants experiencing an episode of bronchiolitis, 40% had HRV versus 7% with RSV. The incidence of HRV-associated bronchiolitis was 75 per 100 infant-years of follow-up. HRV was associated with 12 of 36 hospitalizations (33%), and RSV was associated with 9 of 36 hospitalizations (25%). The incidence of HRV-associated hospitalization was 12 per 100 infant-years of follow-up. The risk of HRV-associated hospitalization was higher for infants with bronchopulmonary dysplasia and those who were not breastfed. CONCLUSIONS HRV is an important and frequent pathogen associated with severe respiratory infections in VLBW infants. Bronchopulmonary dysplasia and the absence of breastfeeding are risk factors for hospitalization. The results of our study reveal that HRV is the predominant pathogen of respiratory infections in premature infants.
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Affiliation(s)
| | | | - Romina Libster
- Departments of Pediatrics and,Fundacion INFANT, Buenos Aires, Argentina
| | | | | | | | - Diego Hijano
- Departments of Pediatrics and,Fundacion INFANT, Buenos Aires, Argentina
| | | | | | | | - M. Ines Klein
- Fundacion INFANT, Buenos Aires, Argentina;,Hospital Juan P. Garrahan, Buenos Aires, Argentina;,Maternidad Sarda, Buenos Aires, Argentina; and
| | | | | | - Steven R. Kleeberger
- The National Institute of Environmental Health Sciences, Raleigh, North Carolina
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