Moore Thomas A, Perry Michelle L, Getsoian Andrew G, Newstead Michael W, Standiford Theodore J
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.
Infect Immun. 2002 Nov;70(11):6310-8. doi: 10.1128/IAI.70.11.6310-6318.2002.
Klebsiella pneumoniae is a leading cause of both community-acquired and nosocomial gram-negative-bacterial pneumonia. A further clinical complication of pulmonary K. pneumoniae infection is dissemination of bacteria from the lung into the peripheral blood, resulting in bacteremia concurrent with the localized pulmonary infection. Here, we report studies detailing the divergent role of gamma interferon (IFN-gamma) in pulmonary versus systemic K. pneumoniae infection. Intratracheal inoculation of IFN-gamma knockout mice resulted in significantly increased mortality compared to that observed for wild-type infected animals. Increased mortality correlated with a 100-fold increase in pulmonary bacteria within 2 days postinfection and upregulation of lung-associated interleukin-10 (IL-10) mRNA. Interestingly, IFN-gamma knockout mice had a twofold reduction in plasma aminospartate transferase activity, indicating diminished liver injury following peripheral blood bacterial dissemination. To study the host response towards blood-borne bacteria in the absence of the ongoing pulmonary infection, intravenous inoculation studies were initiated. IFN-gamma knockout mice were no more susceptible to intravenous infection than their wild-type counterparts. The consistent observation in IFN-gamma knockout mice was for improved survival correlating with increased clearance of blood- and liver-associated bacteria. Intravenous inoculation resulted in a two- to threefold increase in hepatic IL-10 production 24 and 48 h postinfection. Liver injury was also significantly reduced in IFN-gamma knockout mice. These data indicate that IFN-gamma secretion is a critical mediator in the resolution of localized gram-negative pulmonary pneumonia. Surprisingly, host responses towards systemic infection with the same bacteria appear to be IFN-gamma independent.
肺炎克雷伯菌是社区获得性和医院获得性革兰氏阴性菌肺炎的主要病因。肺部肺炎克雷伯菌感染的另一个临床并发症是细菌从肺部扩散到外周血,导致菌血症与局部肺部感染同时发生。在此,我们报告了详细研究γ干扰素(IFN-γ)在肺部与全身性肺炎克雷伯菌感染中不同作用的研究。与野生型感染动物相比,气管内接种IFN-γ基因敲除小鼠导致死亡率显著增加。死亡率增加与感染后2天内肺部细菌增加100倍以及肺相关白细胞介素-10(IL-10)mRNA上调相关。有趣的是,IFN-γ基因敲除小鼠的血浆天冬氨酸转氨酶活性降低了两倍,表明外周血细菌播散后肝损伤减轻。为了研究在没有持续肺部感染的情况下宿主对血源细菌的反应,启动了静脉接种研究。IFN-γ基因敲除小鼠对外静脉感染的易感性并不高于其野生型对照。在IFN-γ基因敲除小鼠中一致观察到的是存活率提高,这与血液和肝脏相关细菌清除增加相关。静脉接种导致感染后24小时和48小时肝脏IL-10产生增加两到三倍。IFN-γ基因敲除小鼠的肝损伤也显著减轻。这些数据表明,IFN-γ分泌是局部革兰氏阴性肺炎消退的关键介质。令人惊讶的是,宿主对同一细菌全身感染的反应似乎与IFN-γ无关。