Moore Thomas A, Perry Michelle L, Getsoian Andrew G, Monteleon Christine L, Cogen Anna L, Standiford Theodore J
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0642, USA.
Infect Immun. 2003 Sep;71(9):4891-900. doi: 10.1128/IAI.71.9.4891-4900.2003.
A significant clinical complication of pulmonary infections with Klebsiella pneumoniae is peripheral blood dissemination, resulting in a systemic infection concurrent with the localized pulmonary infection. In this context, little is known about the role of tumor necrosis factor receptor 1 (TNFR1)-mediated innate immune responses during systemic Klebsiella infections. Mice lacking TNFR1 were significantly more susceptible to Klebsiella-induced mortality following intravenous inoculation. Bacterial clearance was impaired in TNFR1-deficient mice at early times following infection. Unexpectedly, bacterial burdens at the onset of mortality (days 2 to 3 postinfection) were not higher in mice lacking TNFR1. However, elevated production of liver-associated proinflammatory cytokines (interleukin-12, tumor necrosis factor alpha [TNF-alpha[, and gamma interferon [IFN-gamma]) and chemokines (MIP-1 alpha, MIP-2, and MCP-1) was observed within the first 24 h of infection. Additionally, excessive plasma-associated IFN-gamma was also observed late in the course of infection (day 3). Spleen cells from day-3 infected TNFR1-deficient mice secreted markedly enhanced levels of IFN-gamma when cultured in vitro. Additionally, there was a marked increase in the total number of activated lymphocyte subsets as indicated by CD69 upregulation. A notable exception was the sharp decrease in the frequency of splenic NK T cells in infected TNFR1 knockout (KO) mice. Anti-TNF-alpha therapy in TNFR1 KO mice significantly reduced chemokine production and liver injury. Combined, these data indicate a dysregulated antibacterial host response following intravenous Klebsiella infection in the absence of TNFR1 signaling, resulting in heightened cytokine production and hyperactivation of specific splenic lymphocyte subsets.
肺炎克雷伯菌肺部感染的一个重要临床并发症是外周血播散,导致在局部肺部感染的同时发生全身感染。在这种情况下,关于肿瘤坏死因子受体1(TNFR1)介导的先天性免疫反应在全身性克雷伯菌感染中的作用知之甚少。缺乏TNFR1的小鼠在静脉接种后对克雷伯菌诱导的死亡率显著更敏感。在感染后的早期,TNFR1缺陷小鼠的细菌清除受损。出乎意料的是,在缺乏TNFR1的小鼠中,死亡开始时(感染后2至3天)的细菌负荷并不更高。然而,在感染后的头24小时内观察到肝脏相关促炎细胞因子(白细胞介素-12、肿瘤坏死因子α [TNF-α]和γ干扰素 [IFN-γ])和趋化因子(MIP-1α、MIP-2和MCP-1)的产生增加。此外,在感染后期(第3天)也观察到血浆相关IFN-γ过量。来自感染后第3天的TNFR1缺陷小鼠的脾细胞在体外培养时分泌的IFN-γ水平明显增强。此外,如CD69上调所示,活化淋巴细胞亚群的总数显著增加。一个显著的例外是感染的TNFR1基因敲除(KO)小鼠中脾NK T细胞频率急剧下降。在TNFR1 KO小鼠中进行抗TNF-α治疗可显著降低趋化因子产生和肝损伤。综合这些数据表明,在缺乏TNFR1信号的情况下,静脉注射克雷伯菌感染后抗菌宿主反应失调,导致细胞因子产生增加和特定脾淋巴细胞亚群的过度活化。