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失调的巨噬细胞炎症蛋白-2 表达驱动流感细菌合并感染中的疾病发生。

Dysregulated macrophage-inflammatory protein-2 expression drives illness in bacterial superinfection of influenza.

机构信息

Medical Sciences Program, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Immunol. 2010 Feb 15;184(4):2001-13. doi: 10.4049/jimmunol.0903304. Epub 2010 Jan 11.

Abstract

Influenza virus infection is a leading cause of death and disability throughout the world. Influenza-infected hosts are vulnerable to secondary bacterial infection, however, and an ensuing bacterial pneumonia is actually the predominant cause of influenza-attributed deaths during pandemics. A number of mechanisms have been proposed by which influenza may predispose to superinfection with an unrelated or heterologous pathogen, but the subsequent interaction between the host, virus, and bacteria remains an understudied area. In this study, we develop and examine a novel model of heterologous pulmonary infection in which an otherwise subclinical Bordetella parapertussis infection synergizes with an influenza virus infection to yield a life-threatening secondary pneumonia. Despite a profound pulmonary inflammatory response and unaltered viral clearance, bacterial clearance was significantly impaired in heterologously infected mice. No deficits were observed in pulmonary or systemic adaptive immune responses or the viability or function of infiltrating inflammatory cells to explain this phenomenon, and we provide evidence that the onset of severe pulmonary inflammation actually precedes the increased bacterial burden, suggesting that exacerbated inflammation is independent of bacterial burden. To that end, neutralization of the ELR(+) inflammatory chemokine MIP-2 (CXCL2/GRO-beta) attenuated the inflammation, weight loss, and clinical presentation of heterologously infected mice without impacting bacterial burden. These data suggest that pulmonary inflammation, rather than pathogen burden, is the key threat during bacterial superinfection of influenza and that selective chemokine antagonists may be a novel therapeutic intervention in cases of bacterial superinfection of influenza.

摘要

流感病毒感染是全球范围内导致死亡和残疾的主要原因。然而,流感感染宿主易发生继发细菌感染,继发细菌性肺炎实际上是大流行期间流感相关死亡的主要原因。已经提出了许多机制,说明流感如何使宿主易受无关或异源病原体的继发感染,但宿主、病毒和细菌之间的后续相互作用仍然是一个研究不足的领域。在这项研究中,我们开发并检查了一种新的异源肺部感染模型,在该模型中,原本亚临床的百日咳博德特氏菌感染与流感病毒感染协同作用,导致危及生命的继发性肺炎。尽管存在严重的肺部炎症反应和未改变的病毒清除,但异源感染小鼠的细菌清除明显受损。在肺部或系统适应性免疫反应、浸润性炎症细胞的活力或功能方面未观察到缺陷,我们提供的证据表明,严重肺部炎症的发作实际上先于细菌负荷的增加,表明炎症加重与细菌负荷无关。为此,中和 ELR(+)炎症趋化因子 MIP-2(CXCL2/GRO-beta)减轻了异源感染小鼠的炎症、体重减轻和临床症状,而不影响细菌负荷。这些数据表明,在流感继发细菌感染期间,肺部炎症而不是病原体负荷是主要威胁,选择性趋化因子拮抗剂可能是流感继发细菌感染的一种新的治疗干预措施。

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