Early-Life RSV-Infection Alters Local and Systemic Immune Cell Populations in Neonates through TSLP Production

Respiratory syncytial virus (RSV), a ubiquitous human pathogen, infects nearly all children by the age of two. It produces severe lower respiratory tract disease, including bronchiolitis, and is characterized by excessive mucus production and immune-mediated lung damage. Severe RSV bronchiolitis in infancy is strongly correlated with development of recurrent wheezing later in childhood, and boys are twice as likely to be affected than girls. These findings suggest persistent immune system alterations well beyond the time of viral clearance, especially in boys. RSV has the ability to evade the type-1 immune response and prime toward a pathologic Th2/Th17 response. Immunopathology associated with severe RSV infection is believed to be the cause of significant airway diseases later in life. However, sex differences associated with these changes and/or if systemic alterations are occurring along with local lung alterations have not been previously defined. Our studies here show that early-life RSV infection leads to differential long-term effects based upon the sex of the neonate, leaving male mice prone to exacerbation upon secondary allergen exposure while overall protecting female mice. During initial viral infection, we observed better viral control in the female mice with correlative expression of interferon-β that was not observed in male mice. Additionally, we observed persistent immune alterations in male mice at 4 weeks post-infection. These alterations include Th2 and Th17-skewing, innate cytokine expression (Tslp and Il33), and infiltration of innate immune cells (DC and ILC2). Upon exposure to allergen, beginning at 4 weeks following early-life RSV-infection, male mice show severe allergic exacerbation while female mice appear to be protected; knockdown of TSLP signaling using TSLPR-/- mice abrogated allergen exacerbation in male mice. We also show that long-term systemic alterations are occurring following early-life RSV-infection. Bone marrow-derived dendritic cells (BMDC) isolated from early-life RSV-infected male mice at 4 weeks post-infection retained expression of maturation markers (Cd80/86, Ox40l). Chemokines/ cytokines associated with the inflammatory response during RSV-infection were also persistently expressed along with Kdm6b and Tslp. Knockdown of TSLP signaling using TSLPR-/- male mice abrogated this activated phenotype and led to enhanced T cell IFN-γ production. ATAC-seq data indicated differences in the chromatin landscape of WT and TSLPR-/- BMDC, showing more open regions of chromatin near anti-viral type-1 genes, Mid1, Spp1, and Cxcl11 in TSLPR-/- BMDC. qPCR showed increased expression of Mid1, Ifnb and Il12a. Further evaluation of BMDC showed KDM6 demethylases were upregulated upon RSV-infection. KDM6 Chemical inhibition (GSK J4) in BMDC decreased production of chemokines and cytokines associated with the inflammatory response during RSV-infection and decreased maturation marker (CD80/86, MHCII) expression, similar to the TSLPR-/- BMDC phenotype. RSV-infected BMDC treated with GSK J4 altered co-activation of T cell cytokine production. Airway sensitization of naïve mice with RSV-infected BMDCs exacerbate a live challenge with RSV infection but was inhibited when BMDCs were treated with GSK J4 prior to sensitization. Finally, in vivo treatment with GSK J4 during RSV-infection reduced immunopathology. Collectively, these studies highlight the importance of proper anti-viral immune responses to limit RSV-driven Th2 immunopathology and future disease by limiting persistent alterations of the immune system. These data validate neonatal sex-differences to RSV and indicate that sex of the neonate should be considered during RSV disease treatment. These studies identify TSLP as a promising therapeutic target, especially in boys hospitalized with severe RSV.PHDMolecular & Cellular PathologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/153353/1/carrieam_1.pd

Inhibition of uric acid or IL- 1β ameliorates respiratory syncytial virus immunopathology and development of asthma

BackgroundRespiratory syncytial virus (RSV) affects most infants early in life and is associated with increased asthma risk. The specific mechanism remains unknown.ObjectiveTo investigate the role of uric acid (UA) and IL- 1β in RSV immunopathology and asthma predisposition.MethodsTracheal aspirates from human infants with and without RSV were collected and analyzed for pro- IL- 1β mRNA and protein to establish a correlation in human disease. Neonatal mouse models of RSV were employed, wherein mice infected at 6- 7 days of life were analyzed at 8 days postinfection, 5 weeks postinfection, or after a chronic cockroach allergen asthma model. A xanthine oxidase inhibitor or IL- 1 receptor antagonist was administered during RSV infection.ResultsHuman tracheal aspirates from RSV- infected infants showed elevated pro- IL- 1β mRNA and protein. Inhibition of UA or IL- 1β during neonatal murine RSV infection decreased mucus production, reduced cellular infiltrates to the lung (especially ILC2s), and decreased type 2 immune responses. Inhibition of either UA or IL- 1β during RSV infection led to chronic reductions in pulmonary immune cell composition and reduced type 2 immune responses and reduced similar responses after challenge with cockroach antigen.ConclusionsInhibiting UA and IL- 1β during RSV infection ameliorates RSV immunopathology, reduces the consequences of allergen- induced asthma, and presents new therapeutic targets to reduce early- life viral- induced asthma development.Neonatal RSV infection is associated with increases in pulmonary uric acid and IL- 1β and lung immunopathology. XOI or IL- 1RA administration during neonatal RSV infection leads to reduced RSV immunopathology. XOI or IL- 1RA administration during neonatal RSV infection leads to reduced type 2 immune responses during a subsequent model of asthma.Abbreviations: IL- 1RA, IL- 1 receptor antagonist; RSV: Respiratory syncytial virus; XOI, xanthine oxidase inhibitor.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162774/3/all14310.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162774/2/all14310_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162774/1/all14310-sup-0005-TableS1.pd

NLRP3-Inflammasome Inhibition during Respiratory Virus Infection Abrogates Lung Immunopathology and Long-Term Airway Disease Development

Respiratory syncytial virus (RSV) infects most infants by two years of age. It can cause severe disease leading to an increased risk of developing asthma later in life. Previously, our group has shown that RSV infection in mice and infants promotes IL-1β production. Here, we characterized the role of NLRP3-Inflammasome activation during RSV infection in adult mice and neonates. We observed that the inhibition of NLRP3 activation using the small molecule inhibitor, MCC950, or in genetically modified NLRP3 knockout (Nlrp3−/−) mice during in vivo RSV infection led to decreased lung immunopathology along with a reduced expression of the mucus-associated genes and reduced production of innate cytokines (IL-1β, IL-33 and CCL2) linked to severe RSV disease while leading to significant increases in IFN-β. NLRP3-inflammasome inhibition or deletion diminished Th2 cytokines and inflammatory cell infiltration into the lungs. Furthermore, NLRP3 inhibition or deletion during early-life RSV infection led to reducing viral-exacerbated allergic response in a mouse model of RSV-induced allergy exacerbation. Here, we demonstrated the critical role of NLRP3-inflammasome activation in RSV immunopathology and the related long-term airway alteration. Moreover, these findings suggest the NLRP3-inflammasome as a potential therapeutic target to attenuate severe RSV disease and limit childhood asthma development

Inhibition of uric acid or IL‐1β ameliorates respiratory syncytial virus immunopathology and development of asthma

BackgroundRespiratory syncytial virus (RSV) affects most infants early in life and is associated with increased asthma risk. The specific mechanism remains unknown.ObjectiveTo investigate the role of uric acid (UA) and IL- 1β in RSV immunopathology and asthma predisposition.MethodsTracheal aspirates from human infants with and without RSV were collected and analyzed for pro- IL- 1β mRNA and protein to establish a correlation in human disease. Neonatal mouse models of RSV were employed, wherein mice infected at 6- 7 days of life were analyzed at 8 days postinfection, 5 weeks postinfection, or after a chronic cockroach allergen asthma model. A xanthine oxidase inhibitor or IL- 1 receptor antagonist was administered during RSV infection.ResultsHuman tracheal aspirates from RSV- infected infants showed elevated pro- IL- 1β mRNA and protein. Inhibition of UA or IL- 1β during neonatal murine RSV infection decreased mucus production, reduced cellular infiltrates to the lung (especially ILC2s), and decreased type 2 immune responses. Inhibition of either UA or IL- 1β during RSV infection led to chronic reductions in pulmonary immune cell composition and reduced type 2 immune responses and reduced similar responses after challenge with cockroach antigen.ConclusionsInhibiting UA and IL- 1β during RSV infection ameliorates RSV immunopathology, reduces the consequences of allergen- induced asthma, and presents new therapeutic targets to reduce early- life viral- induced asthma development.Neonatal RSV infection is associated with increases in pulmonary uric acid and IL- 1β and lung immunopathology. XOI or IL- 1RA administration during neonatal RSV infection leads to reduced RSV immunopathology. XOI or IL- 1RA administration during neonatal RSV infection leads to reduced type 2 immune responses during a subsequent model of asthma.Abbreviations: IL- 1RA, IL- 1 receptor antagonist; RSV: Respiratory syncytial virus; XOI, xanthine oxidase inhibitor.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162774/3/all14310.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162774/2/all14310_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162774/1/all14310-sup-0005-TableS1.pd

COVID-19 Modulates Inflammatory and Renal Markers That May Predict Hospital Outcomes among African American Males

BACKGROUND AND OBJECTIVES: African Americans and males have elevated risks of infection, hospitalization, and death from SARS-CoV-2 in comparison with other populations. We report immune responses and renal injury markers in African American male patients hospitalized for COVID-19. METHODS: This was a single-center, retrospective study of 56 COVID-19 infected hospitalized African American males 50+ years of age selected from among non-intensive care unit (ICU) and ICU status patients. Demographics, hospitalization-related variables, and medical history were collected from electronic medical records. Plasma samples collected close to admission (≤2 days) were evaluated for cytokines and renal markers; results were compared to a control group (n = 31) and related to COVID-19 in-hospital mortality. RESULTS: Among COVID-19 patients, eight (14.2%) suffered in-hospital mortality; seven (23.3%) in the ICU and one (3.8%) among non-ICU patients. Interleukin (IL)-18 and IL-33 were elevated at admission in COVID-19 patients in comparison with controls. IL-6, IL-18, MCP-1/CCL2, MIP-1α/CCL3, IL-33, GST, and osteopontin were upregulated at admission in ICU patients in comparison with controls. In addition to clinical factors, MCP-1 and GST may provide incremental value for risk prediction of COVID-19 in-hospital mortality. CONCLUSIONS: Qualitatively similar inflammatory responses were observed in comparison to other populations reported in the literature, suggesting non-immunologic factors may account for outcome differences. Further, we provide initial evidence for cytokine and renal toxicity markers as prognostic factors for COVID-19 in-hospital mortality among African American males