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      Evaluation of Innate Immune Mediators Related to Respiratory Viruses in the Lung of Stable COPD Patients

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          Abstract

          Background: Little is known about the innate immune response to viral infections in stable Chronic Obstructive Pulmonary Disease (COPD). Objectives: To evaluate the innate immune mediators related to respiratory viruses in the bronchial biopsies and lung parenchyma of stable COPD patients. Methods: We evaluated the immunohistochemical (IHC) expression of Toll-like receptors 3-7-8-9 (TLR-3-7-8-9), TIR domain-containing adaptor inducing IFNβ (TRIF), Interferon regulatory factor 3 (IRF3), Phospho interferon regulatory factor 3 (pIRF3), Interferon regulatory factor 7 (IRF7), Phospho interferon regulatory factor 7 (pIRF7), retinoic acid-inducible gene I (RIG1), melanoma differentiation-associated protein 5 (MDA5), Probable ATP-dependent RNA helicase DHX58 (LGP2), Mitochondrial antiviral-signaling protein (MAVS), Stimulator of interferon genes (STING), DNA-dependent activator of IFN regulatory factors (DAI), forkhead box protein A3(FOXA3), Interferon alfa (IFNα), and Interferon beta (IFNβ) in the bronchial mucosa of patients with mild/moderate ( n = 16), severe/very severe ( n = 1618) stable COPD, control smokers (CS) ( n = 1612), and control non-smokers (CNS) ( n = 1612). We performed similar IHC analyses in peripheral lung from COPD ( n = 1612) and CS ( n = 1612). IFNα and IFNβ were assessed in bronchoalveolar lavage (BAL) supernatant from CNS ( n = 168), CS ( n = 169) and mild/moderate COPD ( n = 1612). Viral load, including adenovirus-B, -C, Bocavirus, Respiratory syncytial Virus (RSV), Human Rhinovirus (HRV), Coronavirus, Influenza virus A (FLU-A), Influenza virus B (FLU-B), and Parainfluenzae-1 were measured in bronchial rings and lung parenchyma of COPD patients and the related control group (CS). Results: Among the viral-related innate immune mediators, RIG1, LGP2, MAVS, STING, and DAI resulted well expressed in the bronchial and lung tissues of COPD patients, although not in a significantly different mode from control groups. Compared to CS, COPD patients showed no significant differences of viral load in bronchial rings and lung parenchyma. Conclusions: Some virus-related molecules are well-expressed in the lung tissue and bronchi of stable COPD patients independently of the disease severity, suggesting a “primed” tissue environment capable of sensing the potential viral infections occurring in these patients.

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          Most cited references34

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          Susceptibility to exacerbation in chronic obstructive pulmonary disease.

          Although we know that exacerbations are key events in chronic obstructive pulmonary disease (COPD), our understanding of their frequency, determinants, and effects is incomplete. In a large observational cohort, we tested the hypothesis that there is a frequent-exacerbation phenotype of COPD that is independent of disease severity. We analyzed the frequency and associations of exacerbation in 2138 patients enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Exacerbations were defined as events that led a care provider to prescribe antibiotics or corticosteroids (or both) or that led to hospitalization (severe exacerbations). Exacerbation frequency was observed over a period of 3 years. Exacerbations became more frequent (and more severe) as the severity of COPD increased; exacerbation rates in the first year of follow-up were 0.85 per person for patients with stage 2 COPD (with stage defined in accordance with Global Initiative for Chronic Obstructive Lung Disease [GOLD] stages), 1.34 for patients with stage 3, and 2.00 for patients with stage 4. Overall, 22% of patients with stage 2 disease, 33% with stage 3, and 47% with stage 4 had frequent exacerbations (two or more in the first year of follow-up). The single best predictor of exacerbations, across all GOLD stages, was a history of exacerbations. The frequent-exacerbation phenotype appeared to be relatively stable over a period of 3 years and could be predicted on the basis of the patient's recall of previous treated events. In addition to its association with more severe disease and prior exacerbations, the phenotype was independently associated with a history of gastroesophageal reflux or heartburn, poorer quality of life, and elevated white-cell count. Although exacerbations become more frequent and more severe as COPD progresses, the rate at which they occur appears to reflect an independent susceptibility phenotype. This has implications for the targeting of exacerbation-prevention strategies across the spectrum of disease severity. (Funded by GlaxoSmithKline; ClinicalTrials.gov number, NCT00292552.)
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            Innate antiviral responses by means of TLR7-mediated recognition of single-stranded RNA.

            Interferons (IFNs) are critical for protection from viral infection, but the pathways linking virus recognition to IFN induction remain poorly understood. Plasmacytoid dendritic cells produce vast amounts of IFN-alpha in response to the wild-type influenza virus. Here, we show that this requires endosomal recognition of influenza genomic RNA and signaling by means of Toll-like receptor 7 (TLR7) and MyD88. Single-stranded RNA (ssRNA) molecules of nonviral origin also induce TLR7-dependent production of inflammatory cytokines. These results identify ssRNA as a ligand for TLR7 and suggest that cells of the innate immune system sense endosomal ssRNA to detect infection by RNA viruses.
              • Record: found
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              Recognition of single-stranded RNA viruses by Toll-like receptor 7.

              Viral infection of mammalian host results in the activation of innate immune responses. Toll-like receptors (TLRs) have been shown to mediate the recognition of many types of pathogens, including viruses. The genomes of viruses possess unique characteristics that are not found in mammalian genomes, such as high CpG content and double-stranded RNA. These genomic nucleic acids serve as molecular signatures associated with viral infections. Here we show that TLR7 recognizes the single-stranded RNA viruses, vesicular stomatitis virus and influenza virus. The recognition of these viruses by plasmacytoid dendritic cells and B cells through TLR7 results in their activation of costimulatory molecules and production of cytokines. Moreover, this recognition required intact endocytic pathways. Mice deficient in either the TLR7 or the TLR adaptor protein MyD88 demonstrated reduced responses to in vivo infection with vesicular stomatitis virus. These results demonstrate microbial ligand recognition by TLR7 and provide insights into the pathways used by the innate immune cells in the recognition of viral pathogens.

                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                10 June 2020
                June 2020
                : 9
                : 6
                : 1807
                Affiliations
                [1 ]Istituti Clinici Scientifici Maugeri, IRCCS, Divisione di Pneumologia Telese, Via Bagni Vecchi 1, 82037 Benevento, Italy; silvestro.danna@ 123456icsmaugeri.it
                [2 ]Dipartimento di Scienze Cliniche e Biologiche, AOU San Luigi Gonzaga, Orbassano (Torino), Università di Torino, Regione Gonzole 10, 10043 Torino, Italy; vitina.carriero@ 123456unito.it (V.C.); fabioluigimassimo.ricciardolo@ 123456unito.it (F.L.M.R.)
                [3 ]Divisione di Pneumologia e Laboratorio di Citoimmunopatologia dell’Apparato Cardio Respiratorio, Istituti Clinici Scientifici Maugeri SpA, Società Benefit, IRCCS, Veruno, Via Revislate 13, 28010 Novara, Italy; Isabella.gnemmi@ 123456icsmaugeri.it (I.G.); bruno.balbi@ 123456icsmaugeri.it (B.B.); antonino.distefano@ 123456icsmaugeri.it (A.D.S.)
                [4 ]Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Piazza Pugliatti 1, 98122 Messina, Italy; gcaramori@ 123456unime.it (G.C.); dott.fnucera@ 123456gmail.com (F.N.)
                [5 ]Dipartimento di Oncologia, SCDU, Anatomia Patologica, AOU, San Luigi, Orbassano, Università di Torino, Regione Gonzole 10, 10043 Torino, Italy; luisella.righi@ 123456unito.it
                [6 ]Dipartimento di Medicina Molecolare, Sezione di Istologia, Università di Padova, Via Ugo Bassi 58b, 35121 Padova, Italy; paola.brun@ 123456unipd.it
                [7 ]Airways Disease Section, National Heart and Lung Institute, Imperial College London, Dovehouse St, London SW3 6LY, UK; ian.adcock@ 123456imperial.ac.uk
                [8 ]Unità Operativa di Medicina, Ospedale G. Giglio Cefalù, Contrada Pietrapollastra, Via Pisciotto, 90015 Palermo, Italy; mgstella2002@ 123456yahoo.it
                Author notes
                [* ]Correspondence: mauro.maniscalco@ 123456icsmaugeri.it ; Tel.: +39-0824-909357
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0001-6751-9921
                https://orcid.org/0000-0002-9807-327X
                https://orcid.org/0000-0001-8454-5363
                https://orcid.org/0000-0002-4439-1424
                https://orcid.org/0000-0003-2101-8843
                https://orcid.org/0000-0003-3479-0875
                Article
                jcm-09-01807
                10.3390/jcm9061807
                7356645
                32531971
                b96a6903-7f4e-4939-aac0-0050f76c1b98
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 04 May 2020
                : 08 June 2020
                Categories
                Article

                copd pathology,copd phenotypes,viral load,innate immune response,outcome,disability

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