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      GM-CSF overexpression after influenza a virus infection prevents mortality and moderates M1-like airway monocyte/macrophage polarization

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          Abstract

          Background

          Influenza A viruses cause life-threatening pneumonia and lung injury in the lower respiratory tract. Application of high GM-CSF levels prior to infection has been shown to reduce morbidity and mortality from pathogenic influenza infection in mice, but the mechanisms of protection and treatment efficacy have not been established.

          Methods

          Mice were infected intranasally with influenza A virus (PR8 strain). Supra-physiologic levels of GM-CSF were induced in the airways using the double transgenic GM-CSF (DTGM) or littermate control mice starting on 3 days post-infection (dpi). Assessment of respiratory mechanical parameters was performed using the flexiVent rodent ventilator. RNA sequence analysis was performed on FACS-sorted airway macrophage subsets at 8 dpi.

          Results

          Supra-physiologic levels of GM-CSF conferred a survival benefit, arrested the deterioration of lung mechanics, and reduced the abundance of protein exudates in bronchoalveolar (BAL) fluid to near baseline levels. Transcriptome analysis, and subsequent validation ELISA assays, revealed that excess GM-CSF re-directs macrophages from an “M1-like” to a more “M2-like” activation state as revealed by alterations in the ratios of CXCL9 and CCL17 in BAL fluid, respectively. Ingenuity pathway analysis predicted that GM-CSF surplus during IAV infection elicits expression of anti-inflammatory mediators and moderates M1 macrophage pro-inflammatory signaling by Type II interferon (IFN-γ).

          Conclusions

          Our data indicate that application of high levels of GM-CSF in the lung after influenza A virus infection alters pathogenic “M1-like” macrophage inflammation. These results indicate a possible therapeutic strategy for respiratory virus-associated pneumonia and acute lung injury.

          Electronic supplementary material

          The online version of this article (10.1186/s12931-017-0708-5) contains supplementary material, which is available to authorized users.

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          Most cited references44

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          Origin of the lamina propria dendritic cell network.

          CX(3)CR1(+) and CD103(+) dendritic cells (DCs) in intestinal lamina propria play a key role in mucosal immunity. However, the origin and the developmental pathways that regulate their differentiation in the lamina propria remain unclear. We showed that monocytes gave rise exclusively to CD103(-)CX(3)CR1(+) lamina propria DCs under the control of macrophage-colony-stimulating factor receptor (M-CSFR) and Fms-like thyrosine kinase 3 (Flt3) ligands. In contrast, common DC progenitors (CDP) and pre-DCs, which give rise to lymphoid organ DCs but not to monocytes, differentiated exclusively into CD103(+)CX(3)CR1(-) lamina propria DCs under the control of Flt3 and granulocyte-macrophage-colony-stimulating factor receptor (GM-CSFR) ligands. CD103(+)CX(3)CR1(-) DCs but not CD103(-)CX(3)CR1(+) DCs in the lamina propria constitutively expressed CCR7 and were the first DCs to transport pathogenic Salmonella from the intestinal tract to the mesenteric lymph nodes. Altogether, these results underline the diverse origin of the lamina propria DC network and identify mucosal DCs that arise from pre-DCs as key sentinels of the gut immune system.
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            Inhibition of pulmonary antibacterial defense by interferon-gamma during recovery from influenza infection.

            Secondary bacterial infection often occurs after pulmonary virus infection and is a common cause of severe disease in humans, yet the mechanisms responsible for this viral-bacterial synergy in the lung are only poorly understood. We now report that pulmonary interferon-gamma (IFN-gamma) produced during T cell responses to influenza infection in mice inhibits initial bacterial clearance from the lung by alveolar macrophages. This suppression of phagocytosis correlates with lung IFN-gamma abundance, but not viral burden, and leads to enhanced susceptibility to secondary pneumococcal infection, which can be prevented by IFN-gamma neutralization after influenza infection. Direct inoculation of IFN-gamma can mimic influenza infection and downregulate the expression of the class A scavenger receptor MARCO on alveolar macrophages. Thus, IFN-gamma, although probably facilitating induction of specific anti-influenza adaptive immunity, suppresses innate protection against extracellular bacterial pathogens in the lung.
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              Pyogenic bacterial infections in humans with MyD88 deficiency.

              MyD88 is a key downstream adapter for most Toll-like receptors (TLRs) and interleukin-1 receptors (IL-1Rs). MyD88 deficiency in mice leads to susceptibility to a broad range of pathogens in experimental settings of infection. We describe a distinct situation in a natural setting of human infection. Nine children with autosomal recessive MyD88 deficiency suffered from life-threatening, often recurrent pyogenic bacterial infections, including invasive pneumococcal disease. However, these patients were otherwise healthy, with normal resistance to other microbes. Their clinical status improved with age, but not due to any cellular leakiness in MyD88 deficiency. The MyD88-dependent TLRs and IL-1Rs are therefore essential for protective immunity to a small number of pyogenic bacteria, but redundant for host defense to most natural infections.
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                Author and article information

                Contributors
                ehalstead@pennstatehealth.psu.edu
                tumstead2@pennstatehealth.psu.edu
                fluidmosaic@gmail.com
                yimamura@pennstatehealth.psu.edu
                psilveyra@pennstatehealth.psu.edu
                jhowrylak@pennstatehealth.psu.edu
                lenseyang718@gmail.com
                ebiosciences@gmail.com
                sanmeihu@pennstatehealth.psu.edu
                ehewage@pennstatehealth.psu.edu
                zchroneos@pennstatehealth.psu.edu
                Journal
                Respir Res
                Respir. Res
                Respiratory Research
                BioMed Central (London )
                1465-9921
                1465-993X
                5 January 2018
                5 January 2018
                2018
                : 19
                : 3
                Affiliations
                [1 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Department of Pediatrics, , Pennsylvania State University College of Medicine, ; Hershey, PA USA
                [2 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Pulmonary Immunology and Physiology Laboratory, , Pennsylvania State University College of Medicine, ; Hershey, PA USA
                [3 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Departments of Pharmacology & Biochemistry and Molecular Biology, , Institute for Personalized Medicine, Pennsylvania State University College of Medicine, ; Hershey, PA USA
                [4 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Departments of Medicine and Public Health Sciences, , Pennsylvania State University College of Medicine, ; Hershey, PA USA
                [5 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Department of Microbiology and Immunology, , Pennsylvania State University College of Medicine, ; Hershey, PA USA
                Author information
                http://orcid.org/0000-0002-1167-0363
                Article
                708
                10.1186/s12931-017-0708-5
                5756339
                29304863
                f2e72c4c-1c52-46fc-b031-0fb192cec764
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 30 October 2017
                : 18 December 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100009633, Eunice Kennedy Shriver National Institute of Child Health and Human Development;
                Award ID: 2 K12 HD055882
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Respiratory medicine
                influenza,gm-csf,macrophage,alveolar,exudative,pneumonia,rna-seq,interferon
                Respiratory medicine
                influenza, gm-csf, macrophage, alveolar, exudative, pneumonia, rna-seq, interferon

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