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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 JCI+Insight ä ; 2 (7): ä Nephropedia Template TP
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M1-like monocytes are a major immunological determinant of severity in previously healthy adults with life-threatening influenza #MMPMID28405622
Cole SL; Dunning J; Kok WL; Benam KH; Benlahrech A; Repapi E; Martinez FO; Drumright L; Powell TJ; Bennett M; Elderfield R; Thomas C; Dong T; McCauley J; Liew FY; Taylor S; Zambon M; Barclay W; Cerundolo V; Openshaw PJ; McMichael AJ; Ho LP
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In each influenza season, a distinct group of young, otherwise healthy individuals with no risk factors succumbs to life-threatening infection. To better understand the cause for this, we analyzed a broad range of immune responses in blood from a unique cohort of patients, comprising previously healthy individuals hospitalized with and without respiratory failure during one influenza season, and infected with one specific influenza A strain. This analysis was compared with similarly hospitalized influenza patients with known risk factors (total of n = 60 patients recruited). We found a sustained increase in a specific subset of proinflammatory monocytes, with high TNF-? expression and an M1-like phenotype (independent of viral titers), in these previously healthy patients with severe disease. The relationship between M1-like monocytes and immunopathology was strengthened using murine models of influenza, in which severe infection generated using different models (including the high-pathogenicity H5N1 strain) was also accompanied by high levels of circulating M1-like monocytes. Additionally, a raised M1/M2 macrophage ratio in the lungs was observed. These studies identify a specific subtype of monocytes as a modifiable immunological determinant of disease severity in this subgroup of severely ill, previously healthy patients, offering potential novel therapeutic avenues.