Artigo Acesso aberto Revisado por pares

Antiviral immunity is impaired in COPD patients with frequent exacerbations

2019; American Physical Society; Volume: 317; Issue: 6 Linguagem: Inglês

10.1152/ajplung.00253.2019

ISSN

1522-1504

Autores

Aran Singanayagam, Su-Ling Loo, Maria Adelaide Calderazzo, Lydia J. Finney, Maria-Belen Trujillo Torralbo, Eteri Bakhsoliani, Jason Girkin, Punnam Chander Veerati, Prabuddha S. Pathinayake, Kristy Nichol, Andrew T. Reid, Joseph Footitt, Peter Wark, Christopher Grainge, Sebastian L. Johnston, Nathan W. Bartlett, Patrick Mallia,

Tópico(s)

Respiratory viral infections research

Resumo

Patients with frequent exacerbations represent a chronic obstructive pulmonary disease (COPD) subgroup requiring better treatment options. The aim of this study was to determine the innate immune mechanisms that underlie susceptibility to frequent exacerbations in COPD. We measured sputum expression of immune mediators and bacterial loads in samples from patients with COPD at stable state and during virus-associated exacerbations. In vitro immune responses to rhinovirus infection in differentiated primary bronchial epithelial cells (BECs) sampled from patients with COPD were additionally evaluated. Patients were stratified as frequent exacerbators (≥2 exacerbations in the preceding year) or infrequent exacerbators (<2 exacerbations in the preceding year) with comparisons made between these groups. Frequent exacerbators had reduced sputum cell mRNA expression of the antiviral immune mediators type I and III interferons and reduced interferon-stimulated gene (ISG) expression when clinically stable and during virus-associated exacerbation. A role for epithelial cell-intrinsic innate immune dysregulation was identified: induction of interferons and ISGs during in vitro rhinovirus (RV) infection was also impaired in differentiated BECs from frequent exacerbators. Frequent exacerbators additionally had increased sputum bacterial loads at 2 wk following virus-associated exacerbation onset. These data implicate deficient airway innate immunity involving epithelial cells in the increased propensity to exacerbations observed in some patients with COPD. Therapeutic approaches to boost innate antimicrobial immunity in the lung could be a viable strategy for prevention and treatment of frequent exacerbations.

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