Abstract

Obese individuals are at greater risk for death from influenza virus infection. Paralleling human evidence, obese mice are also more susceptible to influenza infection mortality. However, the underlying mechanisms driving greater influenza severity in the obese remain unclear. Metabolic profiling has been utilized in infectious disease models to enhance prognostic or diagnostic methods, and to gain insight into disease pathogenesis by providing a more global picture of dynamic infection responses. Herein, metabolic profiling was used to develop a deeper understanding of the complex processes contributing to impaired influenza protection in obese mice and to facilitate generation of new explanatory hypotheses. Diet-induced obese and lean mice were infected with influenza A/Puerto Rico/8/34. 1H nuclear magnetic resonance-based metabolic profiling of urine, feces, lung, liver, mesenteric white adipose tissue, bronchoalveolar lavage fluid and serum revealed distinct metabolic signatures in infected obese mice, including perturbations in nucleotide, vitamin, ketone body, amino acid, carbohydrate, choline and lipid metabolic pathways. Further, metabolic data was integrated with immune analyses to obtain a more comprehensive understanding of potential immune-metabolic interactions. Of interest, uncovered metabolic signatures in urine and feces allowed for discrimination of infection status in both lean and obese mice at an early influenza time point, which holds prognostic and diagnostic implications for this methodology. These results confirm that obesity causes distinct metabolic perturbations during influenza infection and provide a basis for generation of new hypotheses and use of this methodology in detection of putative biomarkers and metabolic patterns to predict influenza infection outcome.

Highlights

  • Obesity has reached epidemic proportions [1]

  • Several investigations have since established obesity as an independent risk factor for enhanced pandemic H1N1 influenza (pH1N1) [6,7,8,9,10] and seasonal influenza infection severity [11,12,13]

  • A number of innate and adaptive immune defenses are altered by obesity during influenza infection, explanatory mechanisms remain relatively undefined

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Summary

Introduction

Global approximations report that two out of every three individuals are clinically overweight (BMI$25–29.9) or obese (BMI$30) [2]. In 2009, the Centers for Disease Control and Prevention reported a high prevalence of obesity among intensive care patients with confirmed 2009 pandemic H1N1 influenza (pH1N1) infection [6]. Several investigations have since established obesity as an independent risk factor for enhanced pH1N1 [6,7,8,9,10] and seasonal influenza infection severity [11,12,13]. Given that seasonal influenza epidemics result in 250,000 to 500,000 deaths globally [14] and future pandemics are likely imminent [15], understanding how obesity enhances influenza severity is a global public health concern

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