Abstract

Acute lung injury (ALI) is an important cause of morbidity and mortality after viral infections, including influenza A virus H1N1, SARS-CoV, MERS-CoV, and SARS-CoV-2. The angiotensin I converting enzyme 2 (ACE2) is a key host membrane-bound protein that modulates ALI induced by viral infection, pulmonary acid aspiration, and sepsis. However, the contributions of ACE2 sequence variants to individual differences in disease risk and severity after viral infection are not understood. In this study, we quantified H1N1 influenza-infected lung transcriptomes across a family of 41 BXD recombinant inbred strains of mice and both parents—C57BL/6J and DBA/2J. In response to infection Ace2 mRNA levels decreased significantly for both parental strains and the expression levels was associated with disease severity (body weight loss) and viral load (expression levels of viral NA segment) across the BXD family members. Pulmonary RNA-seq for 43 lines was analyzed using weighted gene co-expression network analysis (WGCNA) and Bayesian network approaches. Ace2 not only participated in virus-induced ALI by interacting with TNF, MAPK, and NOTCH signaling pathways, but was also linked with high confidence to gene products that have important functions in the pulmonary epithelium, including Rnf128, Muc5b, and Tmprss2. Comparable sets of transcripts were also highlighted in parallel studies of human SARS-CoV-infected primary human airway epithelial cells. Using conventional mapping methods, we determined that weight loss at two and three days after viral infection maps to chromosome X—the location of Ace2. This finding motivated the hierarchical Bayesian network analysis, which defined molecular endophenotypes of lung infection linked to Ace2 expression and to a key disease outcome. Core members of this Bayesian network include Ace2, Atf4, Csf2, Cxcl2, Lif, Maml3, Muc5b, Reg3g, Ripk3, and Traf3. Collectively, these findings define a causally-rooted Ace2 modulatory network relevant to host response to viral infection and identify potential therapeutic targets for virus-induced respiratory diseases, including those caused by influenza and coronaviruses.

Highlights

  • Five major influenza A virus (IAV) pandemics have swept through human populations in the last 130 years—the 1890 H3N8 pandemic, the devastating 1918 H1N1 pandemic [1], and serious global outbreaks in 1957 (H2N2), 1968 (H3N2), and the 2009 H1N1 swine influenza

  • The B6 maternal parent of the BXDs is resistant to H1N1 infection, whereas the D2 paternal parent is highly susceptible to low virulent PR8 (H1N1) virus

  • The same infection titer was lethal for D2 which died at 5 dpi, and this was matched with lower expression of Ace2 (7.10 ± 0.25) at 1 dpi

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Summary

Introduction

Five major influenza A virus (IAV) pandemics have swept through human populations in the last 130 years—the 1890 H3N8 pandemic, the devastating 1918 H1N1 pandemic [1], and serious global outbreaks in 1957 (H2N2), 1968 (H3N2), and the 2009 H1N1 swine influenza. The current COVID-19 pandemic is caused by a novel coronavirus, termed severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2). This pathogen has spread with unprecedented speed and efficiency from an initial outbreak in November or December 2019. The primary pathological features of the influenza A outbreaks and both the 2002 SARS and current COVID-19 outbreaks are viral pneumonia and acute lung injury (ALI) [2]. The well documented symptoms of influenza A (H1N1) and COVID-19 have substantial overlap. For both viral pathogens, infected humans can have symptoms ranging from mild coughing, congestion, and fever, to severe and lethal pulmonary edema and disseminating diseases of other organs. Individual host genetic differences almost certainly play an important role in the development and severity of the illness and its time course [3,4,5,6,7]

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