Abstract

Neonates and especially premature infants are highly susceptible to infection but still can have a remarkable resilience that is poorly understood. The view that neonates have an incomplete or deficient immune system is changing. Human neonatal studies are challenging, and elucidating host protective responses and underlying cognate pathway biology, in the context of viral infection in early life, remains to be fully explored. In both resource rich and poor settings, human cytomegalovirus (HCMV) is the most common cause of congenital infection. By using unbiased systems analyses of transcriptomic resources for HCMV neonatal infection, we find the systemic response of a preterm congenital HCMV infection, involves a focused IFN regulatory response associated with dendritic cells. Further analysis of transcriptional-programming of neonatal dendritic cells in response to HCMV infection in culture revealed an early dominant IFN-chemokine regulatory subnetworks, and at later times the plasticity of pathways implicated in cell-cycle control and lipid metabolism. Further, we identify previously unknown suppressed networks associated with infection, including a select group of GPCRs. Functional siRNA viral growth screen targeting 516-GPCRs and subsequent validation identified novel GPCR-dependent antiviral (ADORA1) and proviral (GPR146, RGS16, PTAFR, SCTR, GPR84, GPR85, NMUR2, FZ10, RDS, CCL17, and SORT1) roles. By contrast a gene family cluster of protocadherins is significantly differentially induced in neonatal cells, suggestive of possible immunomodulatory roles. Unexpectedly, programming responses of adult and neonatal dendritic cells, upon HCMV infection, demonstrated comparable quantitative and qualitative responses showing that functionally, neonatal dendritic cell are not overly compromised. However, a delay in responses of neonatal cells for IFN subnetworks in comparison with adult-derived cells are notable, suggestive of subtle plasticity differences. These findings support a set-point control mechanism rather than immaturity for explaining not only neonatal susceptibility but also resilience to infection. In summary, our findings show that neonatal HCMV infection leads to a highly plastic and functional robust programming of dendritic cells in vivo and in vitro. In comparison with adults, a minimal number of subtle quantitative and temporal differences may contribute to variability in host susceptibility and resilience, in a context dependent manner.

Highlights

  • Infection remains a leading cause of sickness and death in early life

  • For the purpose of exploring the neonatal cellular response to Human Cytomegalovirus (HCMV) infection, we further investigated a unique study by Renneson et al [14] that previously reported on immune profiling of adult and cord-blood myeloid-derived dendritic cells (DCs) upon HCMV infection

  • To investigate the systemic cellular responses in neonates up­on HCMV infection, the expression of monocyte, neutrophil, dendritic, B, T, and natural killer (NK)/NCT cell markers were analyzed in transcriptomic data, derived from neonatal blood obtained at the first clinical signs of a suspected infection, for a subsequently confirmed congenitally HCMV-infected female preterm infant (37 weeks gestational age)

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Summary

Introduction

Infection remains a leading cause of sickness and death in early life. While there has been extensive work investigating bacterial infections, viral infections are far less studied. Host control of viral infections requires both effective innate and adaptive immune responses. It can be considered that certain viral infection outcomes can be useful as a pan marker for both innate and adaptive immune health. A natural candidate example of an opportunistic viralmarker for human immune health is Human Cytomegalovirus (HCMV), the most common human viral infection acquired in utero. In this context, key features of HCMV that make it a paradigmatic biomarker of immune health include ubiquity as a human pathogen, and especially for early life where HCMV is a leading member of the ToRCH complex of perinatal infections. Most critically, infection of immune-intact individuals results in benign asymptomatic infection while in an immune compromised setting HCMV rapidly becomes a major clinical complication

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