Abstract

Bacterial super-infections are a major complication of influenza virus (IV) infections and often lead to severe pneumonia. One hallmark of IV-associated Staphylococcus aureus (S. aureus) infection is rapid progression to a serious disease outcome. Changes in immune and inflammatory host responses increase morbidity and complicate efficient therapy. A key player during inflammation is the multifunctional cytokine IL-6. Although increased IL-6 levels have been observed after severe disease upon IV and/or bacterial super-infection, the underlying molecular mechanisms still remain to be elucidated. In the present study, we focused on cellular signalling pathways regulating IL-6 production upon IV/S. aureus super-infection. Additionally, infection with viable bacteria was mimicked by lipoteichoic acid stimulation in this model. Analyses of cellular signalling mechanisms revealed synergistically increased activation of the MAPK p38 as well as enhanced phosphorylation of the MAPKs ERK1/2 and JNK in the presence of super-infecting bacteria. Interestingly, inhibition of MAPK activity indicated a strong dependence of IL-6 expression on p38 and ERK1/2, while the MAPK JNK seems not to be involved. Thus, our results provide new molecular insights into the regulation of IL-6, a marker of severe disease, which might contribute to the lethal synergism of IV and S. aureus.

Highlights

  • Bacterial super-infections, notably those caused by Staphylococcus aureus (S. aureus), contribute to the morbidity and mortality of influenza virus (IV) infections[1,2,3,4,5]

  • Up-regulation of certain inflammatory mediators has been linked to serious disease progression, in case of IV infection this has been shown for the multifunctional cytokine IL-616–23

  • S. aureus 6850 infection alone resulted in a marginal induction of these cytokines and chemokines, while IL-1β and CXCL8 mRNA levels were elevated after bacterial infection (Fig. 1c,i)

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Summary

Introduction

Bacterial super-infections, notably those caused by Staphylococcus aureus (S. aureus), contribute to the morbidity and mortality of influenza virus (IV) infections[1,2,3,4,5]. In vitro data suggest that this system is blocked by S. aureus super-infection, leading to enhanced viral replication[15] Another important regulator of immune response and inflammation is the multifunctional cytokine IL-6. A dysregulated inflammatory response after viral or bacterial infection occurs in cases of septicaemia or infection with highly pathogenic avian IV subtypes (HPAIV), resulting in massive over-production of pro-inflammatory cytokines and chemokines. This so called “cytokine storm” has been linked to the activity of the MAPK family members p38 and ERK1/235,36. S. aureus modulates the inflammatory response of the host and induces anti-inflammatory cytokines by selective signalling through the MAPK ERK1/238

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