Abstract

Adenovirus infections are important complications of bone marrow transplantation (BMT). We demonstrate delayed clearance of mouse adenovirus type 1 (MAV-1) from lungs of mice following allogeneic BMT. Virus-induced prostaglandin E2 (PGE2) production was greater in BMT mice than in untransplanted controls, but BMT using PGE2-deficient donors or recipients failed to improve viral clearance, and treatment of untransplanted mice with the PGE2 analog misoprostol did not affect virus clearance. Lymphocyte recruitment to the lungs was not significantly affected by BMT. Intracellular cytokine staining of lung lymphocytes demonstrated impaired production of INF-γ and granzyme B by cells from BMT mice, and production of IFN-γ, IL-2, IL-4, and IL-17 following ex vivo stimulation was impaired in lymphocytes obtained from lungs of BMT mice. Viral clearance was not delayed in untransplanted INF-γ-deficient mice, suggesting that delayed viral clearance in BMT mice was not a direct consequence of impaired IFN-γ production. However, lung viral loads were higher in untransplanted CD8-deficient mice than in controls, suggesting that delayed MAV-1 clearance in BMT mice is due to defective CD8 T cell function. We did not detect significant induction of IFN-β expression in lungs of BMT mice or untransplanted controls, and viral clearance was not delayed in untransplanted type I IFN-unresponsive mice. We conclude that PGE2 overproduction in BMT mice is not directly responsible for delayed viral clearance. PGE2-independent effects on CD8 T cell function likely contribute to the inability of BMT mice to clear MAV-1 from the lungs.

Highlights

  • Viral infection is an important complication in both allogeneic and autologous bone marrow transplantation (BMT) [1,2,3]

  • Human adenoviruses (HAdVs) infection is a potentially devastating complication in hematopoietic stem cell transplant (HSCT) patients, and there are no antiviral or immunomodulatory therapies that have consistently shown a benefit in HSCT patients with HAdV disease

  • We used mouse adenovirus type 1 (MAV-1) to study the effects of BMT on host susceptibility to adenovirus infection

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Summary

Introduction

Viral infection is an important complication in both allogeneic and autologous bone marrow transplantation (BMT) [1,2,3]. Human adenoviruses (HAdVs) cause considerable morbidity and mortality in BMT patients [4,5,6]. Depending on the assay used, HAdVs have been detected in up to 29% of BMT patients during weekly surveillance screening [7,8]. Disease rates as high as 6.5% have been reported, with mortality rates of greater than 50% in BMT patients with HAdV disease in some studies [8,9]. Pediatric patients are at a higher risk for HAdV disease [6,10], likely due to higher infection rates in this population and a relative lack of HAdV species cross-reactive T and B cell responses compared to adults, in whom some HAdV-specific immunity has been established [11]. Severe graft-versus-host disease (GVHD) [12], T-celldepleted grafts, and leukopenia [13] are additional risk factors for HAdV infection following BMT

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