RSV inhibits myeloid cell recruitment during S. aureus coinfection

Abstract

Abstract Respiratory syncytial virus (RSV) infects almost all humans by the age of 2. RSV more often causes severe lower respiratory tract disease in younger children and older adults, which may be exacerbated by increased susceptibility to secondary bacterial infection (coinfection). Like influenza, it is thought that RSV may predispose the lung to opportunistic infections with strains of bacteria normally present as colonizers of the nasopharynx, predominantly Staphylococcus aureus and Streptococcus pneumoniae. While there has been significant investigation into mechanisms of RSV/bacterial coinfection, models that faithfully replicate the pathology of human RSV infection have not been fully explored. To examine this aspect, we infected mice with a strain of RSV (rA2-line 19F, 2×105 PFU) that induces significant IL-13, mucus, and airway hyperresponsiveness. We found that RSV infection six days prior to S. aureus infection (5×107 CFU) reduces bacterial clearance. Flow cytometry data suggest that RSV infection alters cellular recruitment in response to S. aureus, largely by reducing neutrophils and monocytes. Surprisingly, we saw increased levels of the monocyte chemokine CCL2, suggesting compensatory chemokine production in response to dampened cellular recruitment. Additionally, we observed no change in several cytokines that exacerbate inflammation during influenza/S. aureus coinfection, including IL-1β, IL-6, and TNFα. Together, these data suggest a markedly different mechanism of increased susceptibility to bacterial infection during RSV, characterized by reduced--rather than overexuberant--myeloid cell recruitment. Supported by grants from NIH (R35HL144481 to Beth Moore, T32HL007517 to Helen Rich) and the Michigan Postdoctoral Pioneer Program at the University of Michigan Medical School.