Abstract

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in children worldwide. While most develop a mild, self-limiting illness, some develop severe acute lower respiratory infection and persistent airway disease. Exposure to ambient particulate matter has been linked to asthma, bronchitis, and viral infection in multiple epidemiological studies. We hypothesized that coexposure to nanoparticles worsens RSV-induced airway epithelial barrier dysfunction. Bronchial epithelial cells were incubated with titanium dioxide nanoparticles (TiO2-NP) or a combination of TiO2-NP and RSV. Structure and function of epithelial cell barrier were analyzed. Viral titer and the role of reactive oxygen species (ROS) generation were evaluated. In vivo, mice were intranasally incubated with TiO2-NP, RSV, or a combination. Lungs and bronchoalveolar lavage (BAL) fluid were harvested for analysis of airway inflammation and apical junctional complex (AJC) disruption. RSV-induced AJC disruption was amplified by TiO2-NP. Nanoparticle exposure increased viral infection in epithelial cells. TiO2-NP induced generation of ROS, and pretreatment with antioxidant, N-acetylcysteine, reversed said barrier dysfunction. In vivo, RSV-induced injury and AJC disruption were augmented in the lungs of mice given TiO2-NP. Airway inflammation was exacerbated, as evidenced by increased white blood cell infiltration into the BAL, along with exaggeration of peribronchial inflammation and AJC disruption. These data demonstrate that TiO2-NP exposure exacerbates RSV-induced AJC dysfunction and increases inflammation by mechanisms involving generation of ROS. Further studies are required to determine whether NP exposure plays a role in the health disparities of asthma and other lung diseases, and why some children experience more severe airway disease with RSV infection.

Highlights

  • Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection (ALRI) in young children worldwide [34, 40, 41, 76, 102]

  • Similar TiO2-NP-induced apical junctional complexes (AJC) disruption was observed in human primary airway epithelial cell monolayers (Fig. 2, C and D)

  • These results suggest that TiO2-NP exposure disrupts the integrity of a model airway epithelial barrier by triggering focal AJC disassembly

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Summary

Introduction

Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection (ALRI) in young children worldwide [34, 40, 41, 76, 102]. In 2015, more than 33 million occurrences of RSV-related ALRI have been estimated glob-. There are strong associations between RSV, persistent wheezing, and childhood asthma [47, 132]. No effective treatment is available for RSV infection, aside from supportive care [101, 130]. The virus mainly targets airway epithelial cells, triggering profound inflammation and diminishing integrity of the epithelial barrier by disrupting specialized intercellular structures termed apical junctional complexes (AJC) [98, 101]. We and others have demonstrated that RSV stimulates increased permeability and a “leaky airway” both in vitro and in vivo [35, 99, 117]

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