1. Alveolar barrier disruption in varicella pneumonia is associated with neutrophil extracellular trap formation.
- Author
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Ouwendijk WJ, van den Ham HJ, Delany MW, van Kampen JJ, van Nierop GP, Mehraban T, Zaaraoui-Boutahar F, van IJcken WF, van den Brand JM, de Vries RD, Andeweg AC, and Verjans GM
- Subjects
- Acute Lung Injury etiology, Animals, Case-Control Studies, Female, Humans, Macaca mulatta, Male, Varicella Zoster Virus Infection virology, Viral Load, Acute Lung Injury pathology, Disease Models, Animal, Extracellular Traps immunology, Herpesvirus 3, Human physiology, Immunity, Innate immunology, Varicella Zoster Virus Infection complications, Virus Replication
- Abstract
Primary varicella-zoster virus (VZV) infection in adults is often complicated by severe pneumonia, which is difficult to treat and is associated with high morbidity and mortality. Here, the simian varicella virus (SVV) nonhuman primate (NHP) model was used to investigate the pathogenesis of varicella pneumonia. SVV infection resulted in transient fever, viremia, and robust virus replication in alveolar pneumocytes and bronchus-associated lymphoid tissue. Clearance of infectious virus from lungs coincided with robust innate immune responses, leading to recruitment of inflammatory cells, mainly neutrophils and lymphocytes, and finally severe acute lung injury. SVV infection caused neutrophil activation and formation of neutrophil extracellular traps (NETs) in vitro and in vivo. Notably, NETs were also detected in lung and blood specimens of varicella pneumonia patients. Lung pathology in the SVV NHP model was associated with dysregulated expression of alveolar epithelial cell tight junction proteins (claudin-2, claudin-10, and claudin-18) and alveolar endothelial adherens junction protein VE-cadherin. Importantly, factors released by activated neutrophils, including NETs, were sufficient to reduce claudin-18 and VE-cadherin expression in NHP lung slice cultures. Collectively, the data indicate that alveolar barrier disruption in varicella pneumonia is associated with NET formation.
- Published
- 2020
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