Restoration of Type 17 immune signaling is not sufficient for protection during influenza-associated pulmonary aspergillosis
Aijaz AhmadiD, R. B. SinghiD, Kara L. NickolichiD, Matthew J. PilewskiiD, Caden Ngeow, Kwame Frempong-Manso, Keven Mara RobinsoniD
Abstract
Influenza-associated pulmonary aspergillosis (IAPA) is a severe complication of influenza infection that occurs in critically ill patients and results in higher mortality compared to influenza infection alone. Interleukin-17 (IL-17) and the Type 17 immune signaling pathway cytokine family are recognized for their pivotal role in fostering protective immunity against various pathogens. In this study, we investigate the role of IL-17 and Type 17 immune signaling components during IAPA. Wild-type mice were challenged with influenza A H1N1 (Flu) and then exposed to Aspergillus fumigatus ATCC42202 resting conidia on day 6 post-influenza infection, followed by the quantification of cytokines and chemokines at 48 hours post-fungal infection. Gene and protein expression levels revealed that IL-17 and Type 17 immune cytokines and antimicrobial peptides are downregulated during IAPA compared to mice singularly infected solely with A. fumigatus. Restoration of Type 17 immunity was not sufficient to provide protection against the increased fungal burden observed during IAPA. These findings contrast those observed during post-influenza bacterial super-infection, in which restoration of Type 17 immune signaling protects against exacerbation seen during super-infection. Our study highlights the need for future studies to understand the immune mechanisms that increase susceptibility to fungal infection. ImportanceIAPA significantly elevates the risk of mortality in patients with severe influenza. Type-17 immunity is critical to host defense during fungal infections and, therefore, vital to understand its role during IAPA. The observations in this study reveal that Type 17 immunity is impaired during IAPA, potentially increasing susceptibility to secondary infection with Aspergillus fumigatus. However, restoration of IL-17 signaling alone is not sufficient to reduce fungal burden in our murine IAPA model. These observations differ from those observed in post-influenza bacterial super-infections, suggesting that the mechanisms underlying viral-fungal super-infection are different than those that underly viral-bacterial super-infection. By elucidating the complex interactions between the host immune system, influenza, and A. fumigatus, these findings are vital for developing strategies to enhance immune responses and improve survival rates during IAPA.
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