Published ahead of print on August 8, 2008, doi:10.1164/rccm.200803-455OC Am. J. Respir. Crit. Care Med., Volume 178, Number 9, November 2008, 969-976 A more recent version of this article appeared on November 1, 2008
Submitted on March 24, 2008 Influenza A Virus Inhibits Alveolar Fluid Clearance in BALB/c MiceKendra E Wolk1,1 Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, USA, 2 Department of Medicine, University of North Carolina, Chapel Hill, NC, USA, 3 Columbus Children's Research Institute, Columbus, OH, USA; Department of Pediatrics, The Ohio State University, Columbus, OH, USA, 4 Columbus Children's Research Institute, Columbus, OH, USA * To whom correspondence should be addressed. E-mail: davis.2448{at}osu.edu.
Rationale: Pulmonary infections can impair alveolar fluid clearance (AFC), contributing to formation of lung edema. Effects of influenza A virus (IAV) on AFC are unknown.
Objectives: To determine effects of IAV infection on AFC, and to identify intercellular signaling mechanisms underlying influenza-mediated inhibition of AFC.
Methods: BALB/c mice were infected intranasally with influenza A/WSN/33 (10,000 or 2,500 FFU/mouse). AFC was measured in anesthetized, ventilated mice by instilling 5% BSA into the dependent lung.
Measurements and Main Results: Infection with high-dose IAV resulted in a steady decline in arterial oxygen saturation and increased lung water content. AFC was significantly inhibited starting 1 hour after infection, and remained suppressed through day 6. AFC inhibition at early timepoints (1-4 hours after infection) did not require viral replication, while AFC inhibition later in infection was replication-dependent. Low-dose IAV infection impaired AFC for 10 days but induced only mild hypoxemia. High-dose IAV infection increased bronchoalveolar lavage fluid ATP and UTP levels. Impaired AFC at day 2 resulted primarily from reduced amiloride-sensitive AFC, mediated by increased activation of the pyrimidine-P2Y purinergic receptor axis. However, an additional component of AFC impairment was due to activation of A1 adenosine receptors and stimulation of increased CFTR-mediated anion secretion. Finally, IAV-mediated inhibition of AFC at day 2 could be reversed by addition of Key words: orthomyxovirus infections; pneumonia, viral; pulmonary edema; ion transport; adenosine
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||