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TLR4 genotype and environmental LPS mediate RSV bronchiolitis through Th2 polarization.


ABSTRACT: While 30%-70% of RSV-infected infants develop bronchiolitis, 2% require hospitalization. It is not clear why disease severity differs among healthy, full-term infants; however, virus titers, inflammation, and Th2 bias are proposed explanations. While TLR4 is associated with these disease phenotypes, the role of this receptor in respiratory syncytial virus (RSV) pathogenesis is controversial. Here, we evaluated the interaction between TLR4 and environmental factors in RSV disease and defined the immune mediators associated with severe illness. Two independent populations of infants with RSV bronchiolitis revealed that the severity of RSV infection is determined by the TLR4 genotype of the individual and by environmental exposure to LPS. RSV-infected infants with severe disease exhibited a high GATA3/T-bet ratio, which manifested as a high IL-4/IFN-? ratio in respiratory secretions. The IL-4/IFN-? ratio present in infants with severe RSV is indicative of Th2 polarization. Murine models of RSV infection confirmed that LPS exposure, Tlr4 genotype, and Th2 polarization influence disease phenotypes. Together, the results of this study identify environmental and genetic factors that influence RSV pathogenesis and reveal that a high IL-4/IFN-? ratio is associated with severe disease. Moreover, these molecules should be explored as potential targets for therapeutic intervention.

SUBMITTER: Caballero MT 

PROVIDER: S-EPMC4319428 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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TLR4 genotype and environmental LPS mediate RSV bronchiolitis through Th2 polarization.

Caballero Mauricio T MT   Serra M Elina ME   Acosta Patricio L PL   Marzec Jacqui J   Gibbons Luz L   Salim Maximiliano M   Rodriguez Andrea A   Reynaldi Andrea A   Garcia Alejandro A   Bado Daniela D   Buchholz Ursula J UJ   Hijano Diego R DR   Coviello Silvina S   Newcomb Dawn D   Bellabarba Miguel M   Ferolla Fausto M FM   Libster Romina R   Berenstein Ada A   Siniawaski Susana S   Blumetti Valeria V   Echavarria Marcela M   Pinto Leonardo L   Lawrence Andrea A   Ossorio M Fabiana MF   Grosman Arnoldo A   Mateu Cecilia G CG   Bayle Carola C   Dericco Alejandra A   Pellegrini Mariana M   Igarza Ignacio I   Repetto Horacio A HA   Grimaldi Luciano Alva LA   Gudapati Prathyusha P   Polack Norberto R NR   Althabe Fernando F   Shi Min M   Ferrero Fernando F   Bergel Eduardo E   Stein Renato T RT   Peebles R Stokes RS   Boothby Mark M   Kleeberger Steven R SR   Polack Fernando P FP  

The Journal of clinical investigation 20150102 2


While 30%-70% of RSV-infected infants develop bronchiolitis, 2% require hospitalization. It is not clear why disease severity differs among healthy, full-term infants; however, virus titers, inflammation, and Th2 bias are proposed explanations. While TLR4 is associated with these disease phenotypes, the role of this receptor in respiratory syncytial virus (RSV) pathogenesis is controversial. Here, we evaluated the interaction between TLR4 and environmental factors in RSV disease and defined the  ...[more]

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