Novel strategies for prevention and treatment of influenza

Analysis of factors influencing influenza outbreaks in schools in Taicang City, China

Objective

This study aims to analyze the awareness of influenza prevention and control and the behavioral attitudes toward the work among parents and staff in schools in Taicang City and the impact of the vaccination rate among students on influenza outbreaks in schools. The findings can provide references for the development of effective control strategies for the spread of influenza.

Methods

An anonymous questionnaire survey was conducted on 10,962 students from 20 schools in Taicang City, with class as the unit of analysis. The survey investigated their awareness of influenza prevention and control, their attitudes, and the vaccination coverage.

Results

From January to June 2023, a total of 388 influenza outbreaks were reported in schools in Taicang City, involving 77 schools. There were 3,475 confirmed cases, with an average infection rate of 18.53%. In schools where influenza outbreaks had occurred, the incidence rate of those who received influenza vaccine was significantly lower than those who did not, and the vaccine protection rate was 28.22%. The knowledge awareness rates of "the main transmission routes of influenza" and "influenza vaccination can prevent influenza" among parents of students were 95.49 and 93.16%, respectively. The differences between schools involved in the epidemic and non-epidemic were statistically significant (p < 0.05). The correct attitudes of parents toward "actively reporting relevant symptoms to teachers when their children show symptoms" and "avoiding classes with diseases when their children are suspected to be sick" are 98.80 and 96.26%, respectively. The differences between schools with and without epidemic are statistically significant (p < 0.05). The correct attitudes of the class teacher toward "correct management and control of students with flu like symptoms in the class" and "taking correct prevention and control measures in the event of a flu epidemic in the class" were 89.36 and 92.55%, respectively. The differences between epidemic related and non-epidemic related classes were statistically significant (p < 0.05).

Conclusion

Enhance the knowledge level of influenza prevention and control among parents of students, Strengthening the training for class teachers in emergency response to infectious diseases and increasing vaccination coverage among students can effectively reduce the incidence of influenza and thereby the occurrence of cluster outbreaks in schools.

Baicalin inhibits influenza virus A replication via activation of type I IFN signaling by reducing miR‑146a

Influenza virus A (IVA) is one of the predominant causative agents of the seasonal flu and has become an important cause of morbidity worldwide. Great efforts have been paid to develop vaccines against IVA. However, due to antigenic drift in influenza virus A and rapid emergence of drug-resistant strains, current available vaccines or anti-IVA chemotherapeutics are consistently inefficient. Hence, various more broadly effective drugs have become important for the prevention and treatment of IVA. Of these drugs, baicalin, a flavonoid isolated from Radix Scutellaria, is a promising example. However, little is known in regards to its pharmacological mechanism. Here, it was demonstrated that baicalin inhibits the H1N1 and H3N2 viruses in A549 cells. Subsequently, it was found that miR-146a was markedly downregulated by treatment of baicalin. Additionally, further experiments revealed that miR-146a was able to promote the replication of H1N1 and H3N2 by targeting TNF receptor-associated factor 6 (TRAF6), a pivotal adaptor in the interferon (IFN) production signaling pathway, to downregulate type I IFN production, and enrichment of miR-146a eliminated the anti-IVA effects of baicalin on the H1N1 and H3N2 viruses. Additionally, in vivo experiments demonstrated that baicalin could protect mice during H1N1 infection. Taken together, our findings firstly illustrated the anti-IVA molecular mechanism of baicalin and provide new evidence for targeting miRNAs to prevent and treat viral infection, such as the H1N1 and H3N2 viruses.

Potential Role of MicroRNAs in the Regulation of Antiviral Responses to Influenza Infection

Influenza is a major health burden worldwide and is caused by influenza viruses that are enveloped and negative stranded RNA viruses. Little progress has been achieved in targeted intervention, either at a population level or at an individual level (to treat the cause), due to the toxicity of drugs and ineffective vaccines against influenza viruses. MicroRNAs (miRNAs) are small non-coding RNAs that play critical roles in gene expression, cell differentiation, and tissue development and have been shown to silence viral replication in a sequence-specific manner. Investigation of these small endogenous nucleotides may lead to new therapeutics against influenza virus infection. Here, we describe our current understanding of the role of miRNAs in host defense response against influenza virus, as well as their potential and limitation as new therapeutic approaches.

Oroxylin A suppresses influenza A virus replication correlating with neuraminidase inhibition and induction of IFNs

Because it is highly contagious, the influenza A virus (IAV) has the potential to cause pandemics in humans. The emergence of drug-resistant strains requires the development of new chemical therapeutics. Oroxylin A (OA) is a flavonoid which has been shown to have antioxidant and antitumor effects. However, intensive studies in which OA fights against different influenza virus strains and the underlying antiviral mechanisms have not been reported. In our study, the antiviral activities in cells and in mice, the preliminary mechanisms of OA were investigated. Our data show that it can inhibit A/FM/1/47 (H1N1), A/Beijing/32/92 (H3N2) and oseltamivir-resistant A/FM/1/47-H275Y (H1N1-H275Y) viruses in MDCK cells in a dose-dependent manner with inhibitory rates of 70.9%, 59.5% and 23.2%, respectively, at 50μM doses. Orally administered OA effectively protected mice from H1N1 virus-induced death, body weight loss and lung injury, with a survival rate of 60.0% at 100mg/kg/d dose. In addition, the H1N1 M1 gene transcription and protein synthesis were suppressed by 43.7% and 33.2%, respectively, in the late biosynthesis stage. This resulted in inhibition of viral replication. Furthermore, we found that OA has a neuraminidase (NA) inhibitory effect with IC₅₀ values for H1N1-H275Y and A/Anhui/1/2013-R294K (H7N9-R294K) of 241.4μM and 203.6μM, respectively. Interferons (IFNs) produced by the virally infected cells play important roles in antiviral defense, therefore, IFN levels in the blood were also tested in mice. We found that IFN-β and IFN-γ in the OA 100mg/kg/d group were markedly increased by 24.5pg/mL and 859.9pg/mL, respectively, compared with those in the model group. This indicated that OA could induce the secretion of IFNs. The potent inhibition of virus replication and NA inhibitory activity, as well as the promotion of IFN production suggest that OA could be a drug candidate to fight against IAVs including oseltamivir-resistant strains.

Targeting host calpain proteases decreases influenza A virus infection

Influenza A viruses (IAV) trigger contagious acute respiratory diseases. A better understanding of the molecular mechanisms of IAV pathogenesis and host immune responses is required for the development of more efficient treatments of severe influenza. Calpains are intracellular proteases that participate in diverse cellular responses, including inflammation. Here, we used in vitro and in vivo approaches to investigate the role of calpain signaling in IAV pathogenesis. Calpain expression and activity were found altered in IAV-infected bronchial epithelial cells. With the use of small-interfering RNA (siRNA) gene silencing, specific synthetic inhibitors of calpains, and mice overexpressing calpastatin, we found that calpain inhibition dampens IAV replication and IAV-triggered secretion of proinflammatory mediators and leukocyte infiltration. Remarkably, calpain inhibition has a protective impact in IAV infection, since it significantly reduced mortality of mice challenged not only by seasonal H3N2- but also by hypervirulent H5N1 IAV strains. Hence, our study suggests that calpains are promising therapeutic targets for treating IAV acute pneumonia.

14-Deoxy-11,12-dehydroandrographolide exerts anti-influenza A virus activity and inhibits replication of H5N1 virus by restraining nuclear export of viral ribonucleoprotein complexes

The highly pathogenic avian influenza H5N1 virus has become a worldwide public health threat, and current antiviral therapies have limited activity against the emerging, resistant influenza viruses. Therefore, effective drugs with novel targets against influenza A viruses, H5N1 strains in particular, should be developed. In the present study, 14-deoxy-11,12-dehydroandrographolide (DAP), a major component of the traditional Chinese medicine Andrographis paniculata, exerted potent anti-influenza A virus activity against A/chicken/Hubei/327/2004 (H5N1), A/duck/Hubei/XN/2007 (H5N1), A/PR/8/34 (H1N1), A/NanChang/08/2010 (H1N1) and A/HuNan/01/2014 (H3N2) in vitro. To elucidate the underlying mechanisms, a series of experiments was conducted using A/chicken/Hubei/327/2004 (H5N1) as an example. Our results demonstrated that DAP strongly inhibited H5N1 replication by reducing the production of viral nucleoprotein (NP) mRNA, NP and NS1proteins, whereas DAP had no effect on the absorption and release of H5N1 towards/from A549 cells. DAP also effectively restrained the nuclear export of viral ribonucleoprotein (vRNP) complexes. This inhibitory effect ought to be an important anti-H5N1 mechanism of DAP. Meanwhile, DAP significantly reduced the upregulated expression of all the tested proinflammatory cytokines (TNF-α, IL-6, IL-8, IFN-α, IL-1β and IFN-β) and chemokines (CXCL-10 and CCL-2) stimulated by H5N1. Overall results suggest that DAP impairs H5N1 replication at least in part by restraining nuclear export of vRNP complexes, and the inhibition of viral replication leads to a subsequent decrease of the intense proinflammatory cytokine/chemokine expression. In turn, the effect of modification of the host excessive immune response may contribute to overcoming H5N1. To our knowledge, this study is the first to reveal the antiviral and anti-inflammatory activities of DAP in vitro against H5N1 influenza A virus infection.

Baicalin inhibits autophagy induced by influenza A virus H3N2

Baicalin, a natural product isolated from Scutellariaradix, has been reported to have significant in vivo and in vitro anti-influenza virus activity, but the underlying mechanism remains poorly understood. In this study, we found that baicalin inhibited autophagy induced by influenza virus A3/Beijing/30/95 (H3N2) in both A549 and Ana-1 cells. The results showed that H3N2 induced autophagy by suppressing mTOR signaling pathway, which however could be significantly inhibited by baicalin. Baicalin could suppress the expression of Atg5-Atg12 complex and LC3-II, and attenuate autophagy induced by starvation. Thus, the inhibition of autophagy induced by virus may account for the antiviral activities of baicalin against H3N2. Autophagy may be a potential marker in developing novel anti-influenza drugs.

Influenza virus H1N1 activates platelets through FcγRIIA signaling and thrombin generation

Platelets play crucial functions in hemostasis and the prevention of bleeding. During H1N1 influenza A virus infection, platelets display activation markers. The platelet activation triggers during H1N1 infection remain elusive. We observed that H1N1 induces surface receptor activation, lipid mediator synthesis, and release of microparticles from platelets. These activation processes require the presence of serum/plasma, pointing to the contribution of soluble factor(s). Considering that immune complexes in the H1N1 pandemic were reported to play a pathogenic role, we assessed their contribution in H1N1-induced platelet activation. In influenza-immunized subjects, we observed that the virus scaffolds with immunoglobulin G (IgG) to form immune complexes that promote platelet activation. Mechanistically, this activation occurs through stimulation of low-affinity type 2 receptor for Fc portion of IgG (FcγRIIA), a receptor for immune complexes, independently of thrombin. Using a combination of in vitro and in vivo approaches, we found that the antibodies from H3N2-immunized mice activate transgenic mouse platelets that express FcγRIIA when put in the presence of H1N1, suggesting that cross-reacting influenza antibodies suffice. Alternatively, H1N1 can activate platelets via thrombin formation, independently of complement and FcγRIIA. These observations identify both the adaptive immune response and the innate response against pathogens as 2 intertwined processes that activate platelets during influenza infections.

Influenza vaccination in children being treated with chemotherapy for cancer

BACKGROUND

Influenza infection is a potential cause of severe morbidity in children with cancer; therefore vaccination against influenza is recommended. However, data are conflicting regarding the immune response to influenza vaccination in children with cancer, and the value of vaccination remains unclear.

OBJECTIVES

1. To assess the efficacy of influenza vaccination in stimulating an immunological response in children with cancer during chemotherapy, compared with control groups.2. To assess the efficacy of influenza vaccination in preventing confirmed influenza and influenza-like illness and/or in stimulating immunological response in children with cancer treated with chemotherapy, compared with placebo, no intervention or different dosage schedules.3. To identify the adverse effects associated with influenza vaccines in children with cancer treated with chemotherapy, compared with other control groups.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to 2012) and EMBASE (1980 to 2012) up to August 2012. We also searched reference lists of relevant articles and conference proceedings of the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), the Infectious Diseases Society of America (IDSA), the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society of Paediatric Oncology (SIOP).

SELECTION CRITERIA

We considered randomised controlled trials (RCTs) and controlled clinical trials (CCTs) in which the serological response to influenza vaccination of children with cancer was compared with that of control groups. We also considered RCTs and CCTs that compared the effects of influenza vaccination on clinical response and/or immunological response in children with cancer being treated with chemotherapy, compared with placebo, no intervention or different dosage schedules.

DATA COLLECTION AND ANALYSIS

Two independent review authors assessed the methodological quality of included studies and extracted the data.

MAIN RESULTS

We included 1 RCT and 9 CCTs (total number of participants = 770). None of the included studies reported clinical outcomes. All included studies reported on influenza immunity and adverse reactions to vaccination. In five studies, immune responses to influenza vaccine were compared in 272 children receiving chemotherapy and 166 children not receiving chemotherapy. In four studies, responses to influenza vaccine were assessed in 236 children receiving chemotherapy compared with responses in 142 healthy children. Measures used to assess immune responses included a four-fold rise in antibody titre after vaccination, development of a haemagglutination inhibition (HI) titre > 32 and pre- and post-vaccination geometric mean titres (GMTs). Immune responses in children receiving chemotherapy were consistently weaker (four-fold rise of 38% to 65%) than those in children who had completed chemotherapy (50% to 86%) and in healthy children (53% to 89%). In terms of adverse effects, 391 paediatric oncology patients received influenza vaccine, and the adverse effects described included mild local reactions and low-grade fever. No life-threatening or persistent adverse effects were reported.

AUTHORS' CONCLUSIONS

Paediatric oncology patients receiving chemotherapy are able to generate an immune response to the influenza vaccine, but it remains unclear whether this immune response protects them from influenza infection or its complications. We are awaiting results from well-designed RCTs addressing the clinical benefit of influenza vaccination in these patients.

siRNA Genome Screening Approaches to Therapeutic Drug Repositioning

Bridging high-throughput screening (HTS) with RNA interference (RNAi) has allowed for rapid discovery of the molecular basis of many diseases, and identification of potential pathways for developing safe and effective treatments. These features have identified new host gene targets for existing drugs paving the pathway for therapeutic drug repositioning. Using RNAi to discover and help validate new drug targets has also provided a means to filter and prioritize promising therapeutics. This review summarizes these approaches across a spectrum of methods and targets in the host response to pathogens. Particular attention is given to the utility of drug repurposing utilizing the promiscuous nature of some drugs that affect multiple molecules or pathways, and how these biological pathways can be targeted to regulate disease outcome.

Targeting organic anion transporter 3 with probenecid as a novel anti-influenza a virus strategy

Influenza A virus infection is a major global health concern causing significant mortality, morbidity, and economic loss. Antiviral chemotherapeutics that target influenza A virus are available; however, rapid emergence of drug-resistant strains has been reported. Consequently, there is a burgeoning need to identify novel anti-influenza A drugs, particularly those that target host gene products required for virus replication, to reduce the likelihood of drug resistance. In this study, a small interfering RNA (siRNA) screen was performed to identify host druggable gene targets for anti-influenza A virus therapy. The host organic anion transporter-3 gene (OAT3), a member of the SLC22 family of transporters, was validated as being required to support influenza A virus replication. Probenecid, a prototypical uricosuric agent and chemical inhibitor of organic anion transporters known to target OAT3, was shown to be effective in limiting influenza A virus infection in vitro (50% inhibitory concentration [IC(50)] of 5.0 × 10(-5) to 5.0 × 10(-4) μM; P < 0.005) and in vivo (P < 0.05). Probenecid is widely used for treatment of gout and related hyperuricemic disorders, has been extensively studied for pharmacokinetics and safety, and represents an excellent candidate for drug repositioning as a novel anti-influenza A chemotherapeutic.

Receptor for advanced glycation end products is detrimental during influenza A virus pneumonia

Pneumonia caused by influenza A virus (IAV) can have devastating effects, resulting in respiratory failure and death. The idea that a new influenza pandemic might occur in the near future has triggered renewed interests in IAV infection. The receptor for advanced glycation end products (RAGE) is expressed on different cell types and plays a key role in diverse inflammatory processes. We here investigated the role of RAGE in the host response to IAV pneumonia using wild-type (wt) and RAGE deficient ((-/-)) mice. Whereas strong RAGE was constitutively expressed in the lungs of uninfected wt mice, in particular on endothelium, IAV pneumonia was associated with enhanced expression on endothelium and de novo expression on bronchial epithelium. Additionally, the high-affinity RAGE ligand high mobility group box 1 was upregulated during IAV pneumonia. RAGE(-/-) mice were relatively protected from IAV induced mortality and showed an improved viral clearance and enhanced cellular T cell response and activation of neutrophils. These data suggest that RAGE is detrimental during IAV pneumonia.

Influenza vaccination in children being treated with chemotherapy for cancer

BACKGROUND

Influenza infection is a potential cause of severe morbidity in children with cancer, therefore vaccination against influenza is recommended. However, there are conflicting data concerning the immune response to influenza vaccination in children with cancer and the value of vaccination remains unclear.

OBJECTIVES

1. To assess the efficacy of influenza vaccination in stimulating immunological response in children with cancer during chemotherapy, compared to control groups. 2. To assess the efficacy of influenza vaccination in preventing confirmed influenza and influenza-like illness and/or stimulating immunological response in children with cancer treated with chemotherapy, compared to placebo, no intervention or different dosage schedules. 3. To determine the adverse effects associated with influenza vaccination in children with cancer.

SEARCH STRATEGY

We searched CENTRAL, MEDLINE (1966 to 2007) and EMBASE (1980 to 2007) up to February 2007. We also searched reference lists of relevant articles and conference proceedings of ICAAC, IDSA, MASCC and SIOP.

SELECTION CRITERIA

We considered randomised controlled trials (RCTs) and controlled clinical trials (CCTs) in which the serologic response to influenza vaccination of children with cancer was compared to other control groups. We also considered RCTs and CCTs comparing the effects of influenza vaccination on clinical response and/or immunological response in children with cancer, with placebo, no intervention or different dosage schedules.

DATA COLLECTION AND ANALYSIS

Two independent authors assessed the methodological quality of included studies and extracted data.

MAIN RESULTS

We included 1 RCT and 8 CCTs ( total number of participants=708). None of the included studies reported on clinical outcome. All included studies reported on influenza immunity and adverse reactions to vaccination. In five studies, immune responses to influenza vaccine were compared in 272 children on chemotherapy with 166 children not on chemotherapy. In three studies, responses to influenza vaccine were assessed in 204 children on chemotherapy compared with responses in 112 healthy children. The measures used to assess immune responses were: a four-fold rise in antibody titre after vaccination, development of haemagglutination inhibition (HI) titre > 32, and pre- and post-vaccination geometric mean titres (GMT). Immune responses in children receiving chemotherapy were consistently weaker (four-fold rise of 25% to 52%) than in those children who had completed chemotherapy (50% to 86%) and in healthy children (71% to 89%). Concerning adverse effects, 359 paediatric oncology patients received influenza vaccine and the side effects described were mild local reactions and low grade fever. No life-threatening or persistent adverse effects were reported.

AUTHORS' CONCLUSIONS

Paediatric oncology patients receiving chemotherapy are able to generate an immune response to the influenza vaccine, but it remains unclear whether this immune response protects them from influenza infection or its complications. We are awaiting results from well-designed RCTs addressing the clinical benefit of influenza vaccination in these patients.

Multiple components contribute to ability of saliva to inhibit influenza viruses

INTRODUCTION

Saliva is a potentially important barrier against respiratory viral infection but its mechanism of action is not well studied.

METHODS

We tested the antiviral activities of whole saliva, specific salivary gland secretions, and purified salivary proteins against strains of influenza A virus (IAV) in vitro.

RESULTS

Whole saliva or parotid or submandibular/sublingual secretions from healthy donors inhibited IAV based on hemagglutination inhibition and neutralization assays. This differs from human immunodeficiency virus (HIV), for which only submandibular/sublingual secretions are reported to be inhibitory. Among purified salivary proteins, MUC5B, scavenger receptor cysteine-rich glycoprotein 340 (salivary gp-340), histatins, and human neutrophil defensins (HNPs) inhibited IAV at the concentrations present in whole saliva. In contrast, some abundant salivary proteins (acidic proline-rich proteins and amylase) had no activity, nor did several other less abundant salivary proteins with known activity against HIV (e.g. thrombospondin or serum leukocyte protease inhibitor). Whole saliva and MUC5B did not inhibit neuraminidase activity of IAV and viral neutralizing and aggregating activity of MUC5B was potentiated by the neuraminidase inhibitor oseltamivir. Hence, MUC5B inhibits IAV by presenting a sialic acid ligand for the viral hemagglutinin. The mechanism of action of histatins requires further study.

CONCLUSIONS

These findings indicate that saliva represents an important initial barrier to IAV infection and underline the complexity of host defense activity of oral secretions. Of interest, antiviral activity of saliva against IAV and HIV differs in terms of specific glandular secretions and proteins that are inhibitory.

Targeting host cell furin proprotein convertases as a therapeutic strategy against bacterial toxins and viral pathogens

Pathogens or their toxins, including influenza virus, Pseudomonas, and anthrax toxins, require processing by host proprotein convertases (PCs) to enter host cells and to cause disease. Conversely, inhibiting PCs is likely to protect host cells from multiple furin-dependent, but otherwise unrelated, pathogens. To determine if this concept is correct, we designed specific nanomolar inhibitors of PCs modeled from the extended cleavage motif TPQRERRRKKR downward arrowGL of the avian influenza H5N1 hemagglutinin. We then confirmed the efficacy of the inhibitory peptides in vitro against the fluorescent peptide, anthrax protective antigen (PA83), and influenza hemagglutinin substrates and also in mice in vivo against two unrelated toxins, anthrax and Pseudomonas exotoxin. Peptides with Phe/Tyr at P1' were more selective for furin. Peptides with P1' Thr were potent against multiple PCs. Our strategy of basing the peptide sequence on a furin cleavage motif known for an avian flu virus shows the power of starting inhibitor design with a known substrate. Our results confirm that inhibiting furin-like PCs protects the host from the distinct furin-dependent infections and lay a foundation for novel, host cell-focused therapies against acute diseases.

Inhibition of hemagglutination activity of influenza A viruses by SP-A1 and SP-A2 variants expressed in CHO cells

Surfactant protein A (SP-A) inhibits hemagglutination (HA) activity and infectivity of influenza A viruses (IAV). As we have showed before in different assays, SP-A2 gene products are more active than SP-A1. Here, we hypothesized that SP-A1 and SP-A2 mammalian CHO-cell-expressed proteins also differentially modulate HA inhibition of IAV. We found that both SP-A1 and SP-A2 equally displayed alpha(2,3)-linked sialic acids, and had similar activity against a strain (PR-8) that preferentially binds to alpha(2,3)-linked sialic acids. Based on these findings, we speculate that in human lung SP-A1 and SP-A2 will not be different in their activity against IAV that preferably bind to alpha(2,3)-linked sialic acids (like avian strains).

Inhibition of influenza viral neuraminidase activity by collectins

The collectins, lung surfactant proteins A and D (SP-A and SP-D), contribute to innate host defense against influenza A virus (IAV) in vivo. Although collectins bind to the viral hemagglutinin (HA) and inhibit early stages of viral infection in vitro, they also bind to the neuraminidase (NA) and inhibit NA activity. We used a variety of NA functional assays, viral strains and recombinant (mutant or wild type) collectins to characterize the mechanism of NA inhibition. NA inhibition by SP-D correlates with binding of its carbohydrate recognition domain (CRD) to oligomannose oligosaccharides on the viral hemagglutinin (HA). The effects of SP-D are additive with oseltamivir, consistent with differences in mechanism of action. NA inhibition was observed using fetuin or MDCK cells as a substrate, but not in assays using a soluble sialic acid analogue. Collectin multimerization and CRD binding properties are key determinants for NA inhibition. SP-D had greater NA inhibitory activity than mannose-binding lectin, which in turn had greater activity than SP-A. The markedly greater NA inhibitory activity of SP-D compared to SP-A may partly account for the finding that deletion of the SP-D gene in mice has a greater effect on viral replication in vivo.

Detrimental contribution of the Toll-like receptor (TLR)3 to influenza A virus-induced acute pneumonia

Influenza A virus (IAV) is the etiological agent of a highly contagious acute respiratory disease that causes epidemics and considerable mortality annually. Recently, we demonstrated, using an in vitro approach, that the pattern recognition Toll-like receptor (TLR)3 plays a key role in the immune response of lung epithelial cells to IAV. In view of these data and the fact that the functional role of TLR3 in vivo is still debated, we designed an investigation to better understand the role of TLR3 in the mechanisms of IAV pathogenesis and host immune response using an experimental murine model. The time-course of several dynamic parameters, including animal survival, respiratory suffering, viral clearance, leukocyte recruitment into the airspaces and secretion of critical inflammatory mediators, was compared in infected wild-type and TLR3^−/− mice. First, we found that the pulmonary expression of TLR3 is constitutive and markedly upregulated following influenza infection in control mice. Notably, when compared to wild-type mice, infected TLR3^−/− animals displayed significantly reduced inflammatory mediators, including RANTES (regulated upon activation, normal T cell expressed and secreted), interleukin-6, and interleukin-12p40/p70 as well as a lower number of CD8⁺ T lymphocytes in the bronchoalveolar airspace. More important, despite a higher viral production in the lungs, mice deficient in TLR3 had an unexpected survival advantage. Hence, to our knowledge, our findings show for the first time that TLR3-IAV interaction critically contributes to the debilitating effects of a detrimental host inflammatory response.

Influenza A virus (IAV) is responsible for highly contagious acute respiratory disease. Recent concerns have risen concerning a possible influenza pandemic in the near future. Thus, a better understanding of the molecular mechanisms of IAV pathogenesis and host immune responses is required for the development of more efficient means of prevention and treatment of influenza. The Toll-like receptor (TLR)3 is a member of a family of receptors that detects microbes and triggers host defenses. We previously demonstrated using an in vitro approach, that the TLR3 plays a key role in the response of lung epithelial cells to IAV. Here, we used a mouse model to dissect the in vivo importance of TLR3-dependent responses during influenza. The time-course of several parameters, including animal survival, respiratory distress, viral clearance, and inflammation, was compared in infected control wild-type and TLR3-deficient mice. Our findings reveal that TLR3^−/− mice have an unexpected advantage against IAV challenge as we show for the first time that a reduction of TLR3-mediated inflammatory response reduces the clinical manifestations of IAV-induced pneumonia.

Carbohydrate-binding molecules inhibit viral fusion and entry by crosslinking membrane glycoproteins

Defensins are peptides that protect the host against microorganisms. Here we show that the theta-defensin retrocyclin 2 (RC2) inhibited influenza virus infection by blocking membrane fusion mediated by the viral hemagglutinin. RC2 was effective even after hemagglutinin attained a fusogenic conformation or had induced membrane hemifusion. RC2, a multivalent lectin, prevented hemagglutinin-mediated fusion by erecting a network of crosslinked and immobilized surface glycoproteins. RC2 also inhibited fusion mediated by Sindbis virus and baculovirus. Human beta-defensin 3 and mannan-binding lectin also blocked viral fusion by creating a protective barricade of immobilized surface proteins. This general mechanism might explain the broad-spectrum antiviral activity of many multivalent lectins of the innate immune system.