title: Restoration of NET formation by gene therapy in CGD controls aspergillosis.
abstract: Chronic granulomatous disease (CGD) patients have impaired nicotinamide adenine dinucleotide phosphate (NADPH) oxidase function, resulting in poor antimicrobial activity of neutrophils, including the inability to generate neutrophil extracellular traps (NETs). Invasive aspergillosis is the leading cause of death in patients with CGD; it is unclear how neutrophils control Aspergillus species in healthy persons. The aim of this study was to determine whether gene therapy restores NET formation in CGD by complementation of NADPH oxidase function, and whether NETs have antimicrobial activity against Aspergillus nidulans. Here we show that reconstitution of NET formation by gene therapy in a patient with CGD restores neutrophil elimination of A nidulans conidia and hyphae and is associated with rapid cure of preexisting therapy refractory invasive pulmonary aspergillosis, underlining the role of functional NADPH oxidase in NET formation and antifungal activity.
authors.affiliation: Division of Immunology/Haematology/BMT, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bianchi
authors.forename: Abdul
authors.initials: A
authors.lastname: Hakkim
authors.forename: Volker
authors.initials: V
authors.lastname: Brinkmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Siler
authors.forename: Reinhard A
authors.initials: RA
authors.lastname: Seger
authors.forename: Arturo
authors.initials: A
authors.lastname: Zychlinsky
authors.forename: Janine
authors.initials: J
authors.lastname: Reichenbach
mesh_terms: D000935:Antifungal Agents / Q000378:metabolism; D001228:Aspergillosis / Q000209:etiology / Q000235:genetics / Q000378:metabolism / Q000517:prevention & control*; D001233:Aspergillus nidulans; D002634:Chemotaxis, Leukocyte / Q000235:genetics* / Q000276:immunology; D002648:Child; D015316:Genetic Therapy / Q000379:methods; D006105:Granulomatous Disease, Chronic / Q000150:complications / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D006801:Humans; D008297:Male; D009504:Neutrophils / Q000378:metabolism / Q000502:physiology*
chemical_list: D000935:Antifungal Agents