title: Reduction of natural killer but not effector CD8 T lymphocytes in three consecutive cases of severe/lethal H1N1/09 influenza A virus infection.
abstract: BACKGROUND
  The cause of severe disease in some patients infected with pandemic influenza A virus is unclear.
  
  
  RESULTS
  We present the cellular immunology profile in the blood, and detailed clinical (and post-mortem) findings of three patients with rapidly progressive infection, including a pregnant patient who died. The striking finding is of reduction in natural killer (NK) cells but preservation of activated effector CD8 T lymphocytes; with viraemia in the patient who had no NK cells. Comparison with control groups suggests that the reduction of NK cells is unique to these severely ill patients.
  
  
  CONCLUSIONS
  Our report shows markedly reduced NK cells in the three patients that we sampled and raises the hypothesis that NK may have a more significant role than T lymphocytes in controlling viral burden when the host is confronted with a new influenza A virus subtype.
authors.affiliation: Medical Research Council Human Immunology Unit, Weatherall Institute of Molecular Medicine, Oxford University, Oxford, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: Denney
authors.forename: Celia
authors.initials: C
authors.lastname: Aitken
authors.forename: Chris Ka-Fai
authors.initials: CK
authors.lastname: Li
authors.forename: Eleri
authors.initials: E
authors.lastname: Wilson-Davies
authors.forename: Wai Ling
authors.initials: WL
authors.lastname: Kok
authors.forename: Colin
authors.initials: C
authors.lastname: Clelland
authors.forename: Kevin
authors.initials: K
authors.lastname: Rooney
authors.forename: Duncan
authors.initials: D
authors.lastname: Young
authors.forename: Tao
authors.initials: T
authors.lastname: Dong
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McMichael
authors.forename: William F
authors.initials: WF
authors.lastname: Carman
authors.forename: Ling-Pei
authors.initials: LP
authors.lastname: Ho
mesh_terms: D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D005615:Freezing; D006262:Health; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007251:Influenza, Human / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology* / Q000821:virology*; D007694:Killer Cells, Natural / Q000276:immunology* / Q000821:virology; D008168:Lung / Q000276:immunology / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D011247:Pregnancy; D012367:RNA, Viral / Q000097:blood; D013902:Radiography, Thoracic; D055815:Young Adult
chemical_list: D012367:RNA, Viral