title: Dissecting influenza virus pathogenesis uncovers a novel chemical approach to combat the infection.
abstract: The cytokine storm is an aggressive immune response characterized by the recruitment of inflammatory leukocytes and exaggerated levels of cytokines and chemokines at the site of infection. Here we review evidence that cytokine storm directly contributes to the morbidity and mortality resulting from influenza virus infection and that sphingosine-1-phosphate (S1P) receptor agonists can abort cytokine storms providing significant protection against pathogenic human influenza viral infections. In experiments using murine models and the human pathogenic 2009 influenza viruses, S1P1 receptor agonist alone reduced deaths from influenza virus by over 80% as compared to lesser protection (50%) offered by the antiviral neuraminidase inhibitor oseltamivir. Optimal protection of 96% was achieved by combined therapy with the S1P1 receptor agonist and oseltamivir. The functional mechanism of S1P receptor agonist(s) action and the predominant role played by pulmonary endothelial cells as amplifiers of cytokine storm during influenza infection are described.
authors.affiliation: Viral-Immunobiology Laboratory, Department of Immunology & Microbial Science, The Scripps Research Institute, La Jolla, CA 92037, USA. mbaobo@scripps.edu
authors.forename: Michael B A
authors.initials: MB
authors.lastname: Oldstone
authors.forename: John R
authors.initials: JR
authors.lastname: Teijaro
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Walsh
authors.forename: Hugh
authors.initials: H
authors.lastname: Rosen
mesh_terms: D000818:Animals; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D042783:Endothelial Cells / Q000187:drug effects / Q000473:pathology / Q000821:virology; D004791:Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects* / Q000472:pathogenicity* / Q000502:physiology; D007251:Influenza, Human / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000821:virology; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000821:virology; D051379:Mice; D009183:Mycotoxins / Q000494:pharmacology* / Q000627:therapeutic use; D009976:Orthomyxoviridae Infections / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000821:virology; D053139:Oseltamivir / Q000494:pharmacology* / Q000627:therapeutic use; D049349:Receptors, Lysosphingolipid / Q000819:agonists* / Q000235:genetics; D015996:Survival Rate
chemical_list: D016207:Cytokines; D004791:Enzyme Inhibitors; D009183:Mycotoxins; D049349:Receptors, Lysosphingolipid; D053139:Oseltamivir