title: Combination therapy with hepatocyte growth factor and oseltamivir confers enhanced protection against influenza viral pneumonia.
abstract: Frequent outbreaks caused by influenza viruses pose considerable public health threats worldwide. Virus-inflicted alveolar damage represents a major contributor of acute lung injury in influenza. We have previously demonstrated that hepatocyte growth factor (HGF) produced by macrophages enhances alveolar epithelial proliferation during influenza infection. Here, we investigated the therapeutic efficacy of recombinant human HGF (rhHGF) and an antiviral agent (oseltamivir) alone or in combination to treat influenza viral pneumonia in macrophage-depleted BALB/c mice. Combination therapy of infected mice significantly reduced lung pathology and mortality compared to other animal groups that received either treatment alone. Combination treatment with rhHGF induced alveolar type II (AT2) epithelial hyperplasia more prominently in the distal airways, evident by increased cells with double-positive staining for surfactant protein-C and proliferating cell nuclear antigen within the alveolar epithelial lining. Similarly, rhHGF supplementation also induced stem cell antigen-1 (SCA-1) transcriptional expression at 5 days post-infection (dpi), but mRNA levels of both SCA-1 and its receptor c-KIT were decreased by 10 dpi. Microarray and pathway analyses indicated that rhHGF administration may act by accelerating tissue repair and suppressing inflammatory processes to minimize damage by infection and to restore lung function by earlier repair. These results reveal that transient administration of rhHGF may confer synergistic effects in enhancing pulmonary repair by promoting AT2 cell proliferation. Thus, the combination of rhHGF and oseltamivir may represent a promising therapeutic option against influenza pneumonia to improve existing antiviral treatment regimens.
authors.forename: T
authors.initials: T
authors.lastname: Narasaraju
authors.forename: E
authors.initials: E
authors.lastname: Yang
authors.forename: R P
authors.initials: RP
authors.lastname: Samy
authors.forename: K S
authors.initials: KS
authors.lastname: Tan
authors.forename: A N
authors.initials: AN
authors.lastname: Moorthy
authors.forename: M C
authors.initials: MC
authors.lastname: Phoon
authors.forename: N
authors.initials: N
authors.lastname: van  Rooijen
authors.forename: H W
authors.initials: HW
authors.lastname: Choi
authors.affiliation: Host and Pathogen Interactivity Laboratory, Department of Microbiology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, 5 Science Drive 2, Kent Ridge 117545, Singapore. micctk@nus.edu.sg.
authors.forename: V T
authors.initials: VT
authors.lastname: Chow
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D017228:Hepatocyte Growth Factor / Q000627:therapeutic use*; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy*; D051379:Mice; D008807:Mice, Inbred BALB C; D053139:Oseltamivir / Q000627:therapeutic use*; D011024:Pneumonia, Viral / Q000188:drug therapy*
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir; D017228:Hepatocyte Growth Factor