title: Proinflammatory chemokines are major mediators of exuberant immune response associated with Influenza A (H1N1) pdm09 virus infection.
abstract: In India, the case fatality ratio of the pandemic A (H1N1) pdm09 influenza was relatively higher when compared to seasonal Influenza A infection. Hypercytokinemia or "cytokine storm" has been previously implicated in the pathogenesis of other influenza viruses. The present study was undertaken to compare the cytokine profiles of A (H1N1) pdm09 influenza and seasonal H3 infection in Indian population and to correlate the findings with disease severity. Plasma levels of 18 cytokines/chemokines were measured by flow-cytometry using a bead based assay in patients infected with A (H1N1) pdm09 virus (n = 96) and Influenza A seasonal H3 virus (n = 30) categorised into mild, moderate, and severe groups along with healthy controls (n = 36). There was an overall trend indicating an exuberant cytokine/chemokine response in A (H1N1) pdm09 as compared to seasonal H3 influenza, which was more evident in severe cases, suggesting a role for these cytokines/chemokines in the pathogenesis of A(H1N1) pdm09. Increased levels of CXCL-8/IL-8, IL-10, IL-6, and IL-17A were seen in both A(H1N1) pdm09 influenza and seasonal H3 cases when compared to healthy controls. However, dysregulated production of proinflammatory chemokines was seen more pronounced in A (H1N1) pdm09 influenza cases as compared to seasonal H3 cases. This study has brought forth the potential role of chemokines as prognostic indicators of disease severity and outcome. Further research on modulating the host immune response to limit severity of the disease could help in the treatment and management of influenza.
authors.affiliation: Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Maria
authors.identifier: 0000-0001-6771-0742
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Reeta Subramaniam
authors.initials: RS
authors.lastname: Mani
authors.affiliation: Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Mariamma
authors.initials: M
authors.lastname: Philip
authors.affiliation: Department of Microbiology, Manipal Hospital, Bangalore, India.
authors.forename: Ranjeeta
authors.initials: R
authors.lastname: Adhikary
authors.affiliation: Department of Microbiology, Manipal Hospital, Bangalore, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Influenza Division, Rajiv Gandhi Institute for Chest Diseases, Bangalore, India.
authors.forename: Srigiri S
authors.initials: SS
authors.lastname: Revadi
authors.affiliation: Influenza Division, Rajiv Gandhi Institute for Chest Diseases, Bangalore, India.
authors.forename: Shashidhar
authors.initials: S
authors.lastname: Buggi
authors.affiliation: Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Desai
authors.affiliation: Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Vasanthapuram
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018925:Chemokines / Q000097:blood*; D002648:Child; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007194:India; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D007251:Influenza, Human / Q000473:pathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D018925:Chemokines
keywords: cytokines/chemokines; immunopathology; influenza virus