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Survival during influenza-associated bacterial superinfection improves following viral- and bacterial-specific monoclonal antibody treatment
Keven M. Robinson, … , Taylor S. Cohen, John F. Alcorn
Keven M. Robinson, … , Taylor S. Cohen, John F. Alcorn
Published July 25, 2019
Citation Information: JCI Insight. 2019;4(14):e125554. https://doi.org/10.1172/jci.insight.125554.
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Research Article Immunology Infectious disease

Survival during influenza-associated bacterial superinfection improves following viral- and bacterial-specific monoclonal antibody treatment

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Abstract

Postinfluenza bacterial superinfections cause increased morbidity and mortality compared with singular infection with influenza during both pandemics and seasonal epidemics. Vaccines and current treatments provide limited benefit, a rationale to conduct studies utilizing alternative therapies. FY1 and an optimized version, MEDI8852, anti-influenza HA mAbs, have been shown to neutralize influenza virus during singular influenza infection. MEDI4893*, an anti–Staphylococcus aureus α-toxin mAb, has been shown to improve survival when administered prophylactically prior to S. aureus pneumonia. Our objective was to determine if mAbs can improve survival during postinfluenza bacterial pneumonia. We administered FY1 in a murine model of postinfluenza methicillin-resistant S. aureus (MRSA) pneumonia and observed improved survival rates when given early during the course of influenza infection. Our findings indicate decreased lung injury and increased uptake and binding of bacteria by macrophages in the mice that received FY1 earlier in the course of influenza infection, corresponding to decreased bacterial burden. We also observed improved survival when mice were treated with a combination of FY1 and MEDI4893* late during the course of postinfluenza MRSA pneumonia. In conclusion, both FY1 and MEDI4893* prolong survival when used in a murine model of postinfluenza MRSA pneumonia, suggesting pathogen-specific mAbs as a possible therapeutic in the context of bacterial superinfection.

Authors

Keven M. Robinson, Krishnaveni Ramanan, Joshua M. Tobin, Kara L. Nickolich, Matthew J. Pilewski, Nicole L. Kallewaard, Bret R. Sellman, Taylor S. Cohen, John F. Alcorn

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Figure 6

S. aureus α-toxin targeting mAb MEDI4893* protects against influenza-associated bacterial pneumonia.

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S. aureus α-toxin targeting mAb MEDI4893* protects against influenza-as...
(A) Study design with groups of C57BL/6 mice infected with 100 PFUs of influenza A PR/8/34 and receiving a single dose of MEDI4893* or IgG control on day 5 after influenza infection. Mice received secondary infection with 5 x 108 CFUs of MRSA on day 6 after influenza infection (n = 8). (B) Survival curve. (C) Study design with groups of C57BL/6 mice infected with 100 PFUs of influenza A PR/8/34 and receiving a single dose of MEDI4893* or FYI or IgG control or single doses of both MEDI4893* and FYI on day 5 after influenza infection. Mice received secondary infection with 5 × 108 CFUs of MRSA on day 6 after influenza infection (n = 12). (D) Survival curve. *P as indicated in each experiment compared with control. Significance was tested by log-rank Mantel-Cox test. Each experiment was independently performed at least twice and data are shown from combined experiments.

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