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BCG immunization mitigates SARS-CoV-2 replication in macaques via monocyte efferocytosis and neutrophil recruitment in lungs
Mohammad Arif Rahman, Katherine C. Goldfarbmuren, Sarkis Sarkis, Massimiliano Bissa, Anna Gutowska, Luca Schifanella, Ramona Moles, Melvin N. Doster, Hanne Andersen, Yogita Jethmalani, Leonid Serebryannyy, Timothy Cardozo, Mark G. Lewis, Genoveffa Franchini
Mohammad Arif Rahman, Katherine C. Goldfarbmuren, Sarkis Sarkis, Massimiliano Bissa, Anna Gutowska, Luca Schifanella, Ramona Moles, Melvin N. Doster, Hanne Andersen, Yogita Jethmalani, Leonid Serebryannyy, Timothy Cardozo, Mark G. Lewis, Genoveffa Franchini
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Research Article Immunology Infectious disease

BCG immunization mitigates SARS-CoV-2 replication in macaques via monocyte efferocytosis and neutrophil recruitment in lungs

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Abstract

Exposure to Bacillus Calmette-Guérin (BCG) or Canarypox ALVAC/Alum vaccine elicits pro- or antiinflammatory innate responses, respectively. We tested whether prior exposure of macaques to these immunogens protected against SARS-CoV-2 replication in lungs and found more efficient replication control after the pro-inflammatory immunity elicited by BCG. The decreased virus level in lungs was linked to early infiltrates of classical monocytes producing IL-8 with systemic neutrophils, Th2 cells, and Ki67+CD95+CD4+ T cells producing CCR7. At the time of SARS-CoV-2 exposure, BCG-treated animals had higher frequencies of lung infiltrating neutrophils and higher CD14+ cells expressing efferocytosis marker MERTK, responses correlating with decreased SARS-CoV-2 replication in lung. At the same time point, plasma IL-18, TNF-α, TNFSF-10, and VEGFA levels were also higher in the BCG group and correlated with decreased virus replication. Finally, after SARS-CoV-2 exposure, decreased virus replication correlated with neutrophils producing IL-10 and CCR7 preferentially recruited to the lungs of BCG-vaccinated animals. These data point to the importance of the spatiotemporal distribution of functional monocytes and neutrophils in controlling SARS-CoV-2 levels and suggest a central role of monocyte efferocytosis in curbing replication.

Authors

Mohammad Arif Rahman, Katherine C. Goldfarbmuren, Sarkis Sarkis, Massimiliano Bissa, Anna Gutowska, Luca Schifanella, Ramona Moles, Melvin N. Doster, Hanne Andersen, Yogita Jethmalani, Leonid Serebryannyy, Timothy Cardozo, Mark G. Lewis, Genoveffa Franchini

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Figure 4

Differences in cell subsets and cytokines between ALVAC/Alum and BCG following SARS-CoV-2 infection.

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Differences in cell subsets and cytokines between ALVAC/Alum and BCG fol...
(A and C) Heatmaps display row-scaled frequencies of cell populations (A) in BAL and blood or plasma cytokine levels (C) across BCG, ALVAC/Alum, and nonvaccinated control animals, sorted by their significant difference pattern (2-tailed Mann-Whitney P < 0.05) at specified postinfection time points. Only cell populations with 2-tailed Mann-Whitney P < 0.05 for at least 1 pair of groups are shown. Underlay colors highlight the cell/cytokine marker across time points or compartments. Red and green arrows indicate the BCG-vaccinated animal that did not control virus replication and the nonvaccinated animal that did control virus replication, respectively. (B and D) Correlation plots link cell frequencies (B) and cytokine levels (D) at specified postinfection time points with replicating VL in BAL at 7 days after SARS-CoV-2 infection. Differences between groups are summarized from A or C, indicated by circles (BCG vs. ALVAC/Alum) or triangles (vaccinated vs. nonvaccinated control). Populations that were not significantly different (Mann-Whitney P < 0.05) between at least 1 pair of groups were omitted for clarity. Underlay colors highlight the cell/cytokine marker, and alluvial flow connects each population/cytokine associated in both compartments or time points. Thirteen rhesus macaques were analyzed in this figure: BCG vaccine (n = 4), ALVAC/Alum vaccine (n = 4), and controls (n = 5).

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