[HTML][HTML] Recovery from severe H7N9 disease is associated with diverse response mechanisms dominated by CD8+ T cells

Z Wang, Y Wan, C Qiu, S Quinones-Parra, Z Zhu… - Nature …, 2015 - nature.com
Z Wang, Y Wan, C Qiu, S Quinones-Parra, Z Zhu, L Loh, D Tian, Y Ren, Y Hu, X Zhang…
Nature communications, 2015nature.com
The avian origin A/H7N9 influenza virus causes high admission rates (> 99%) and mortality
(> 30%), with ultimately favourable outcomes ranging from rapid recovery to prolonged
hospitalization. Using a multicolour assay for monitoring adaptive and innate immunity, here
we dissect the kinetic emergence of different effector mechanisms across the spectrum of
H7N9 disease and recovery. We find that a diversity of response mechanisms contribute to
resolution and survival. Patients discharged within 2–3 weeks have early prominent H7N9 …
Abstract
The avian origin A/H7N9 influenza virus causes high admission rates (>99%) and mortality (>30%), with ultimately favourable outcomes ranging from rapid recovery to prolonged hospitalization. Using a multicolour assay for monitoring adaptive and innate immunity, here we dissect the kinetic emergence of different effector mechanisms across the spectrum of H7N9 disease and recovery. We find that a diversity of response mechanisms contribute to resolution and survival. Patients discharged within 2–3 weeks have early prominent H7N9-specific CD8+ T-cell responses, while individuals with prolonged hospital stays have late recruitment of CD8+/CD4+ T cells and antibodies simultaneously (recovery by week 4), augmented even later by prominent NK cell responses (recovery >30 days). In contrast, those who succumbed have minimal influenza-specific immunity and little evidence of T-cell activation. Our study illustrates the importance of robust CD8+ T-cell memory for protection against severe influenza disease caused by newly emerging influenza A viruses.
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