1. Capturing the systemic immune signature of a norovirus infection: an n-of-1 case study within a clinical trial
- Author
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Kara Hunter, Sarah L Caddy, Marcin L. Pekalski, Jia Lu, Neil Walker, Ian Goodfellow, Deborah J. Smyth, Ben Challis, Linda S. Wicker, Ricardo C. Ferreira, Antony J. Cutler, John A. Todd, Helen Stevens, João J. Oliveira, Jane Kennet, Frank Waldron-Lynch, Wang, Sarah [0000-0002-9790-7420], Lu, Jia [0000-0003-3995-324X], Goodfellow, Ian [0000-0002-9483-510X], Waldron-Lynch, Frank [0000-0002-0597-4328], Apollo - University of Cambridge Repository, Cutler, Antony J [0000-0002-9617-9994], and Wicker, Linda S [0000-0001-7771-0324]
- Subjects
0301 basic medicine ,T regulatory cells ,3207 Medical Microbiology ,Library science ,Medicine (miscellaneous) ,norovirus ,chemical and pharmacologic phenomena ,32 Biomedical and Clinical Sciences ,General Biochemistry, Genetics and Molecular Biology ,Combinatorics ,Immunomodulation ,Vaccine Related ,03 medical and health sciences ,0302 clinical medicine ,Aldesleukin ,Clinical Research ,Medicine ,2.1 Biological and endogenous factors ,Proleukin ,Antigen Processing & Recognition ,Immune Response ,Immunity to Infections ,030304 developmental biology ,2 Aetiology ,0303 health sciences ,Viral Infections (without HIV) ,business.industry ,Inflammatory and immune system ,hemic and immune systems ,clinical trial ,Articles ,Immunological Biomarkers ,Innate Immunity ,3. Good health ,3204 Immunology ,030104 developmental biology ,Infectious Diseases ,Emerging Infectious Diseases ,Research centre ,Interleukin-2 ,Clinical Immunology ,aldesleukin ,business ,Digestive Diseases ,Infection ,030215 immunology ,Research Article - Abstract
Background: The infection of a participant with norovirus during the adaptive study of interleukin-2 dose on regulatory T cells in type 1 diabetes (DILT1D) allowed a detailed insight into the cellular and cytokine immune responses to this prevalent gastrointestinal pathogen. Methods: Serial blood, serum and peripheral blood mononuclear cell (PBMC) samples were collected pre-, and post-development of the infection. To differentiate between the immune response to norovirus and to control for the administration of a single dose of aldesleukin (recombinant interleukin-2, rIL-2) alone, samples from five non-infected participants administered similar doses were analysed in parallel. Results: Norovirus infection was self-limited and resolved within 24 hours, with the subsequent development of anti-norovirus antibodies. Serum pro- and anti-inflammatory cytokine levels, including IL-10, peaked during the symptomatic period of infection, coincident with increased frequencies of monocytes and neutrophils. At the same time, the frequency of regulatory CD4+ T cell (Treg), effector T cell (Teff) CD4+ and CD8+ subsets were dynamically reduced, rebounding to baseline levels or above at the next sampling point 24 hours later. NK cells and NKT cells transiently increased CD69 expression and classical monocytes expressed increased levels of CD40, HLA-DR and SIGLEC-1, biomarkers of an interferon response. We also observed activation and mobilisation of Teffs, where increased frequencies of CD69+ and Ki-67+ effector memory Teffs were followed by the emergence of memory CD8+ Teff expressing the mucosal tissue homing markers CD103 and β7 integrin. Treg responses were coincident with the innate cell, Teff and cytokine response. Key Treg molecules FOXP3, CTLA-4, and CD25 were upregulated following infection, alongside an increase in frequency of Tregs with the capacity to home to tissues. Conclusions: The results illustrate the innate, adaptive and counter-regulatory immune responses to norovirus infection. Low-dose IL-2 administration induces many of the Treg responses observed during infection.
- Published
- 2017