AI Article Synopsis

  • - Pulmonary infections like influenza A virus (IAV) can significantly disrupt alveolar fluid clearance (AFC), leading to lung edema and other complications.
  • - A study using BALB/c mice showed that high-dose IAV infection caused a rapid decrease in oxygen levels and lung fluid clearance, with inhibition lasting several days.
  • - The research identified that early AFC inhibition wasn't dependent on the virus replicating, but later effects were; various signaling mechanisms were involved, suggesting potential treatments using beta-adrenergic agonists could help restore normal lung function.

Article Abstract

Rationale: Pulmonary infections can impair alveolar fluid clearance (AFC), contributing to formation of lung edema. Effects of influenza A virus (IAV) on AFC are unknown.

Objectives: To determine effects of IAV infection on AFC, and to identify intercellular signaling mechanisms underlying influenza-mediated inhibition of AFC.

Methods: BALB/c mice were infected intranasally with influenza A/WSN/33 (10,000 or 2,500 focus-forming units per mouse). AFC was measured in anesthetized, ventilated mice by instilling 5% bovine serum albumin into the dependent lung.

Measurements And Main Results: Infection with high-dose IAV resulted in a steady decline in arterial oxygen saturation and increased lung water content. AFC was significantly inhibited starting 1 hour after infection, and remained suppressed through Day 6. AFC inhibition at early time points (1-4 h after infection) did not require viral replication, whereas AFC inhibition later in infection was replication-dependent. Low-dose IAV infection impaired AFC for 10 days, but induced only mild hypoxemia. High-dose IAV infection increased bronchoalveolar lavage fluid ATP and UTP levels. Impaired AFC at Day 2 resulted primarily from reduced amiloride-sensitive AFC, mediated by increased activation of the pyrimidine-P2Y purinergic receptor axis. However, an additional component of AFC impairment was due to activation of A(1) adenosine receptors and stimulation of increased cystic fibrosis transmembrane regulator-mediated anion secretion. Finally, IAV-mediated inhibition of AFC at Day 2 could be reversed by addition of beta-adrenergic agonists to the AFC instillate.

Conclusions: AFC inhibition may be an important feature of early IAV infection. Its blockade may reduce the severity of pulmonary edema and hypoxemia associated with influenza pneumonia.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2577730PMC
http://dx.doi.org/10.1164/rccm.200803-455OCDOI Listing

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