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  • Neutrophils-related host fa...
    Tang, Benjamin M; Shojaei, Maryam; Teoh, Sally; Meyers, Adrienne; Ho, John; Ball, T Blake; Keynan, Yoav; Pisipati, Amarnath; Kumar, Aseem; Eisen, Damon P; Lai, Kevin; Gillett, Mark; Santram, Rahul; Geffers, Robert; Schreiber, Jens; Mozhui, Khyobeni; Huang, Stephen; Parnell, Grant P; Nalos, Marek; Holubova, Monika; Chew, Tracy; Booth, David; Kumar, Anand; McLean, Anthony; Schughart, Klaus

    Nature communications, 07/2019, Letnik: 10, Številka: 1
    Journal Article

    Severe influenza infection has no effective treatment available. One of the key barriers to developing host-directed therapy is a lack of reliable prognostic factors needed to guide such therapy. Here, we use a network analysis approach to identify host factors associated with severe influenza and fatal outcome. In influenza patients with moderate-to-severe diseases, we uncover a complex landscape of immunological pathways, with the main changes occurring in pathways related to circulating neutrophils. Patients with severe disease display excessive neutrophil extracellular traps formation, neutrophil-inflammation and delayed apoptosis, all of which have been associated with fatal outcome in animal models. Excessive neutrophil activation correlates with worsening oxygenation impairment and predicted fatal outcome (AUROC 0.817-0.898). These findings provide new evidence that neutrophil-dominated host response is associated with poor outcomes. Measuring neutrophil-related changes may improve risk stratification and patient selection, a critical first step in developing host-directed immune therapy.