Randomized trial investigates the role of tissue resident memory cells in asthma development after neonatal HMPV infection, suggesting therapeutic targets.
Introduction Viral lower respiratory tract infections are remarkably common amongst children less than 5 years old. Human metapneumovirus (HMPV) is one leading cause of these infections in children under 5 years old. Additionally, infants diagnosed with HMPV bronchiolitis are at a four-fold increased risk of developing asthma. The mechanisms by which early-life HMPV infection influences long-term immune responses remain poorly understood. Methods To model this clinical phenomenon, neonatal or adult mice were infected with HMPV, then re-challenged 6 weeks later. We assessed mucus, airway reactivity, eosinophil recruitment, and T cell subset phenotypes. FTY720 and anti-CD4 were used to modulate TRM populations. Treatment with fedratinib, a Jak2-selective, was performed on the first 3 days of rechallenge via oral gavage. Results We demonstrated that neonatal mice re-challenged with HMPV as adults mount a robust Th2 response consistent with asthma pathology (e.g. eosinophil recruitment, mucus production, and airway hyperreactivity). Mice initially infected with HMPV as adults followed by HMPV re-challenge showed no signs of Th2 inflammation. The tissue resident memory compartment (TRMs) also showed evidence of Th2-skewing following neonatal, but not adult, HMPV infection. Mice treated with FTY720, an inhibitor of lymphocyte trafficking, had a robust Th2 response in the neonatal/adult rechallenge model. Local and systemic depletion of CD4+ T cells mitigated this response. Further, this subset of enriched Th2 TRMs following neonatal HMPV had a unique transcriptional profile, including differential expression Jak2. Mice treated with fedratinib showed reduced eosinophil recruitment, Th2 cytokine production, and mucus hypersecretion compared to vehicle controls. Conclusion Collectively, these studies identify a targetable Th2 TRM population following early life infection that can contribute to asthma-like inflammation following re-exposure to a viral pathogen. Funding Source The AAAAI Foundation Faculty Development Award and NIAID Topic Categories Immediate Hypersensitivity, Asthma, and Allergic Responses (HYP)
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