Host lung microbiota promotes malaria-associated acute respiratory distress syndrome.

Host lung microbiota promotes malaria-associated acute respiratory distress syndrome.
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DOI:
10.1038/s41467-022-31301-8
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发表时间:
2022-06-29
影响因子:
16.6
通讯作者:
--
中科院分区:
综合性期刊1区
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--
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严重疟疾可表现为各种公认的高度预测死亡的临床表型-严重贫血、昏迷(脑型疟疾)、多器官衰竭和呼吸窘迫。为什么一个受感染的个体发展一种病理而不是另一种病理的原因仍然知之甚少。在这里,我们使用不同的啮齿动物感染模型来表明宿主微生物群是疟疾感染背景下呼吸窘迫综合征和宿主死亡率(疟疾相关急性呼吸窘迫综合征,MA-ARDS)发展的一个促成因素。我们表明,寄生虫隔离在肺部的结果在持续的免疫激活。随后T细胞产生的抗炎细胞因子IL-10损害了微生物控制,导致严重的肺部疾病。值得注意的是,利奈唑胺(一种常用于临床环境中控制肺相关细菌感染的抗生素)的细菌清除可预防MA-ARDS相关致死性。因此,我们认为宿主限制组织损伤的抗炎反应可能导致微生物控制的丧失,从而促进MA-ARDS。在对危及生命的呼吸系统并发症进行干预时,必须考虑到这一点。疟疾表现出各种公认的临床表型的原因仍然知之甚少。在这里,使用不同的啮齿动物模型,作者揭示了肺部定植的微生物群在疟疾感染期间促进呼吸窘迫综合征和死亡率。
Severe malaria can manifest itself with a variety of well-recognized clinical phenotypes that are highly predictive of death – severe anaemia, coma (cerebral malaria), multiple organ failure, and respiratory distress. The reasons why an infected individual develops one pathology rather than another remain poorly understood. Here we use distinct rodent models of infection to show that the host microbiota is a contributing factor for the development of respiratory distress syndrome and host mortality in the context of malaria infections (malaria-associated acute respiratory distress syndrome, MA-ARDS). We show that parasite sequestration in the lung results in sustained immune activation. Subsequent production of the anti-inflammatory cytokine IL-10 by T cells compromises microbial control, leading to severe lung disease. Notably, bacterial clearance with linezolid, an antibiotic commonly used in the clinical setting to control lung-associated bacterial infections, prevents MA-ARDS-associated lethality. Thus, we propose that the host’s anti-inflammatory response to limit tissue damage can result in loss of microbial control, which promotes MA-ARDS. This must be considered when intervening against life-threatening respiratory complications. The reasons why malaria manifests with a variety of well-recognized clinical phenotypes remain poorly understood. Here, using distinct rodent models, the authors reveal that the microbiota colonizing the lung promotes respiratory distress syndrome and mortality during malaria infections.
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