Cross-sectional study of the relationship of peripheral blood cell profiles with severity of infection by adenovirus type 55

Abstract

BackgroundThe immunologic profiles of patients with human adenovirus serotype 55 (HAdV-55) infections were characterized in subjects diagnosed with silent infections (n = 30), minor infections (n = 27), severe infections (n = 34), and healthy controls (n = 30) during a recent outbreak among Chinese military trainees.MethodsBlood was sampled at the disease peak and four weeks later, and samples were analyzed to measure changes in leukocyte and platelet profiles in patients with different severities of disease. Differential lymphocyte subsets and cytokine profiles were measured by flow cytometry and Luminex xMAP®, and serum antibodies were analyzed by ELISA and immunofluorescence staining.ResultsPatients with severe HAdV infections had higher proportions of neutrophils and reduced levels of lymphocytes (p < 0.005 for both). Patients with minor and severe infections had significantly lower platelet counts (p < 0.005 for both) than those with silent infections. The silent and minor infection groups had higher levels of dendritic cells than the severe infection group. Relative to patients with silent infections, patients with severe infections had significantly higher levels of IL-17+CD4+ cells, decreased levels of IL-17+CD8+ cells, and higher levels of IFN-γ, IL-4, IL-10, and IFN-α2 (p < 0.001 for all comparisons).ConclusionsPatients with different severities of disease due to HAdV-55 infection had significantly different immune responses. These data provide an initial step toward the identification of patients at risk for more severe disease and the development of treatments against HAdV-55 infection.

Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012–2016

“…Interestingly, during the same period, 5 fatal cases of AdV pneumonia caused by AdV-55—with 80% mortality rate—were reported in China (13), which also highlights the emerging highly virulent AdV pathogens. An outbreak of AdV respiratory infection including severe pneumonia was also reported in Chinese military trainees and efforts have been made to identify the immunological profiles of patients with AdV-55 pneumonia (9), which may partly help to identify those more vulnerable to developing severe disease and to develop a treatment strategy. In our study, because approximately one third of the 69 patients with pneumonia caused by AdV-55 had respiratory failure (one of whom died), one might consider AdV-55 as a virulent pathogen.…”

“…It is well-known that AdV respiratory tract infections are usually mild and self-limiting in a non-immunocompromised host, in contrast with immunocompromised hosts, in whom AdV infection can be fatal (234). Since the fatal case of AdV pneumonia in a healthy adult was described in the 1960s (5), severe disease caused by AdV has been reported among non-immunocompromised adults, especially in vulnerable populations, such as military recruits and residents of health care facilities (6789). Recent studies have also described fatal cases of severe AdV pneumonia caused by particular serotypes, which provide insight into emerging, highly virulent serotypes, even in non-immunocompromised patients (1011121314).…”

Characterization of immunological responses in patients with severe fever with thrombocytopenia syndrome: A cohort study in China

“…The high viral load was defined if one patient's maximum viral load exceeded the median value of all patients during the hospital process. Lymphocytes and lymphocyte subsets were quantified by flow cytometry [13]. Detailed information on these laboratory tests are provided in the supplementary material.…”

Surveillance for respiratory infectious diseases caused by 6 common viruses in a recruit training site in the Northern region of China

“…According to several adenovirus infection outbreaks in the past, diseases caused by adenovirus type 7 are mild and, compared with infection by adenovirus type 55, their incidence of pneumonia is low. In the event of pneumonia, it is mainly mild, and has a short course and good prognosis, without severe cases [4][5][6][7]. In this study, group B adenovirus types 4 and 3 are the main types causing febrile respiratory diseases.…”

“…Furthermore, due to dramatic weather changes, the incidence of ARDs is higher in autumn and winter when recruitment in China usually occurs, and recruits are sensitive to respiratory infections. In recent years, a number of massive ARDs epidemics associated with adenovirus infection have occurred at recruit training sites [4][5][6][7][8], causing significant damage to soldiers' health and imposing a huge burden of health protection and disease prevention in the troops [9].…”