Highly pathogenic H5N1 avian influenza viruses have caused infection in humans, with a high mortality rate, since 1997. While the pathogenesis of this infection is not completely understood, hypercytokinaemia and alveolar macrophages are thought to play a role. To gain further insight into the cytokine-mediated pathogenesis of this infection in humans, we measured various cytokines produced by primary human macrophages infected with H5N1, pandemic H1N1 or seasonal influenza viruses. We found that many cytokines were produced at higher levels on infection with the H5N1 strains tested compared with seasonal influenza viruses. Interestingly, the extent of cytokine induction varied among the H5N1 strains and did not correlate with replicative ability in macrophages. Further, a pandemic H1N1 virus induced higher levels of several cytokines compared with seasonal viruses and some H5N1 strains. Our results demonstrate that high cytokine induction is not a universal feature of all H5N1 viruses.Highly pathogenic H5N1 avian influenza virus infection of humans has continued since 1997, with a mortality rate of nearly 60 % (Abdel-Ghafar et al., 2008; Claas et al., 1998). The mechanism underlying the pathogenesis of these infections is not fully understood, although hypercytokinaemia has been linked to the high pathogenicity (de Jong et al., 2005(de Jong et al., , 2006Peiris et al., 2004;To et al., 2001;Uiprasertkul et al., 2005). Alveolar macrophages are central players in both innate and adaptive immune responses to respiratory infection. In studies in vitro, human primary macrophages infected with H5N1 viruses produce higher levels of cytokines compared with those infected with seasonal viruses (Cheung et al., 2002;Guan et al., 2004;Lee et al., 2009;Mok et al., 2009;Woo et al., 2010). However, the H5N1 viruses examined in these studies were isolated before 2005, and the number of cytokines studied was limited.In 2009, a novel swine-origin H1N1 influenza virus (2009 pandemic H1N1 virus; pdm H1N1) caused a pandemic (Khan et al., 2009). During the first phase of this pandemic, 9 % of patients were hospitalized with pneumonia, respiratory failure or acute respiratory distress syndrome (Peng et al., 1999;Shimizu et al., 2007; Taylor et al., 2005). The phenotype of the human macrophages derived from the peripheral blood monocytes used in this study is similar to that of human alveolar macrophages (Shimizu et al., 2007; Taylor et al., 2005), suggesting that this is a useful model with which to study the dynamics of influenza virus infection in the human lung.To evaluate the susceptibility of primary human macrophages to avian H5N1 and human influenza viruses, we examined whether a-2,3-and a-2,6-linked sialic acids, which are avian and human virus receptors, respectively, were present on the cells by using lectins specific for these sialooligosaccharides: Sambucus nigra agglutinin (SNA) for a-2,6-linked and Maackia amurensis agglutinin II (MAAII) (Vector laboratories) for a-2,3-linked sialic acids. Cells were incubated with bi...