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Infect Immun, March 1998, p. 912-922, Vol. 66, No. 3
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Cytokine Kinetics and Other Host Factors in
Response to Pneumococcal Pulmonary Infection in Mice
Yves
Bergeron,
Nathalie
Ouellet,
Anne-Marie
Deslauriers,
Marie
Simard,
Martin
Olivier, and
Michel G.
Bergeron*
Centre de Recherche en Infectiologie, Centre
Hospitalier de l'Université Laval, and Département de
Microbiologie, Faculté de Médecine, Université
Laval, Québec, Canada G1V 4G2
Received 29 August 1997/Returned for modification 14 October
1997/Accepted 5 December 1997
There is a need for more insight into the pathogenesis of
Streptococcus pneumoniae pneumonia, as the fatality rate
associated with this disease remains high despite appropriate
antibiotherapy. The host response to pneumococci was
investigated after intranasal inoculation of CD1 mice with
107 log-phase CFU of bacteria. We identified five major
pathogenesis steps from initial infection to death. In step 1 (0 to
4 h), there was ineffective phagocytosis by alveolar macrophages,
with concurrent release of tumor necrosis factor alpha (TNF),
interleukin-6 (IL-6), and nitric oxide (NO) in bronchoalveolar lavage
(BAL) fluid, TNF, IL-6, and interleukin-1 alpha (IL-1) in lung tissues,
and IL-6 in serum, which were associated with tachypnea and
hemoconcentration. In step 2 (4 to 24 h), bacterial growth in
alveoli and polymorphonuclear cell recruitment from bloodstream to lung
tissue (high myeloperoxidase levels) to alveoli were associated with
high release of all three cytokines and leukotriene B4
(LTB4) in tissue and BAL fluid, as well as transient
spillover of IL-1 in serum. In step 3 (24 to 48 h), despite
downregulation of TNF and IL-1 in BAL fluid and lungs, there was
appearance of injury to alveolar ultrastructure, edema to interstitium,
and increase in lung weight as well as regeneration of type II
pneumocytes and increased secretion of surfactant; bacteria progressed
from alveoli to tissue to blood, and body weight loss occurred. In step
4 (48 to 72 h), strong monocyte recruitment from blood to alveoli
was associated with high NO release in tissue and BAL fluid, but there
was also noticeable lymphocyte recruitment and leukopenia; bacteremia
was associated with TNF and IL-6 release in blood and thrombocytopenia.
In step 5 (72 to 96 h), severe airspace disorganization, lipid
peroxidation (high malondialdehyde release in BAL fluid), and diffuse
tissue damage coincided with high NO levels; there was further increase in lung weight and bacterial growth, loss in body weight, and high
mortality rate. Delineation of the sequential steps that contribute to
the pathogenesis of pneumococcal pneumonia may generate markers of
evolution of disease and lead to better targeted intervention.
*
Corresponding author. Mailing address: Centre de
Recherche en Infectiologie, Centre Hospitalier de l'Université
Laval, 2705 Boul. Laurier, Sainte-Foy, Québec, Canada G1V 4G2.
Phone: (418) 654-2705. Fax: (418) 654-2715. E-mail:
Michel.G.Bergeron{at}crchul.ulaval.ca.
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