Differential type I interferon response and primary airway neutrophil extracellular trap release in children with acute respiratory distress syndrome

• Type of Material: Article
• Authors: Jocelyn Grunwell, Emory University; Susan T. Stephenson, Emory University; Ahmad F. Mohammad, Emory University; Kaitlin Jones, Children's Healthcare of Atlanta Egleston; Carrie Mason, Children's Healthcare of Atlanta Egleston; Cydney Opolka, Children's Healthcare of Atlanta Egleston; Anne Fitzpatrick, Emory University
• Language: English
• Date: 2020-11-04
• Publisher: NATURE RESEARCH
• Publication Version: Final Published Version
• Copyright Statement: © 2020, The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-020-76122-1
• Title of Journal or Parent Work: SCIENTIFIC REPORTS
• Volume: 10
• Issue: 1
• Start Page: 19049
• End Page: 19049
• Grant/Funding Information: Drs. Grunwell and Fitzpatrick received support for research from the National Institutes of Health. Funding was provided by NIH grants K12HD072245 (Atlanta Pediatric Scholars Program), K23 HL151897-01, and an Emory University Pediatrics Research Alliance Junior Faculty Focused Pilot award to JG.
• Keywords: PATHOGENESIS; Science & Technology; ACUTE LUNG INJURY; RISK; INNATE; CONTRIBUTE; NETOSIS; Science & Technology - Other Topics; MORTALITY; Multidisciplinary Sciences; DNA
• Research Categories: Biology, Cell; Health Sciences, Medicine and Surgery; Health Sciences, Pathology

Abstract

Acute respiratory distress syndrome (ARDS) is a heterogeneous condition characterized by the recruitment of large numbers of neutrophils into the lungs. Neutrophils isolated from the blood of adults with ARDS have elevated expression of interferon (IFN) stimulated genes (ISGs) associated with decreased capacity of neutrophils to kill Staphylococcus aureus and worse clinical outcomes. Neutrophil extracellular traps (NETs) are elevated in adults with ARDS. Whether pediatric ARDS (PARDS) is similarly associated with altered neutrophil expression of ISGs and neutrophil extracellular trap release is not known. Tracheal aspirate fluid and cells were collected within 72 h from seventy-seven intubated children. Primary airway neutrophils were analyzed for differential ISG expression by PCR, STAT1 phosphorylation and markers of degranulation and activation by flow cytometry. Airway fluid was analyzed for the release of NETs by myeloperoxidase-DNA complexes using an ELISA. Higher STAT1 phosphorylation, markers of neutrophil degranulation, activation and NET release were found in children with versus without PARDS. Higher NETs were detected in the airways of children with ventilator-free days less than 20 days. Increased airway cell IFN signaling, neutrophil activation, and NET production is associated with PARDS. Higher levels of airway NETs are associated with fewer ventilator-free days.