Risk Assessment of the Tropism and Pathogenesis of the Highly Pathogenic Avian Influenza A/H7N9 Virus Using Ex Vivo and In Vitro Cultures of Human Respiratory Tract

J Infect Dis. 2019 Jul 19;220(4):578-588. doi: 10.1093/infdis/jiz165.

Abstract

Background: Highly pathogenic avian influenza (HPAI)-H7N9 virus arising from low pathogenic avian influenza (LPAI)-H7N9 virus with polybasic amino acid substitutions in the hemagglutinin was detected in 2017.

Methods: We compared the tropism, replication competence, and cytokine induction of HPAI-H7N9, LPAI-H7N9, and HPAI-H5N1 in ex vivo human respiratory tract explants, in vitro culture of human alveolar epithelial cells (AECs) and pulmonary microvascular endothelial cells (HMVEC-L).

Results: Replication competence of HPAI- and LPAI-H7N9 were comparable in ex vivo cultures of bronchus and lung. HPAI-H7N9 predominantly infected AECs, whereas limited infection was observed in bronchus. The reduced tropism of HPAI-H7N9 in bronchial epithelium may explain the lack of human-to-human transmission despite a number of mammalian adaptation markers. Apical and basolateral release of virus was observed only in HPAI-H7N9- and H5N1-infected AECs regardless of infection route. HPAI-H7N9, but not LPAI-H7N9 efficiently replicated in HMVEC-L.

Conclusions: Our findings demonstrate that a HPAI-H7N9 virus efficiently replicating in ex vivo cultures of human bronchus and lung. The HPAI-H7N9 was more efficient at replicating in human AECs and HMVEC-L than LPAI-H7N9 implying that endothelial tropism may involve in pathogenesis of HPAI-H7N9 disease.

Keywords: H7N9; HPAI; alveolar epithelial cells; influenza; risk assessment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Epithelial Cells / immunology
  • Alveolar Epithelial Cells / virology
  • Bronchi / immunology
  • Bronchi / virology
  • Cells, Cultured
  • Cytokines / immunology
  • Endothelial Cells / immunology
  • Endothelial Cells / virology
  • Humans
  • Influenza A Virus, H7N9 Subtype / immunology
  • Influenza A Virus, H7N9 Subtype / pathogenicity
  • Influenza A Virus, H7N9 Subtype / physiology*
  • Influenza, Human / immunology
  • Influenza, Human / virology*
  • Lung / immunology
  • Lung / virology
  • Respiratory System / immunology
  • Respiratory System / virology*
  • Risk Assessment
  • Viral Tropism*
  • Virus Replication*

Substances

  • Cytokines