My first tweetorial! On our new #InnateImmunity and viral interference study @JExpMed. It started with puzzling observations that pointed to the importance of kinetics. We saw a robust interferon response in the upper airway in all COVID patients studied, mild and severe:
..But these samples were from different times in the disease course. To get at timing, we studied serial swabs from patients picked up early in infection, when the viral load was still going up. We measured virus and CXCL10, a biomarker of the interferon response…
…both went up, then down, almost perfectly in synch… except for lag in the antiviral response in the first few days of infection. Replication in the first few days was exponential and fast! (avg. doubling time 6 hr)....
….but it was all over when the interferon response kicked in. So we asked- what happens if we alter the kinetics of the IFN response with the common cold? We infected with rhinovirus prior to COVID (in organoids, not patients!), and this completely blocked COVID replication:
..by jump-starting the interferon response, which started much earlier in epithelial cells which had seen rhinovirus a few days before. Rhinovirus induced ISGs, even in uninfected cells, for at least 5 days (all cells ISG high, but <2% of cells RV-positive at day 5)...
Interference from RV required the interferon response, but during infection with COVID only (high infectious dose), the interferon response had no impact on early viral replication. At a lower infectious dose, however, interferon response did slow COVID down significantly...
This also prompted us to speculate, based on work by @mugecevik and others, that one mechanism for increased transmissibility of variants could be better blockade of IFN responses (outruns IFN response> higher NP viral load). This seems to be the case in preprint from @KroganLab
..Our study also raises a question about the extent to which heterologous innate immunity happens "in real life".. could periods of high common cold virus circulation this potentially mitigate against spread of other viruses?
But picture may be more complex- timing and host innate immune status matter. With intact innate immunity, both RV and COVID decreased during co-infection, but if we blocked these responses, both viruses increased. See full paper for details --rupress.org/jem/article/21…
Thank you, #COVID19 scientists and #scicomm pros for your great work and communication during this pandemic, which informed/inspired this study.🙏🙏🙏
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Backstory on our recent paper @JExpMed, showing that frequent viral and bacterial infections drive heightened nasal innate immunity in children. This work was inspired by the puzzling observation that kids were less susceptible to #COVID_19 than adults... a thread (1/12) rupress.org/jem/article/22…
(2/12) Studies during the pandemic showed that innate immune defenses were hyperactivated in the upper respiratory tracts of children compared to adults, suggesting a reason for lower susceptibility in children. For example, @TheBinderLab showed increased interferon responses, pro-inflammatory responses, and innate immune cells in the nasal mucosa of children compared to adults. However, the reason was not known…. nature.com/articles/s4158…
(3/12)…We suspected that respiratory viruses and infectious bacteria might be playing a role, since studies prior to the pandemic showed very high rates of these infections in children (often asymptomatic), as reviewed by @DebbyBogaert and colleagues... journals.plos.org/plospathogens/…
Tweetorial on our recent study @LancetMicrobe in which we used the nasal innate immune response to find undiagnosed respiratory viruses. A thread (1/14)... thelancet.com/journals/lanmi…
In many patients undergoing comprehensive viral PCR testing, no virus is ever found. While most of these folks have symptoms for another reason, we could be missing some viruses. But how to find them..? Our hospital has hundreds of virus-negative nasal swabs per week... (2/14)
Too many! We sought to narrow down the search by testing for CXCL10, a cytokine produced by the lining of the nose when the body's innate immune system senses a virus, as we showed in a previous study (3/14)... academic.oup.com/jid/article/21…
Preprint on COVID human challenge study clarifies some much debated questions. This shows viral load by PCR (blue) and live virus (red) following infection - virus comes up first in throat but reaches higher level in nose. (1/4). researchsquare.com/article/rs-112…
A positive rapid antigen test appears to be a pretty good reflection of live virus shedding (black bars) (2/4)
Comparing the timelines of symptoms to virus shedding fits the idea that you can spread the virus when asymptomatic (green = "just noticeable", yellow = "bothersome some of the time") (3/4)