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Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection

Kulcsar, Kirsten A.; Coleman, Christopher M.; Beck, Sarah E.; Frieman, Matthew B.

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Authors

Kirsten A. Kulcsar

CHRISTOPHER COLEMAN CHRISTOPHER.COLEMAN@NOTTINGHAM.AC.UK
Assistant Professor of Infection Immunology

Sarah E. Beck

Matthew B. Frieman



Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 in Saudi Arabia and has caused over 2400 cases and more than 800 deaths. Epidemiological studies identified diabetes as the primary comorbidity associated with severe or lethal MERS-CoV infection. Understanding how diabetes affects MERS is important because of the global burden of diabetes and pandemic potential of MERS-CoV. We used a model in which mice were made susceptible to MERS-CoV by expressing human DPP4, and type 2 diabetes was induced by administering a high-fat diet. Upon infection with MERS-CoV, diabetic mice had a prolonged phase of severe disease and delayed recovery that was independent of virus titers. Histological analysis revealed that diabetic mice had delayed inflammation, which was then prolonged through 21 days after infection. Diabetic mice had fewer inflammatory monocyte/macrophages and CD4+ T cells, which correlated with lower levels of Ccl2 and Cxcl10 expression. Diabetic mice also had lower levels of Tnfa, Il6, Il12b, and Arg1 expression and higher levels of Il17a expression. These data suggest that the increased disease severity observed in individuals with MERS and comorbid type 2 diabetes is likely due to a dysregulated immune response, which results in more severe and prolonged lung pathology.

Citation

Kulcsar, K. A., Coleman, C. M., Beck, S. E., & Frieman, M. B. (2019). Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection. JCI insight, 4(20), 1-18. https://doi.org/10.1172/jci.insight.131774

Journal Article Type Article
Acceptance Date Sep 18, 2019
Online Publication Date Oct 17, 2019
Publication Date Oct 17, 2019
Deposit Date Dec 17, 2019
Publicly Available Date Mar 29, 2024
Journal JCI Insight
Electronic ISSN 2379-3708
Peer Reviewed Peer Reviewed
Volume 4
Issue 20
Pages 1-18
DOI https://doi.org/10.1172/jci.insight.131774
Public URL https://nottingham-repository.worktribe.com/output/3589497
Publisher URL https://insight.jci.org/articles/view/131774

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