Study Points to Essential Role of IL-22 in Lung Repair After the Flu

Results of new study published in The American Journal of Pathology

Philadelphia, PA, March 11, 2013 – Once the initial episode of influenza has passed, the chronic effects tend to be overlooked. The results of a new study indicate that the cytokine interleukin-22 (IL-22) plays a critical role in normal lung repair following influenza infection. This study is published in the April 2013 issue of The American Journal of Pathology.

“With the increasing prevalence of more infective and/or virulent strains of influenza, understanding the impact of virus on the host epithelium and the processes involved in lung repair are of great importance,” says John F. Alcorn, PhD, an immunologist affiliated with the department of pediatrics at the Children’s Hospital of Pittsburgh of UPMC. He notes that the findings open up new possibilities for developing therapeutic agents that promote recovery of normal lung function and architecture after influenza infection and lessen the likelihood of secondary infections. “A key finding is that even after the resolution of infection, influenza results in lung parenchymal remodeling that may be critical to susceptibility to further injury,” says Dr. Alcorn.

This series of experiments used 6- to 8-week-old wild-type (WT) mice (C57BL/6 strain) as well as IL-22–deficient mice, infected with influenza A PR/8/34 H1N1 or control vehicle. To determine the distribution of IL-22 in the lung, they used immunohistochemistry for the high affinity IL-22Ra1 receptor. Investigators found that in WT mice not inflected with influenza, IL-22 receptors were distributed on epithelial cells of the large and small airways, but not within the parenchyma. They noted that this receptor distribution suggests that in the absence of lung injury, IL-22 interacts mainly with the bronchial epithelial cells.

By 21 days post influenza infection, IL-22 receptors were observed in parenchymal tissue in injured areas, such as alveoli under repair. Researchers suggest that the IL-22 receptor can be upregulated at sites of influenza-associated injury.

The investigators also reported that 10 days after influenza infection, IL-22–deficient mice showed significantly more severe damage and greater lung edema than WT control mice, as indicated by higher lactate dehydrogenase levels and more total protein content in bronchoalveolar lavage. No differences were found in viral load. Another indication of more severe lung injury was an increase in the number of lymphocytes in the IL-22–deficient animals.

IL-22–deficient mice also showed functional impairments. For instance, those infected with influenza showed significantly decreased compliance (referring to lung distensibility) and increased hysteresis (referring to compliance differences during inspiration and expiration), indicating lung stiffness. Histological examination 21 days after influenza infection showed that IL-22–deficient mice displayed regions of diffuse inflammation and alveolar injury, few areas of metaplasia, higher intimal thickening, proteinaceous accumulation, and increased collagen deposition compared to WT mice. Gene expression analysis revealed aberrant expression of epithelial genes involved in repair processes in the mice lacking IL-22.

“The role of IL-22 in promoting epithelial repair is emerging. We demonstrate that IL-22 plays a critical role in regulating pulmonary epithelial repair responses during influenza infection and resolution,” says Dr. Alcorn. IL-22 is currently under development as a potential therapeutic in human clinical trials.

# # #

Notes for Editors
"IL-22 is essential for lung epithelial repair following influenza infection," by Derek A. Pociask, Erich V. Scheller, Sivanarayana Mandalapu, et al. (DOI: http://dx.doi.org/10.1016/j.ajpath.2012.12.007). It appears in The American Journal of Pathology, Volume 182, Issue 4 (April 2013) published by Elsevier.

Full text of the article is available to credentialed journalists upon request; contact David Sampson at +1 215 239 3171 or ajpmedia@elsevier.com. Journalists wishing to interview the authors may contact Andrea Kunicky, Media coordinator, +1 412 692 6254 Andrea.kunicky@chp.edu.

About The American Journal of Pathology
The American Journal of Pathology (http://ajp.amjpathol.org), official journal of the American Society for Investigative Pathology, seeks to publish high-quality, original papers on the cellular and molecular biology of disease. The editors accept manuscripts that advance basic and translational knowledge of the pathogenesis, classification, diagnosis, and mechanisms of disease, without preference for a specific analytic method. High priority is given to studies on human disease and relevant experimental models using cellular, molecular, animal, biological, chemical, and immunological approaches in conjunction with morphology.

The leading global forum for reporting quality original research on cellular and molecular mechanisms of disease, The American Journal of Pathology is the most highly cited journal in Pathology – over 38,000 citations in 2011 – with an Impact Factor of 4.890 according to 2011 Journal Citation Reports®, Thomson Reuters.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contacts
David Sampson
Elsevier
+1 215 239 3171
ajpmedia@elsevier.com

Dr. Chhavi Chauhan
The American Journal of Pathology
+1 301 634 7953
cchauhan@asip.org