Abstract.
Despite 100 years and countless scientific advances since the devastating flu pandemic
of 1918, viral respiratory illnesses remain a great pandemic threat. The current COVID-
19 outbreak has only emphasized our inability to deal with these deadly viruses. A major
shortcoming in treatment is the inability to reduce the massive and life-threatening
pulmonary inflammation and injury caused by infection. As we work to develop
therapeutic approaches, our lab has turned to the one population that is consistently
protected from severe viral pneumonias: children. We postulate that by identifying the
mechanisms behind this youthful privilege, we can develop novel therapies to reduce the
deadly pneumonia that occurs during severe fatal infection. While just as likely to become
infected during viral pandemics, children (ages 4-18) do not typically undergo the severe
pulmonary inflammation or mortality that can occur in adults. We are able to recapitulate
this protection in prepubescent mice (p23-27) during fatal pandemic flu infection. Our
preliminary data show that young mice are less susceptible to mortality and do not
undergo the severe pneumonia that is common during severe infection. Moreover, we
have discovered that prepubescent mice have sustained output of newly produced CD4+
recent thymic emigrants (RTEs) which migrate to the lung during infection. It has been
commonly thought that these cells are unimportant during infection as they are
phenotypically “immature”, yet our preliminary data show that thymectomy and removal
of RTEs prior to infection leads to exuberant pulmonary inflammation and increased
mortality. Further, tracheal instillation of CD4+RTEs during infection reduces pulmonary
inflammation, suggesting these cells have ant-inflammatory properties. Taken together,
these data lead us to our central hypothesis that sustained output of anti-inflammatory
CD4+ RTEs reduces influenza induced pulmonary inflammation. The overall objectives
of this exploratory R21 application is to, for the first time, demonstrate the importance of
CD4 RTEs in an infectious inflammatory setting and to identify how they reduce
inflammation. The rationale for this proposed work is that it will allow for the identification
of potential cellular and immune therapies that can be used to reduce life threatening
inflammation.