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1 August 2002

Volume 186, Number 3
The Journal of Infectious Diseases 2002;186:341–350
0022-1899/2002/18603-0006$15.00
DOI: 10.1086/341462

Lethal Synergism between Influenza Virus and Streptococcus pneumoniae: Characterization of a Mouse Model and the Role of Platelet‐Activating Factor Receptor

Jonathan A. McCullers1 and

Jerold E. Rehg2

Departments of 1Infectious Diseases and 2Pathology, St. Jude Children’s Research Hospital, Memphis, Tennessee

A lethal synergism exists between influenza virus and pneumococcus, which likely accounts for excess mortality from secondary bacterial pneumonia during influenza epidemics. Characterization of a mouse model of synergy revealed that influenza infection preceding pneumococcal challenge primed for pneumonia and led to 100% mortality. This effect was specific for viral infection preceding bacterial infection, because reversal of the order of administration led to protection from influenza and improved survival. The hypothesis that influenza up‐regulates the platelet‐activating factor receptor (PAFr) and thereby potentiates pneumococcal adherence and invasion in the lung was examined in the model. Groups of mice receiving CV‐6209, a competitive antagonist of PAFr, had survival rates similar to those of control mice, and lung and blood bacterial titers increased during PAFr inhibition. These data suggest that PAFr‐independent pathways are operative in the model, prompting further study of receptor interactions during pneumonia and bacteremia. The model of lethal synergism will be a useful tool for exploring this and other mechanisms underlying viral‐bacterial interactions.

Received 21 February 2002; revised 3 April 2002; electronically published 10 July 2002.

Reprints or correspondence: Dr. Jonathan A. McCullers, St. Jude Children’s Research Hospital, Dept. of Infectious Diseases, 332 N. Lauderdale St., Memphis, TN 38105‐2794 ().

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  • Animals used in this study were cared for in accordance with the guidelines of the Committee on Care and Use of Laboratory Animals (Institute of Laboratory Animal Resources, National Research Council) under an approved protocol from the Animal Care and Use Committee of St. Jude Children’s Research Hospital. All work with infected animals was carried out in biosafety level 2 facilities.

    Financial Support: National Institutes of Health (AI‐49178); Cancer Center Support Grant (CA‐21765); American Lebanese Syrian Associated Charities.

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