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<title xml:lang="en">Dysregulated T-Helper Type 1 (Th1):Th2 Cytokine Profile and Poor Immune Response in Pregnant Ferrets Infected With 2009 Pandemic Influenza A(H1N1) Virus</title>
<author>
<name sortKey="Yoon, Sun Woo" sort="Yoon, Sun Woo" uniqKey="Yoon S" first="Sun-Woo" last="Yoon">Sun-Woo Yoon</name>
<affiliation>
<nlm:aff id="AF0001">Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0002">Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wong, Sook San" sort="Wong, Sook San" uniqKey="Wong S" first="Sook-San" last="Wong">Sook-San Wong</name>
<affiliation>
<nlm:aff id="AF0001">Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zhu, Huachen" sort="Zhu, Huachen" uniqKey="Zhu H" first="Huachen" last="Zhu">Huachen Zhu</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0004">State Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0005">State Key Laboratory of Emerging Infectious Diseases</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0006">Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chen, Rirong" sort="Chen, Rirong" uniqKey="Chen R" first="Rirong" last="Chen">Rirong Chen</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Li, Long" sort="Li, Long" uniqKey="Li L" first="Long" last="Li">Long Li</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zhang, Yu" sort="Zhang, Yu" uniqKey="Zhang Y" first="Yu" last="Zhang">Yu Zhang</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Guan, Yi" sort="Guan, Yi" uniqKey="Guan Y" first="Yi" last="Guan">Yi Guan</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0004">State Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0005">State Key Laboratory of Emerging Infectious Diseases</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0006">Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Webby, Richard J" sort="Webby, Richard J" uniqKey="Webby R" first="Richard J" last="Webby">Richard J. Webby</name>
<affiliation>
<nlm:aff id="AF0001">Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
</author>
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<idno type="pmid">28973317</idno>
<idno type="pmc">5853788</idno>
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<idno type="RBID">PMC:5853788</idno>
<idno type="doi">10.1093/infdis/jix328</idno>
<date when="2017">2017</date>
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<title xml:lang="en" level="a" type="main">Dysregulated T-Helper Type 1 (Th1):Th2 Cytokine Profile and Poor Immune Response in Pregnant Ferrets Infected With 2009 Pandemic Influenza A(H1N1) Virus</title>
<author>
<name sortKey="Yoon, Sun Woo" sort="Yoon, Sun Woo" uniqKey="Yoon S" first="Sun-Woo" last="Yoon">Sun-Woo Yoon</name>
<affiliation>
<nlm:aff id="AF0001">Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0002">Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wong, Sook San" sort="Wong, Sook San" uniqKey="Wong S" first="Sook-San" last="Wong">Sook-San Wong</name>
<affiliation>
<nlm:aff id="AF0001">Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zhu, Huachen" sort="Zhu, Huachen" uniqKey="Zhu H" first="Huachen" last="Zhu">Huachen Zhu</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0004">State Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0005">State Key Laboratory of Emerging Infectious Diseases</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0006">Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chen, Rirong" sort="Chen, Rirong" uniqKey="Chen R" first="Rirong" last="Chen">Rirong Chen</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Li, Long" sort="Li, Long" uniqKey="Li L" first="Long" last="Li">Long Li</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zhang, Yu" sort="Zhang, Yu" uniqKey="Zhang Y" first="Yu" last="Zhang">Yu Zhang</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Guan, Yi" sort="Guan, Yi" uniqKey="Guan Y" first="Yi" last="Guan">Yi Guan</name>
<affiliation>
<nlm:aff id="AF0003">Joint Influenza Research Centre, Shantou University Medical College, Shantou</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0004">State Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0005">State Key Laboratory of Emerging Infectious Diseases</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AF0006">Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Webby, Richard J" sort="Webby, Richard J" uniqKey="Webby R" first="Richard J" last="Webby">Richard J. Webby</name>
<affiliation>
<nlm:aff id="AF0001">Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">The Journal of Infectious Diseases</title>
<idno type="ISSN">0022-1899</idno>
<idno type="eISSN">1537-6613</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
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<front>
<div type="abstract" xml:lang="en">
<p>Infection with 2009 pandemic influenza A(H1N1) virus during pregnancy induces more-severe disease as a consequence of elevated viral loads and innate responses combined with a diminished adaptive response. These factors likely contributed to the increased morbidity and mortality observed in pregnant women during the 2009 pandemic.</p>
</div>
</front>
</TEI>
<pmc article-type="brief-report">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">jid</journal-id>
<journal-title-group>
<journal-title>The Journal of Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-1899</issn>
<issn pub-type="epub">1537-6613</issn>
<publisher>
<publisher-name>Oxford University Press</publisher-name>
<publisher-loc>US</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">28973317</article-id>
<article-id pub-id-type="pmc">5853788</article-id>
<article-id pub-id-type="doi">10.1093/infdis/jix328</article-id>
<article-id pub-id-type="publisher-id">jix328</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Major Articles and Brief Reports</subject>
<subj-group subj-group-type="category-toc-heading">
<subject>Viruses</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Dysregulated T-Helper Type 1 (Th1):Th2 Cytokine Profile and Poor Immune Response in Pregnant Ferrets Infected With 2009 Pandemic Influenza A(H1N1) Virus</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Yoon</surname>
<given-names>Sun-Woo</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0002">2</xref>
<xref ref-type="author-notes" rid="fn-0001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wong</surname>
<given-names>Sook-San</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="author-notes" rid="fn-0001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhu</surname>
<given-names>Huachen</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
<xref ref-type="aff" rid="AF0004">4</xref>
<xref ref-type="aff" rid="AF0005">5</xref>
<xref ref-type="aff" rid="AF0006">6</xref>
<xref ref-type="author-notes" rid="fn-0001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chen</surname>
<given-names>Rirong</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Long</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>Yu</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Guan</surname>
<given-names>Yi</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
<xref ref-type="aff" rid="AF0004">4</xref>
<xref ref-type="aff" rid="AF0005">5</xref>
<xref ref-type="aff" rid="AF0006">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Webby</surname>
<given-names>Richard J</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="corresp" rid="c1"></xref>
<pmc-comment>richard.webby@stjude.org</pmc-comment>
</contrib>
</contrib-group>
<aff id="AF0001">
<label>1</label>
Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee</aff>
<aff id="AF0002">
<label>2</label>
Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea</aff>
<aff id="AF0003">
<label>3</label>
Joint Influenza Research Centre, Shantou University Medical College, Shantou</aff>
<aff id="AF0004">
<label>4</label>
State Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen</aff>
<aff id="AF0005">
<label>5</label>
State Key Laboratory of Emerging Infectious Diseases</aff>
<aff id="AF0006">
<label>6</label>
Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China</aff>
<author-notes>
<fn id="fn-0001">
<p>S.-W. Y., S.-S. W., and H. Z. contributed equally to this work.</p>
</fn>
<corresp id="c1">Correspondence: R. J. Webby, PhD, Department of Infectious Diseases, St Jude Children’s Research Hospital, 262 Danny Thomas Pl, Mailstop 330, Memphis, TN 38105 (
<email>richard.webby@stjude.org</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub">
<day>01</day>
<month>2</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub" iso-8601-date="2017-07-18">
<day>18</day>
<month>7</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>17</day>
<month>1</month>
<year>2019</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the . </pmc-comment>
<volume>217</volume>
<issue>3</issue>
<fpage>438</fpage>
<lpage>442</lpage>
<history>
<date date-type="received">
<day>05</day>
<month>4</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>7</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</copyright-statement>
<copyright-year>2017</copyright-year>
</permissions>
<self-uri xlink:href="jix328.pdf"></self-uri>
<abstract abstract-type="teaser">
<p>Infection with 2009 pandemic influenza A(H1N1) virus during pregnancy induces more-severe disease as a consequence of elevated viral loads and innate responses combined with a diminished adaptive response. These factors likely contributed to the increased morbidity and mortality observed in pregnant women during the 2009 pandemic.</p>
</abstract>
<abstract>
<title>Abstract</title>
<p>Pregnancy has been associated with severe influenza, an association highlighted during the 2009 pandemic of influenza A(H1N1) virus (A[H1N1]pdm09) infection. To assess the underlying mechanism, we infected pregnant and non-pregnant ferrets with A(H1N1) pdm09 virus. A(H1N1)pdm09-infected pregnant ferrets also had higher levels of inflammatory cytokines in their pulmonary tracts. Systemically, total CD8
<sup>+</sup>
T cell counts and A(H1N1)pdm09-specific B-cell responses in blood were significantly lower in pregnant ferrets. This model predicts that the poorer outcome for pregnant women during the A(H1N1)pdm09 pandemic was due to an elevated level of viral replication and to a cytokine imbalance that led to a less effective immune response.</p>
</abstract>
<kwd-group>
<kwd>Pregnancy</kwd>
<kwd>pandemic influenza A virus</kwd>
<kwd>immune response</kwd>
</kwd-group>
<funding-group>
<award-group award-type="grant">
<funding-source>
<named-content content-type="funder-name">National Institute of Allergy and Infectious Diseases</named-content>
<named-content content-type="funder-identifier">10.13039/100000060</named-content>
</funding-source>
<award-id>HHSN266200700005C</award-id>
</award-group>
<award-group award-type="grant">
<funding-source>
<named-content content-type="funder-name">St. Jude Children’s Research Hospital</named-content>
<named-content content-type="funder-identifier">10.13039/100007737</named-content>
</funding-source>
</award-group>
</funding-group>
<counts>
<page-count count="5"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>

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