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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">MERS-CoV infection is associated with downregulation of genes encoding Th1 and Th2 cytokines/chemokines and elevated inflammatory innate immune response in the lower respiratory tract</title>
<author><name sortKey="Alosaimi, B" sort="Alosaimi, B" uniqKey="Alosaimi B" first="B." last="Alosaimi">B. Alosaimi</name>
<affiliation><nlm:aff id="aff0005">King Fahad Medical City,College of Medicine,Research Center</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0010">King Saud University, College of Science</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0015">Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Awadalla, M" sort="Awadalla, M" uniqKey="Awadalla M" first="M." last="Awadalla">M. Awadalla</name>
<affiliation><nlm:aff id="aff0005">King Fahad Medical City,College of Medicine,Research Center</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0010">King Saud University, College of Science</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0015">Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Enani, M" sort="Enani, M" uniqKey="Enani M" first="M." last="Enani">M. Enani</name>
<affiliation><nlm:aff id="aff0005">King Fahad Medical City,College of Medicine,Research Center</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0010">King Saud University, College of Science</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0015">Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmc">7128615</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128615</idno>
<idno type="RBID">PMC:7128615</idno>
<idno type="doi">10.1016/j.jiph.2020.01.179</idno>
<idno type="pmid">NONE</idno>
<date when="2020">2020</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">MERS-CoV infection is associated with downregulation of genes encoding Th1 and Th2 cytokines/chemokines and elevated inflammatory innate immune response in the lower respiratory tract</title>
<author><name sortKey="Alosaimi, B" sort="Alosaimi, B" uniqKey="Alosaimi B" first="B." last="Alosaimi">B. Alosaimi</name>
<affiliation><nlm:aff id="aff0005">King Fahad Medical City,College of Medicine,Research Center</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0010">King Saud University, College of Science</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0015">Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Awadalla, M" sort="Awadalla, M" uniqKey="Awadalla M" first="M." last="Awadalla">M. Awadalla</name>
<affiliation><nlm:aff id="aff0005">King Fahad Medical City,College of Medicine,Research Center</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0010">King Saud University, College of Science</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0015">Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Enani, M" sort="Enani, M" uniqKey="Enani M" first="M." last="Enani">M. Enani</name>
<affiliation><nlm:aff id="aff0005">King Fahad Medical City,College of Medicine,Research Center</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0010">King Saud University, College of Science</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff0015">Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of Infection and Public Health</title>
<idno type="ISSN">1876-0341</idno>
<idno type="eISSN">1876-035X</idno>
<imprint><date when="2020">2020</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
</TEI>
<pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect Public Health</journal-id>
<journal-id journal-id-type="iso-abbrev">J Infect Public Health</journal-id>
<journal-title-group><journal-title>Journal of Infection and Public Health</journal-title>
</journal-title-group>
<issn pub-type="ppub">1876-0341</issn>
<issn pub-type="epub">1876-035X</issn>
<publisher><publisher-name>Published by Elsevier Ltd.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmc">7128615</article-id>
<article-id pub-id-type="publisher-id">S1876-0341(20)30180-5</article-id>
<article-id pub-id-type="doi">10.1016/j.jiph.2020.01.179</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>MERS-CoV infection is associated with downregulation of genes encoding Th1 and Th2 cytokines/chemokines and elevated inflammatory innate immune response in the lower respiratory tract</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Alosaimi</surname>
<given-names>B.</given-names>
</name>
<xref rid="aff0005" ref-type="aff">1</xref>
<xref rid="aff0010" ref-type="aff">2</xref>
<xref rid="aff0015" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author" id="aut0010"><name><surname>Awadalla</surname>
<given-names>M.</given-names>
</name>
<xref rid="aff0005" ref-type="aff">1</xref>
<xref rid="aff0010" ref-type="aff">2</xref>
<xref rid="aff0015" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author" id="aut0015"><name><surname>Enani</surname>
<given-names>M.</given-names>
</name>
<xref rid="aff0005" ref-type="aff">1</xref>
<xref rid="aff0010" ref-type="aff">2</xref>
<xref rid="aff0015" ref-type="aff">3</xref>
</contrib>
</contrib-group>
<aff id="aff0005"><label>1</label>
King Fahad Medical City,College of Medicine,Research Center</aff>
<aff id="aff0010"><label>2</label>
King Saud University, College of Science</aff>
<aff id="aff0015"><label>3</label>
Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City</aff>
<pub-date pub-type="pmc-release"><day>5</day>
<month>2</month>
<year>2020</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>2</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub"><day>5</day>
<month>2</month>
<year>2020</year>
</pub-date>
<volume>13</volume>
<issue>2</issue>
<fpage>371</fpage>
<lpage>372</lpage>
<permissions><copyright-statement>Copyright © 2020 Published by Elsevier Ltd.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder></copyright-holder>
<license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
</article-meta>
</front>
<body><p id="par0005"><bold>Background and Purpose</bold>
MERS-CoV, a highly pathogenic virus in humans, is associated with high morbidity and case fatality. Inflammatory responses have a significant impact on MERS-CoV pathogenesis and disease outcome. However, CD4+ T-cell induced immune responses during acute MERS-CoV infection are barely detectable, with potent inhibition of effector T cells and downregulation of antigen presentation. The local pulmonary immune response, particularly the Th1/Th2 immune response during acute MERS-CoV infection is not fully understood. The purpose of this study was to study the pulmonary gene expression profile of Th1 and Th2-related cytokines, chemokines, and receptors (Th1 & Th2 responses) during acute MERS-CoV infection using RT<sup>2</sup>
Profiler PCR Arrays and expression level of primary inflammatory cytokines/chemokines. Results and Discussions: Our results showed a downregulation of Th2, inadequate (partial) Th1 immune response and high expression levels of inflammatory cytokines IL-1 α and IL-1 β and the neutrophil chemoattractant chemokine IL-8 (CXCL8) in the lower respiratory tract of MERS-CoV infected patients. Moreover, we identified a high viral load in all included patients.Genes encoding Th1 and Th2 cytokines/chemokines were largely downregulated in the lower respiratory tract of MERS-CoV infected patients, with selective upregulation of IL-18, CXCR3, SOCS5, and CCR2. It is possible that overexpression of IL-1 α, IL-1 β, IL-8 (CXCL8), IL-18, CXCR3, SOCS5, and CCR2 play a vital role in the severity, immunopathology, and case fatality of MERS-CoV infected patients. We observed a correlation between inflammatory cytokines, Th1, and Th2 downregulation and the case fatality rate.</p>
<p id="par0010"><bold>Conclusions</bold>
Th1 and Th2 response downregulation, high expression of inflammatory cytokines, and high viral load may contribute to lung inflammation, severe infection, the evolution of pneumonia and ARDS, and a higher case fatality rate. Further study of the molecular mechanisms underlying the Th1 and Th2 regulatory pathways will be vital for active vaccine development and the identification of novel therapeutic strategies.</p>
</body>
</pmc>
</record>
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