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1.
Sci Rep ; 11(1): 14090, 2021 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238985

RESUMO

MAIT cells have been shown to be activated upon several viral infections in a TCR-independent manner by responding to inflammatory cytokines secreted by antigen-presenting cells. Recently, a few studies have shown a similar activation of MAIT cells in response to severe acute respiratory coronavirus 2 (SARS-CoV-2) infection. In this study, we investigate the effect of SARS-CoV-2 infection on the frequency and phenotype of MAIT cells by flow cytometry, and we test in vitro stimulation conditions on the capacity to enhance or rescue the antiviral function of MAIT cells from patients with coronavirus disease 2019 (COVID-19). Our study, in agreement with recently published studies, confirmed the decline in MAIT cell frequency of hospitalized donors in comparison to healthy donors. MAIT cells of COVID-19 patients also had lower expression levels of TNF-alpha, perforin and granzyme B upon stimulation with IL-12 + IL-18. 24 h' incubation with IL-7 successfully restored perforin expression levels in COVID-19 patients. Combined, our findings support the growing evidence that SARS-CoV-2 is dysregulating MAIT cells and that IL-7 treatment might improve their function, rendering them more effective in protecting the body against the virus.


Assuntos
COVID-19/prevenção & controle , COVID-19/virologia , Interleucina-7/farmacologia , Células T Invariantes Associadas à Mucosa/fisiologia , Células T Invariantes Associadas à Mucosa/virologia , SARS-CoV-2/patogenicidade , Células Cultivadas , Feminino , Granzimas/metabolismo , Humanos , Masculino , Células T Invariantes Associadas à Mucosa/metabolismo , Perforina/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
2.
Gastroenterology ; 161(5): 1567-1583.e9, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34302839

RESUMO

BACKGROUND & AIMS: The hepatitis D virus (HDV) causes the most severe form of chronic hepatitis, often progressing to cirrhosis within 5 to 10 years. There is no curative treatment, and the mechanisms underlying the accelerated liver disease progression are unknown. METHODS: Innate and adaptive immune responses were studied in blood and liver of 24 patients infected with HDV and 30 uninfected controls by multiparameter flow cytometry in correlation with disease severity and stage. RESULTS: The 2 main intrahepatic innate immune-cell populations, mucosal-associated invariant T cells and natural killer (NK) cells, were reduced in the livers of patients infected with HDV compared with those of uninfected controls but were more frequently activated in the liver compared with the blood. Most intrahepatic cluster of differentiation (CD) 8-positive (CD8+) T cells were memory cells or terminal effector memory cells, and most of the activated and degranulating (CD107a+) HDV-specific and total CD8+ T cells were liver-resident (CD69+C-X-C motif chemokine receptor 6+). Unsupervised analysis of flow cytometry data identified an activated, memory-like, tissue-resident HDV-specific CD8+ T-cell cluster with expression of innate-like NK protein 30 (NKp30) and NK group 2D (NKG2D) receptors. The size of this population correlated with liver enzyme activity (r = 1.0). NKp30 and NKG2D expression extended beyond the HDV-specific to the total intrahepatic CD8+ T-cell population, suggesting global bystander activation. This was supported by the correlations between (i) NKG2D expression with degranulation of intrahepatic CD8+ T cells, (ii) frequency of degranulating CD8+ T cells with liver enzyme activity and the aspartate aminotransferase-to-platelet ratio index score, and by the in vitro demonstration of cytokine-induced NKG2D-dependent cytotoxicity. CONCLUSION: Antigen-nonspecific activation of liver-resident CD8+ T cells may contribute to inflammation and disease stage in HDV infection.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Hepatite D Crônica/imunologia , Vírus Delta da Hepatite/imunologia , Células Matadoras Naturais/imunologia , Fígado/imunologia , Ativação Linfocitária , Células T Invariantes Associadas à Mucosa/imunologia , Imunidade Adaptativa , Adulto , Idoso , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/virologia , Estudos de Casos e Controles , Degranulação Celular , Linhagem Celular Tumoral , Citocinas/sangue , Progressão da Doença , Feminino , Hepatite D Crônica/sangue , Hepatite D Crônica/diagnóstico , Hepatite D Crônica/virologia , Vírus Delta da Hepatite/patogenicidade , Interações Hospedeiro-Patógeno , Humanos , Imunidade Inata , Memória Imunológica , Células Matadoras Naturais/metabolismo , Células Matadoras Naturais/virologia , Fígado/metabolismo , Fígado/virologia , Masculino , Pessoa de Meia-Idade , Células T Invariantes Associadas à Mucosa/metabolismo , Células T Invariantes Associadas à Mucosa/virologia , Subfamília K de Receptores Semelhantes a Lectina de Células NK/metabolismo , Receptor 3 Desencadeador da Citotoxicidade Natural/metabolismo , Fenótipo , Adulto Jovem
3.
Viruses ; 13(5)2021 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-34066765

RESUMO

There were an estimated 10 million new cases of tuberculosis (TB) disease in 2019. While over 90% of individuals successfully control Mycobacterium tuberculosis (Mtb) infection, which causes TB disease, HIV co-infection often leads to active TB disease. Despite the co-endemic nature of HIV and TB, knowledge of the immune mechanisms contributing to the loss of control of Mtb replication during HIV infection is lacking. Mucosal-associated invariant T (MAIT) cells are innate-like T cells that target and destroy bacterially-infected cells and may contribute to the control of Mtb infection. Studies examining MAIT cells in human Mtb infection are commonly performed using peripheral blood samples. However, because Mtb infection occurs primarily in lung tissue and lung-associated lymph nodes, these studies may not be fully translatable to the tissues. Additionally, studies longitudinally examining MAIT cell dynamics during HIV/Mtb co-infection are rare, and lung and lymph node tissue samples from HIV+ patients are typically unavailable. Nonhuman primates (NHP) provide a model system to characterize MAIT cell activity during Mtb infection, both in Simian Immunodeficiency Virus (SIV)-infected and SIV-naïve animals. Using NHPs allows for a more comprehensive understanding of tissue-based MAIT cell dynamics during infection with both pathogens. NHP SIV and Mtb infection is similar to human HIV and Mtb infection, and MAIT cells are phenotypically similar in humans and NHPs. Here, we discuss current knowledge surrounding MAIT cells in SIV and Mtb infection, how SIV infection impairs MAIT cell function during Mtb co-infection, and knowledge gaps to address.


Assuntos
Coinfecção/microbiologia , Coinfecção/virologia , Células T Invariantes Associadas à Mucosa/imunologia , Células T Invariantes Associadas à Mucosa/virologia , Mycobacterium tuberculosis/imunologia , Vírus da Imunodeficiência Símia/imunologia , Animais , Coinfecção/imunologia , Humanos , Imunidade nas Mucosas , Ativação Linfocitária/imunologia , Macaca mulatta , Fenótipo , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Tuberculose/virologia
4.
Cell Rep Med ; 2(3): 100220, 2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-33763658

RESUMO

Hantaviruses are zoonotic RNA viruses that cause severe acute disease in humans. Infected individuals have strong inflammatory responses that likely cause immunopathology. Here, we studied the response of mucosal-associated invariant T (MAIT) cells in peripheral blood of individuals with hemorrhagic fever with renal syndrome (HFRS) caused by Puumala orthohantavirus, a hantavirus endemic in Europe. We show that MAIT cell levels decrease in the blood during HFRS and that residual MAIT cells are highly activated. This activation correlates with HFRS severity markers. In vitro activation of MAIT cells by hantavirus-exposed antigen-presenting cells is dependent on type I interferons (IFNs) and independent of interleukin-18 (IL-18). These findings highlight the role of type I IFNs in virus-driven MAIT cell activation and suggest a potential role of MAIT cells in the disease pathogenesis of viral infections.


Assuntos
Células Apresentadoras de Antígenos/imunologia , Infecções por Hantavirus/imunologia , Febre Hemorrágica com Síndrome Renal/imunologia , Ativação Linfocitária , Células T Invariantes Associadas à Mucosa/imunologia , Virus Puumala/patogenicidade , Adulto , Anticorpos Antivirais/sangue , Células Apresentadoras de Antígenos/virologia , Biomarcadores/metabolismo , Estudos de Casos e Controles , Progressão da Doença , Células Endoteliais/imunologia , Células Endoteliais/virologia , Feminino , Regulação da Expressão Gênica , Infecções por Hantavirus/genética , Infecções por Hantavirus/patologia , Infecções por Hantavirus/virologia , Febre Hemorrágica com Síndrome Renal/genética , Febre Hemorrágica com Síndrome Renal/patologia , Febre Hemorrágica com Síndrome Renal/virologia , Humanos , Imunofenotipagem , Interferon Tipo I/genética , Interferon Tipo I/imunologia , Interferon gama/genética , Interferon gama/imunologia , Interleucina-10/genética , Interleucina-10/imunologia , Interleucina-6/genética , Interleucina-6/imunologia , Masculino , Pessoa de Meia-Idade , Monócitos/imunologia , Monócitos/virologia , Células T Invariantes Associadas à Mucosa/virologia , Virus Puumala/imunologia , Índice de Gravidade de Doença
5.
J Infect Dis ; 223(4): 667-672, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-32623457

RESUMO

Measles virus (MeV) binds, infects, and kills CD150+ memory T cells, leading to immune amnesia. Whether MeV targets innate, memory-like T cells is unknown. We demonstrate that human peripheral blood and hepatic mucosa-associated invariant T (MAIT) cells and invariant natural killer T cells express surprisingly high levels of CD150, more than other lymphocyte subsets. Furthermore, exposing MAIT cells to MeV results in their efficient infection and rapid apoptosis. This constitutes the first report of direct MAIT cell infection by a viral pathogen. Given MAIT cells' antimicrobial properties, their elimination by MeV may contribute to measles-induced immunosuppression and heightened vulnerability to unrelated infections.


Assuntos
Apoptose , Vírus do Sarampo/fisiologia , Células T Invariantes Associadas à Mucosa/fisiologia , Células T Invariantes Associadas à Mucosa/virologia , Feminino , Humanos , Interleucina-12/imunologia , Interleucina-18/imunologia , Leucócitos Mononucleares/imunologia , Masculino , Proteína Cofatora de Membrana/genética , Proteína Cofatora de Membrana/metabolismo , Células T Invariantes Associadas à Mucosa/imunologia , Células T Matadoras Naturais/imunologia , Células T Matadoras Naturais/metabolismo , Membro 1 da Família de Moléculas de Sinalização da Ativação Linfocitária/genética , Membro 1 da Família de Moléculas de Sinalização da Ativação Linfocitária/metabolismo , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo
6.
Sci Adv ; 6(8): eaaz0374, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32128419

RESUMO

Mucosal-associated invariant T (MAIT) cells in HIV-1-infected individuals are functionally impaired by poorly understood mechanisms. Single-cell transcriptional and surface protein analyses revealed that peripheral MAIT cells from HIV-1-infected subjects were highly activated with the up-regulation of interferon (IFN)-stimulated genes as compared to healthy individuals. Sustained IFN-α treatment suppressed MAIT cell responses to Escherichia coli by triggering high-level interleukin-10 (IL-10) production by monocytes, which subsequently inhibited the secretion of IL-12, a crucial costimulatory cytokine for MAIT cell activation. Blocking IFN-α or IL-10 receptors prevented MAIT cell dysfunction induced by HIV-1 exposure in vitro. Moreover, blocking the IL-10 receptor significantly improved anti-Mycobacterium tuberculosis responses of MAIT cells from HIV-1-infected patients. Our findings demonstrate the central role of the IFN-I/IL-10 axis in MAIT cell dysfunction during HIV-1 infection, which has implications for the development of anti-IFN-I/IL-10 strategies against bacterial coinfections in HIV-1-infected patients.


Assuntos
Infecções por HIV/imunologia , Infecções por HIV/metabolismo , Infecções por HIV/virologia , Interferon Tipo I/metabolismo , Interleucina-10/biossíntese , Células T Invariantes Associadas à Mucosa/imunologia , Células T Invariantes Associadas à Mucosa/metabolismo , Células T Invariantes Associadas à Mucosa/virologia , Terapia Antirretroviral de Alta Atividade , Receptores Coestimuladores e Inibidores de Linfócitos T/metabolismo , Citocinas/metabolismo , Escherichia coli/imunologia , Infecções por Escherichia coli/etiologia , Feminino , Infecções por HIV/complicações , HIV-1/imunologia , Interações Hospedeiro-Patógeno/imunologia , Humanos , Ativação Linfocitária , Masculino , Transdução de Sinais
7.
Tuberculosis (Edinb) ; 116S: S11-S18, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31072689

RESUMO

TB is a catastrophic infectious disease, affecting roughly one third of the world's population. Mucosal-associated invariant T (MAIT) cells are innate-like T cells that recognize vitamin B metabolites produced by bacteria, possess effector memory phenotype, and express tissue-homing markers driving migration to sites of infection. Previous research in both Mtb and HIV infections has shown that MAIT cells are depleted in the human periphery, possibly migrating to the tissue sites of infection. We investigated this hypothesis using rhesus macaques (RMs) with active TB, latent TB (LTBI), and SIV-coinfection to explore the effects of different disease states on the MAIT cell populations in vivo. Early in infection, we observed that MAIT cells increased in the blood and bronchoalveolar lavage fluid (BAL) of all infected RMs, irrespective of clinical outcome. However, the frequency of MAIT cells rapidly normalized such that they had returned to baseline levels prior to endpoint. Furthermore, following infection, the chemokines expressed on MAIT cells reflected a strong shift towards a Th1 phenotype from a shared Th1/Th17 phenotype. In conclusion, MAIT cells with enhanced Th1 functions migrating to the site of Mtb-infection. The anti-mycobacterial effector functions of MAIT cells, particularly during the early stages of Mtb infection, had been of interest in promoting protective long-term TB immunity. Our research shows, however, that they have relatively short-acting responses in the host.


Assuntos
Movimento Celular , Proliferação de Células , Imunidade nas Mucosas , Tuberculose Latente/microbiologia , Pulmão/microbiologia , Ativação Linfocitária , Células T Invariantes Associadas à Mucosa/microbiologia , Mycobacterium tuberculosis/patogenicidade , Tuberculose Pulmonar/microbiologia , Animais , Coinfecção , Modelos Animais de Doenças , Interações Hospedeiro-Patógeno , Tuberculose Latente/imunologia , Pulmão/imunologia , Macaca mulatta , Células T Invariantes Associadas à Mucosa/imunologia , Células T Invariantes Associadas à Mucosa/virologia , Mycobacterium tuberculosis/imunologia , Fenótipo , Síndrome de Imunodeficiência Adquirida dos Símios/imunologia , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus 40 dos Símios/imunologia , Vírus 40 dos Símios/patogenicidade , Células Th1/imunologia , Células Th1/microbiologia , Células Th2/imunologia , Células Th2/microbiologia , Fatores de Tempo , Tuberculose Pulmonar/imunologia
8.
Nat Commun ; 9(1): 4706, 2018 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-30413689

RESUMO

Mucosal associated invariant T (MAIT) cells are evolutionarily-conserved, innate-like lymphocytes which are abundant in human lungs and can contribute to protection against pulmonary bacterial infection. MAIT cells are also activated during human viral infections, yet it remains unknown whether MAIT cells play a significant protective or even detrimental role during viral infections in vivo. Using murine experimental challenge with two strains of influenza A virus, we show that MAIT cells accumulate and are activated early in infection, with upregulation of CD25, CD69 and Granzyme B, peaking at 5 days post-infection. Activation is modulated via cytokines independently of MR1. MAIT cell-deficient MR1-/- mice show enhanced weight loss and mortality to severe (H1N1) influenza. This is ameliorated by prior adoptive transfer of pulmonary MAIT cells in both immunocompetent and immunodeficient RAG2-/-γC-/- mice. Thus, MAIT cells contribute to protection during respiratory viral infections, and constitute a potential target for therapeutic manipulation.


Assuntos
Influenza Humana/patologia , Influenza Humana/virologia , Células T Invariantes Associadas à Mucosa/virologia , Infecções por Orthomyxoviridae/patologia , Infecções por Orthomyxoviridae/virologia , Transferência Adotiva , Animais , Citocinas/metabolismo , Antígenos de Histocompatibilidade Classe I/metabolismo , Humanos , Pulmão/patologia , Camundongos Endogâmicos C57BL , Antígenos de Histocompatibilidade Menor/metabolismo
9.
J Infect Dis ; 216(8): 969-976, 2017 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-28968772

RESUMO

Background: Mucosal-associated invariant T (MAIT) cells might play a role in control of viral replication during chronic hepatitis B (cHBV) infection, but little is known of their number, phenotype, or function in cHBV patients. Methods: We performed flow cytometry on CD3+Vɑ7.2+CD161+ MAIT cells in blood of 55 cHBV patients. Nine patients were sampled before and on entecavir treatment. Six patients on therapy underwent a liver biopsy for flow cytometric analysis. Measurements included MAIT cell frequency, phenotype, and cytokine-producing capacity. Results: The MAIT cells were not deleted in blood or liver of cHBV patients compared with healthy controls, but they had higher percentages of CD38+ MAIT cells in blood, which declined on entecavir treatment. Peripheral MAIT cells of patients in the HBeAg-negative phase were least activated. Cytokine-producing MAIT cells were as frequent, but granzyme B-producing MAIT cells were more frequent upon stimulation with Escherichia coli compared with healthy controls. Conclusions: We demonstrate that, in sharp contrast to hepatitis C virus and human immunodeficiency virus patients, MAIT cells isolated from HBV patients are not deleted but are more activated, which can be normalized by nucleoside analog therapy. These observations may aid in deciphering the role of MAIT cells in immune responses to HBV.


Assuntos
Antivirais/uso terapêutico , Vírus da Hepatite B/imunologia , Hepatite B Crônica/imunologia , Células T Invariantes Associadas à Mucosa/imunologia , Subfamília B de Receptores Semelhantes a Lectina de Células NK/imunologia , Adolescente , Adulto , Feminino , Vírus da Hepatite B/genética , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/virologia , Humanos , Imunidade Celular , Masculino , Pessoa de Meia-Idade , Células T Invariantes Associadas à Mucosa/virologia , Adulto Jovem
10.
Gastroenterology ; 153(5): 1392-1403.e2, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28780074

RESUMO

BACKGROUND & AIMS: Chronic hepatitis affects phenotypes of innate and adaptive immune cells. Mucosal-associated invariant T (MAIT) cells are enriched in the liver as compared with the blood, respond to intra-hepatic cytokines, and (via the semi-invariant T-cell receptor) to bacteria translocated from the gut. Little is known about the role of MAIT cells in livers of patients with chronic hepatitis C virus (HCV) infection and their fate after antiviral therapy. METHODS: We collected blood samples from 42 patients with chronic HCV infection who achieved a sustained virologic response after 12 weeks of treatment with sofosbuvir and velpatasvir. Mononuclear cells were isolated from blood before treatment, at weeks 4 and 12 during treatment, and 24 weeks after the end of treatment. Liver biopsies were collected from 37 of the patients prior to and at week 4 of treatment. Mononuclear cells from 56 blood donors and 10 livers that were not suitable for transplantation were used as controls. Liver samples were assessed histologically for inflammation and fibrosis. Mononuclear cells from liver and blood were studied by flow cytometry and analyzed for responses to cytokine and bacterial stimulation. RESULTS: The frequency of MAIT cells among T cells was significantly lower in blood and liver samples of patients with HCV infection than of controls (median, 1.31% vs 2.32% for blood samples, P = .0048; and median, 4.34% vs 13.40% for liver samples, P = .001). There was an inverse correlation between the frequency of MAIT cells in the liver and histologically determined levels of liver inflammation (r = -.5437, P = .0006) and fibrosis (r = -.5829, P = .0002). MAIT cells from the liver had higher levels of activation and cytotoxicity than MAIT cells from blood (P < .0001). Production of interferon gamma by MAIT cells was dependent on monocyte-derived interleukin 18, and was reduced in patients with HCV infection in response to T-cell receptor-mediated but not cytokine-mediated stimulation, as compared with controls. Anti-viral therapy rapidly decreased liver inflammation and MAIT cell activation and cytotoxicity, and increased the MAIT cell frequency among intra-hepatic but not blood T cells. The MAIT cell response to T-cell receptor-mediated stimulation did not change during the 12 weeks of antiviral therapy. CONCLUSIONS: In analyses of paired blood and liver samples from patients with chronic HCV infection before, during, and after antiviral therapy with sofosbuvir and velpatasvir, we found that intrahepatic MAIT cells are activated by monocyte-derived cytokines and depleted in HCV-induced liver inflammation.


Assuntos
Hepatite C Crônica/imunologia , Fígado/imunologia , Células T Invariantes Associadas à Mucosa/imunologia , Antivirais/uso terapêutico , Biópsia , Carbamatos/uso terapêutico , Estudos de Casos e Controles , Citocinas/imunologia , Combinação de Medicamentos , Hepatite C Crônica/sangue , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/virologia , Compostos Heterocíclicos de 4 ou mais Anéis/uso terapêutico , Humanos , Contagem de Leucócitos , Fígado/efeitos dos fármacos , Fígado/virologia , Ativação Linfocitária , Monócitos/imunologia , Células T Invariantes Associadas à Mucosa/efeitos dos fármacos , Células T Invariantes Associadas à Mucosa/virologia , Comunicação Parácrina , Fenótipo , Sofosbuvir/uso terapêutico , Resposta Viral Sustentada , Fatores de Tempo , Resultado do Tratamento
11.
Proc Natl Acad Sci U S A ; 113(36): 10133-8, 2016 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-27543331

RESUMO

Mucosal-associated invariant T (MAIT) cells are innate-like T lymphocytes known to elicit potent immunity to a broad range of bacteria, mainly via the rapid production of inflammatory cytokines. Whether MAIT cells contribute to antiviral immunity is less clear. Here we asked whether MAIT cells produce cytokines/chemokines during severe human influenza virus infection. Our analysis in patients hospitalized with avian H7N9 influenza pneumonia showed that individuals who recovered had higher numbers of CD161(+)Vα7.2(+) MAIT cells in peripheral blood compared with those who succumbed, suggesting a possible protective role for this lymphocyte population. To understand the mechanism underlying MAIT cell activation during influenza, we cocultured influenza A virus (IAV)-infected human lung epithelial cells (A549) and human peripheral blood mononuclear cells in vitro, then assayed them by intracellular cytokine staining. Comparison of influenza-induced MAIT cell activation with the profile for natural killer cells (CD56(+)CD3(-)) showed robust up-regulation of IFNγ for both cell populations and granzyme B in MAIT cells, although the individual responses varied among healthy donors. However, in contrast to the requirement for cell-associated factors to promote NK cell activation, the induction of MAIT cell cytokine production was dependent on IL-18 (but not IL-12) production by IAV-exposed CD14(+) monocytes. Overall, this evidence for IAV activation via an indirect, IL-18-dependent mechanism indicates that MAIT cells are protective in influenza, and also possibly in any human disease process in which inflammation and IL-18 production occur.


Assuntos
Imunidade nas Mucosas , Subtipo H7N9 do Vírus da Influenza A/patogenicidade , Influenza Humana/imunologia , Interleucina-18/imunologia , Células T Invariantes Associadas à Mucosa/imunologia , Pneumonia Viral/imunologia , Células A549 , Comunicação Celular/imunologia , Técnicas de Cocultura , Expressão Gênica , Granzimas/genética , Granzimas/imunologia , Humanos , Imunidade Inata , Imunofenotipagem , Subtipo H7N9 do Vírus da Influenza A/imunologia , Influenza Humana/mortalidade , Influenza Humana/patologia , Influenza Humana/virologia , Interferon gama/genética , Interferon gama/imunologia , Interleucina-18/genética , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/virologia , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/virologia , Ativação Linfocitária , Monócitos/imunologia , Monócitos/virologia , Células T Invariantes Associadas à Mucosa/virologia , Subfamília B de Receptores Semelhantes a Lectina de Células NK/genética , Subfamília B de Receptores Semelhantes a Lectina de Células NK/imunologia , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Transdução de Sinais , Análise de Sobrevida
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