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    Recurrent respiratory syncytial virus (RSV) infection requiring hospitalization is rare and the underlying mechanism is unknown. We aimed to determine the role of CD14-mediated immunity in the pathogenesis of recurrent RSV infection. We performed genotyping and longitudinal immunophenotyping of the first patient with a genetic CD14 deficiency who developed recurrent RSV infection. We analyzed gene expression profiles and interleukin (IL)-6 production by patient peripheral blood mononuclear cells in response to RSV pre- and post-fusion (F) protein. We generated CD14-deficient human nasal epithelial cells cultured at air-liquid interface (HNEC-ALI) of patient-derived cells and after CRISPR-based gene editing of control cells. We analyzed viral replication upon RSV infection. Sanger sequencing revealed a homozygous single-nucleotide deletion in CD14, resulting in absence of the CD14 protein in the index patient. In vitro, viral replication was similar in wild-type and CD14-/- HNEC-ALI. Loss of immune cell CD14 led to impaired cytokine and chemokine responses to RSV pre- and post-F protein, characterized by absence of IL-6 production. We report an association of recurrent RSV bronchiolitis with a loss of CD14 function in immune cells. Lack of CD14 function led to defective immune responses to RSV pre- and post-F protein without a change in viral replication. © The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

    Citation

    Sjanna B Besteman, Emily Phung, Henriette H M Raeven, Gimano D Amatngalim, Matevž Rumpret, Juliet Crabtree, Rutger M Schepp, Lisa W Rodenburg, Susanna G Siemonsma, Nile Verleur, Rianne van Slooten, Karen Duran, Gijs W van Haaften, Jeffrey M Beekman, Lauren A Chang, Linde Meyaard, Tjomme van der Bruggen, Guy A M Berbers, Nicole Derksen, Stefan Nierkens, Kaitlyn M Morabito, Tracy J Ruckwardt, Evelyn A Kurt-Jones, Douglas Golenbock, Barney S Graham, Louis J Bont. Recurrent Respiratory Syncytial Virus Infection in a CD14-Deficient Patient. The Journal of infectious diseases. 2022 Apr 16;226(2):258-269

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    PMID: 35429403

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