Cytomegalovirus (CMV) Pneumonitis: Cell Tropism, Inflammation, and Immunity

Abstract

Human cytomegalovirus (HCMV) is an opportunistic pathogen causing disease mainly in immunocompromised patients or after congenital infection. HCMV infection of the respiratory tract leads to pneumonitis in the immunocompromised host, which is often associated with a bad clinical course. The related mouse cytomegalovirus (MCMV) likewise exhibits a distinct tropism for the lung and thus provides an elegant model to study host-pathogen interaction. Accordingly, fundamental features of cytomegalovirus (CMV) pneumonitis have been discovered in mice that correlate with clinical data obtained from humans. Recent studies have provided insight into MCMV cell tropism and localized inflammation after infection of the respiratory tract. Accordingly, the nodular inflammatory focus (NIF) has been identified as the anatomical correlate of immune control in lungs. Several hematopoietic cells involved in antiviral immunity reside in NIFs and their key effector molecules have been deciphered. Here, we review what has been learned from the mouse model with focus on the microanatomy of infection sites and antiviral immunity in MCMV pneumonitis.

Next-generation sequencing technology for detecting pulmonary fungal infection in bronchoalveolar lavage fluid of a patient with dermatomyositis: a case report and literature review

“…Primary infection is usually subclinical in healthy adults due to a complex antiviral immune response. However, patients receiving immunosuppressive medication are a high-risk group [6]. CMV is the most common infection among immunocompromised patients and has a major impact on morbidity, mortality and graft survival [7].…”

The Differentiation of Human Cytomegalovirus Infected-Monocytes Is Required for Viral Replication

“…In immune-compromised individuals, including AIDS patients and solid organ/bone marrow transplant recipients, HCMV infection can cause severe morbidity and mortality (Boehme et al, 2006 ; Ramanan and Razonable, 2013 ; Adland et al, 2015 ; Stern et al, 2019 ). For example, HCMV infection can cause pneumonia, retinitis, encephalitis, and bowel disease (Arribas et al, 1996 ; Boeckh et al, 2003 ; Heiden et al, 2007 ; Garrido et al, 2013 ; Fonseca Brito et al, 2019 ). In organ transplant recipients, HCMV-mediated disease and the risk for the development of HCMV-mediated disease is dependent on the nature of the transplant (i.e., solid organ vs. bone marrow; Ramanan and Razonable, 2013 ; Stern et al, 2019 ).…”

gB co‐immunization with GP96 enhances pulmonary‐resident CD8 T cells and exerts a long‐term defence against MCMV pneumonitis

“…Because of its strict species specificity, it was hard to establish an animal model of HCMV infection. However, both HCMV and MCMV showed tropism to similar host cells and also lead to comparable histopathology in the site of infection 2 . Moreover, as early as in 1978&1982, Jordan and Shanley had described an interstitial pneumonitis caused by MCMV after intranasal application of the virus 41,42 .…”

“…As a double‐stranded DNA virus, cytomegalovirus (CMV) belongs to the β‐herpesvirus subfamily 1 . Human cytomegalovirus (HCMV) infection in the respiratory tract results in pneumonitis in the immune deficiency host, which often goes along with a severe mortality 2 . Currently, little efficient vaccines or therapeutic reagents are available against HCMV infection—especially for HCMV pneumonitis 3 .…”