One-sentence summaryWe demonstrate that activation of innate immune responses to arbovirus at the mosquito bite is a limiting factor for preventing efficient systemic dissemination of virus and that therapeutic targeting of skin-resident macrophages can have defining inhibitory effects on the later systemic course.
25Abstract Arthropod-borne viruses (arboviruses) are important human pathogens for which there are no specific antiviral medicines. The large number of genetically-distinct arbovirus species, coupled with the unpredictable nature of their outbreaks, has made developing virus-specific 30 anti-viral medicines challenging. Instead, we have defined and targeted a key aspect of the host innate immune response to virus at the arthropod bite that is common to all arbovirus infections, potentially circumventing the need for virus-specific therapies at this site. Using mouse models and human skin explants, we identify innate immune responses by dermal macrophages in the skin as a key determinant of disease severity. Post-exposure treatment of 35 the inoculation site by a topical innate immune agonist significantly suppressed both the local and subsequent systemic course of infection and improved clinical outcome in mice to infection with a variety of arboviruses from the Alphavirus, Flavivirus and Orthobunyavirus genuses. In the absence of treatment, anti-viral interferon expression to virus in the skin was restricted to dermal dendritic cells. In contrast, targeting the more populous skin-resident 40 macrophages with an immune agonist elicited protective responses in key cellular targets of virus that otherwise replicated virus to high levels. By defining and targeting a key aspect of the innate immune response to virus at the mosquito bite site, we have shown that it is possible to improve outcome to infection by targeting pathways activated at the site of inoculation, and thereby identified a putative new strategy for limiting disease following 45 infection with a variety of genetically-distinct arboviruses.
IntroductionEmerging and re-emerging arboviruses pose an increasing threat to human health. There has been a substantial increase in both the incidence and geographical range of medicallyimportant arboviruses spread by mosquitoes, which infect hundreds of millions of people each 50 year and include the Zika (ZIKV), dengue (DENV) and chikungunya (CHIKV) viruses.Arboviruses are a large, genetically-diverse group of viruses that cause a wide spectrum of diseases in humans (1-5). Despite their genetic diversity, it is nonetheless difficult to clinically differentiate between these infections in the early stages of disease, as they are either asymptomatic or present as a non-specific febrile viral illness. In many geographic areas this 55 is compounded by the widespread co-circulation of distinct species of arboviruses in the same geographic area (6). Together, these factors complicate the use of putative virus-specific antivirals, which for acute infections are most often only efficacious when given during e...