Viral infection makes us feel sick. The extent of these changes to our metabolism are relative to the severity of disease. Whether blood glucose levels are subject to infection-induced modulation is largely unknown. Here we show that strong, non-lethal infection restricts systemic glucose availability which promotes the antiviral IFN-I response. Following systemic viral infection of mice, we find that IFNγ produced by γδ T cells directly stimulates pancreatic β-cells to increase glucose-induced insulin release. Subsequently, hyperinsulinemia lessens endogenous glucose output by the liver. Glucose restriction enhances type-I interferon production by curtailing lactate-mediated inhibition of IRF3 and NF-κB signaling. Induced hyperglycemia constrained IFN-I production and increased mortality upon infection. Our findings identify glucose restriction as a physiological mechanism to bring the body into a heightened state of responsiveness to viral pathogens. This immune-endocrine circuit is disrupted in hyperglycemia, which explains why people with metabolic disease are more susceptible to viral infection.
MAINA reduced sense of wellbeing, commonly referred to as 'feeling sick', is one of the best known yet most poorly understood symptoms of viral infection. Whereas it is perceived as pathological, 'feeling sick' is the result of a carefully regulated set of metabolic adaptations mediated by the immune system. Its proposed purpose is to optimize nutrient availability to the immune system 1, 2, 3 , whilst impairing viral replication 4, 5 . Adjusting systemic metabolism is not without risk as it impacts vital functions of the body.The level of modulation is therefore proportional to the severity of infection and thus the risk that is acceptable to counter a pathogenic threat 3 . A key parameter of which differential regulation depends on the intensity of infection is blood glucose. Blood glucose concentrations must be retained between defined threshold values to prevent hypoglycemic coma and hyperglycemia-induced tissue damage 6 .Multiple regulatory mechanisms exist, but the hormone insulin plays a central role in glycemic control. If glucose levels rise, insulin is produced by pancreatic β-cells which stimulates glucose uptake and storage in organs such as adipose tissue and skeletal muscle and impairs glucose release by the liver 7 . Previously, we showed that following mild infection the immune system reduces insulin sensitivity of skeletal muscle cells. As a result, the pancreas compensated through increased insulin production which retained blood glucose levels within threshold values but also directly boosted the CD8 + T cell response 8, 9 . Following Control 2x10 7 IFU LCMV FPG 3 days p. i.