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Necroptosis blockade prevents lung injury in severe influenza

Avishekh Gautam, David F. Boyd, Sameer Nikhar, Ting Zhang, Ioannis Siokas, Lee-Ann Van de Velde, Jessica Gaevert, Victoria Meliopoulos, Bikash Thapa, Diego A. Rodriguez, Kathy Q. Cai, Chaoran Yin, Daniel Schnepf, Julius Beer, Carly DeAntoneo, Riley M. Williams, Maria Shubina, Brandi Livingston, Dingqiang Zhang, Mark D. Andrake, Seungheon Lee, Raghavender Boda, Anantha L. Duddupudi, Jeremy Chase Crawford, Peter Vogel, Christian Loch, Martin Schwemmle, Lawrence C. Fritz, Stacey Schultz-Cherry, Douglas R. Green, Gregory D. Cuny, Paul G. Thomas, Alexei Degterev & Siddharth Balachandran
Nature
April 2024
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Necroptosis blockade prevents lung injury in severe influenza

Abstract

Severe influenza A virus (IAV) infections can result in hyper-inflammation, lung injury and acute respiratory distress syndrome (ARDS), for which there are no effective pharmacological therapies. Necroptosis is an attractive entry point for therapeutic intervention in ARDS and related inflammatory conditions because it drives pathogenic lung inflammation and lethality during severe IAV infection and can potentially be targeted by receptor interacting protein kinase 3 (RIPK3) inhibitors. Here we show that a newly developed RIPK3 inhibitor, UH15-38, potently and selectively blocked IAV-triggered necroptosis in alveolar epithelial cells in vivo. UH15-38 ameliorated lung inflammation and prevented mortality following infection with laboratory-adapted and pandemic strains of IAV, without compromising antiviral adaptive immune responses or impeding viral clearance. UH15-38 displayed robust therapeutic efficacy even when administered late in the course of infection, suggesting that RIPK3 blockade may provide clinical benefit in patients with IAV-driven ARDS and other hyper-inflammatory pathologies.

https://www.nature.com/articles/s41586-024-07265-8
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