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Chronic Alcohol Consumption Increases the Severity of Murine Influenza Virus Infections¹

David K. Meyerholz^2,*, Michelle Edsen-Moore^2,*, Jodi McGill^*,, Ruth A. Coleman^*, Robert T. Cook^* and Kevin L. Legge^3,*,

^* Department of Pathology and Interdisciplinary Graduate Program in Immunology, University of Iowa, Iowa City, IA 52242

Respiratory infections with both seasonal as well as potential pandemic Influenza viruses represent a significant burden on human health. Furthermore, viruses such as Influenza are increasingly recognized as important etiologic agents in community acquired pneumonia. Within the U.S. alone, 12.9 million people are heavy drinkers and chronic abuse of alcohol is known to increase the risk and severity of community acquired pneumonia. Given the lack of knowledge regarding Influenza disease in this population, we determined the effects of chronic alcohol consumption on Influenza virus infection. Herein, we report that mice exposed to chronic ethanol have sharp increases in morbidity, mortality, and pulmonary virus titers relative to controls. These increases in influenza severity correspond with inhibited pulmonary influenza-specific CD8 T cell responses. Further, chronic ethanol consumption results in an enhanced pulmonary lesion severity, similar to that recently described for pandemic influenzas. Together, our results suggest that chronic alcohol consumption may increase the risk for severe influenza virus infections by altering the pulmonary inflammatory environment and CD8 T cell response.

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

¹ This work was supported by National Institutes of Health Grant AA-014405 to R.T.C. and Department of Pathology Start-Up Funds to K.L.L.

² D.K.M. and M.E.-M. contributed equally to this work.

³ Address correspondence and reprint requests to Dr. Kevin L. Legge, Department of Pathology, 1036 Medical Laboratories, 200 Hawkins Drive, Iowa City, IA 52242. E-mail address: kevin-legge{at}uiowa.edu

⁴ Abbreviations used in this paper: CAP, community-acquired pneumonia; EtOH, ethanol; p.i., postinfection; RSV, respiratory syncytial virus; NP, influenza nucleocapsid protein; HA, influenza hemagglutinin protein; PA, influenza acid polymerase protein; PKC, protein kinase C; DC, dendritic cell.