{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:31:37Z","timestamp":1779204697989,"version":"3.51.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006955","name":"HHS | NIH | Office of Extramural Research, National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002345"],"award-info":[{"award-number":["UL1TR002345"]}],"id":[{"id":"10.13039\/100006955","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or seasonal influenza may lead to respiratory failure requiring intubation and mechanical ventilation. The pathophysiology of this respiratory failure is attributed to local immune dysregulation, but how the immune response to viral infection in the lower airways of the human lung differs between individuals with respiratory failure and those without is not well understood. We used quantitative multiparameter flow cytometry and multiplex cytokine assays to evaluate matched blood and bronchoalveolar lavage (BAL) samples from control human subjects, subjects with symptomatic seasonal influenza who did not have respiratory failure, and subjects with severe seasonal influenza or SARS-CoV-2 infection with respiratory failure. We find that severe cases are associated with an influx of nonclassical monocytes, activated T cells, and plasmablast B cells into the lower airways. Cytokine concentrations were not elevated in the lower airways of moderate influenza patients compared with controls; however, 28 of 35 measured cytokines were significantly elevated in severe influenza, severe SARS-CoV-2 infection, or both. We noted the largest elevations in IL-6, IP-10, MCP-1, and IL-8. IL-1 family cytokines and RANTES were higher in severe influenza infection than severe SARS-CoV-2 infection. Interestingly, only the concentration of IP-10\u2013correlated between blood and BAL during severe infection. Our results demonstrate inflammatory immune dysregulation in the lower airways during severe viral pneumonia that is distinct from lower airway responses seen in human patients with symptomatic, but not severe, illness and suggest that measurement of blood IP-10 concentration may predict this unique dysregulation.<\/jats:p>","DOI":"10.4049\/jimmunol.2100294","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T18:40:13Z","timestamp":1628102413000},"page":"1229-1238","source":"Crossref","is-referenced-by-count":37,"title":["Comprehensive Immunologic Evaluation of Bronchoalveolar Lavage Samples from Human Patients with Moderate and Severe Seasonal Influenza and Severe COVID-19"],"prefix":"10.1093","volume":"207","author":[{"given":"Daniel","family":"Reynolds","sequence":"first","affiliation":[{"name":"Division of Pulmonology and Critical Care, Department of Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Vazquez Guillamet","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care, Department of Medicine, Washington University School of Medicine , Saint Louis, MO"},{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Borcherding","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4190-946X","authenticated-orcid":false,"given":"Rodrigo","family":"Vazquez Guillamet","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care, Department of Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Alberto","family":"Chore\u00f1o-Parra","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas , M\u00e9xico City ,","place":["M\u00e9xico"]},{"name":"Escuela Nacional de Ciencias Biol\u00f3gicas, Instituto Polit\u00e9cnico Nacional , M\u00e9xico City ,","place":["M\u00e9xico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1161-4529","authenticated-orcid":false,"given":"Stacey L","family":"House","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8265-9471","authenticated-orcid":false,"given":"Jane A","family":"O\u2019Halloran","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"Z\u00fa\u00f1iga","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas , M\u00e9xico City ,","place":["M\u00e9xico"]},{"name":"Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud , M\u00e9xico City ,","place":["M\u00e9xico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali H","family":"Ellebedy","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology, Washington University School of Medicine , Saint Louis, MO"},{"name":"Bursky Center for Human Immunology and Immunotherapy Program, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek E","family":"Byers","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care, Department of Medicine, Washington University School of Medicine , Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3860-5473","authenticated-orcid":false,"given":"Philip A","family":"Mudd","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Washington University School of Medicine , Saint Louis, 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