CD73 controls neutrophil responsiveness to type I interferon impairing antibacterial responses during influenza A virus/ Streptococcus pneumoniae co-infection

Abstract

Streptococcus pneumoniae (pneumococcus) are asymptomatic colonizers of the nasopharynx but can progress to pulmonary and systemic pathogens upon influenza A virus (IAV) infection. Polymorphonuclear cells (PMNs) are required to control bacterial numbers, but we previously found that IAV infection impairs their ability to kill S. pneumoniae. Here, using a model that allows transition of pneumococci from colonizers to disease-causing pathogens upon IAV co-infection, we examined the signaling pathways impairing PMN responses. When we investigated the effect of type I interferons (IFN) produced upon IAV infection on PMN antibacterial activity, we found that PMNs treated with IFN were unable to kill S. pneumoniae ex vivo, and that in vivo blocking of IFN receptor 1 (IFNAR1) in IAV infected mice rescued PMN antibacterial function. In exploring what controls PMN responsiveness to IFN, we examined CD73, an ectonucleotidase that is known to regulate PMN function in primary pneumococcal pneumonia. To test if there is an intersection between CD73 and IFN signaling, we examined receptor levels and IFN production in wildtype versus CD73KO mice and found no difference in IFNAR expression on PMNs or IFN[a] and IFN levels in the lungs and circulation. However, CD73KO PMNs expressed significantly lower levels of the interferon stimulated protein IFIT1. When we looked at ex vivo PMN responsiveness to IFNs, CD73KO PMNs were less responsive to IFN-mediated inhibition of antimicrobial activity. In exploring mechanisms, we found that CD73 expressing PMNs had elevated production of reactive oxygen species in response to IAV challenge, that paradoxically impaired their ability to kill S. pneumoniae. Importantly, despite similar pathogen loads in the respiratory tract, co-infected CD73KO mice cleared bacteremia and survived significantly better than wildtype controls. These findings suggest that CD73 impairs host defense against IAV/S. pneumoniae co-infection in part by sensitizing PMNs to type I IFN-mediated inhibition of antibacterial function. Author SummaryDespite available therapeutics and vaccines, secondary bacterial pneumonia following influenza A virus (IAV) infection remains a major cause of disease. A common cause of secondary bacterial pneumonia are Streptococcus pneumoniae (pneumococcus), bacteria that resides asymptomatically in the nasopharynx, but upon viral infection can transition to cause severe disease in susceptible hosts. In this study we examined how host responses change during single versus polymicrobial infections. We focused on neutrophils, which are innate immune cells that are required for effective clearance of S. pneumoniae, and proper control of IAV. We found that the immune response to IAV, mediated by type I interferons (IFN), impair the ability of neutrophils to kill bacteria. We identified an enzyme called CD73 to be required for the ability of neutrophils to respond to IFN. In exploring mechanisms, we found that IFN and CD73 result in dysregulated reactive oxygen species production by neutrophils. Importantly, this impairs the ability of the host to clear bacteria that spread from the lungs to the blood upon viral co-infection and results in overall worse host outcome. This study describes a novel interaction between CD73 and type I interferons and provides a new therapeutic target to treat secondary pneumococcal pneumonia.