Autoantibodies against type I IFNs in patients with critical influenza pneumonia

Q Zhang, A Pizzorno, L Miorin, P Bastard… - Journal of Experimental …, 2022 - rupress.org
Q Zhang, A Pizzorno, L Miorin, P Bastard, A Gervais, T Le Voyer, L Bizien, J Manry, J Rosain…
Journal of Experimental Medicine, 2022rupress.org
Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19
pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring
autoantibodies neutralizing IFN-α2 alone (five patients) or with IFN-ω (eight patients) from a
cohort of 279 patients (4.7%) aged 6–73 yr with critical influenza pneumonia. Nine and four
patients had antibodies neutralizing high and low concentrations, respectively, of IFN-α2,
and six and two patients had antibodies neutralizing high and low concentrations …
Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-α2 alone (five patients) or with IFN-ω (eight patients) from a cohort of 279 patients (4.7%) aged 6–73 yr with critical influenza pneumonia. Nine and four patients had antibodies neutralizing high and low concentrations, respectively, of IFN-α2, and six and two patients had antibodies neutralizing high and low concentrations, respectively, of IFN-ω. The patients’ autoantibodies increased influenza A virus replication in both A549 cells and reconstituted human airway epithelia. The prevalence of these antibodies was significantly higher than that in the general population for patients <70 yr of age (5.7 vs. 1.1%, P = 2.2 × 10−5), but not >70 yr of age (3.1 vs. 4.4%, P = 0.68). The risk of critical influenza was highest in patients with antibodies neutralizing high concentrations of both IFN-α2 and IFN-ω (OR = 11.7, P = 1.3 × 10−5), especially those <70 yr old (OR = 139.9, P = 3.1 × 10−10). We also identified 10 patients in additional influenza patient cohorts. Autoantibodies neutralizing type I IFNs account for ∼5% of cases of life-threatening influenza pneumonia in patients <70 yr old.
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