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Early cell-autonomous and niche-mediated epithelial response to influenza infection in primary alveolar organoids
Amber Elitz, Sharlene Fernandes, Kathleen C.S. Cook, Helen I. Warheit-Niemi, Barbara Zhao, Andrea Toth, Amanda L. Zacharias, William J. Zacharias
Amber Elitz, Sharlene Fernandes, Kathleen C.S. Cook, Helen I. Warheit-Niemi, Barbara Zhao, Andrea Toth, Amanda L. Zacharias, William J. Zacharias
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Research Article Infectious disease Pulmonology

Early cell-autonomous and niche-mediated epithelial response to influenza infection in primary alveolar organoids

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Abstract

Influenza A virus (IAV) infection is a major cause of morbidity and mortality for patients worldwide. Alveolar type 2 (AT2) cells are the preferential target of IAV as part of the pathogenesis of viral pneumonia and acute respiratory distress syndrome (ARDS). Early IAV infection of alveolar cells has been challenging to model both in vitro and in vivo. To address this challenge, we used a combination of murine and human primary alveolar organoids to define methods for robust IAV infection and evaluated cell-autonomous consequences of IAV using a temporal series of multiome paired single-nucleus RNA and ATAC sequencing assays. Infected AT2 cells demonstrated conserved changes defined by early loss of surfactant secretion, decreased lipid biogenesis, a rapid burst of antiviral response, and late virus-mediated suppression. Surprisingly, uninfected AT2 cells underwent substantial transcriptional and epigenomic changes in IAV-treated cultures, leading to transition to damage-associated cell states within hours via a process driven by the inflammatory milieu of murine organoids. Together, these data provide methods for high-fidelity modeling of IAV infection in alveolar cells and defined a conserved AT2 cell response signature to IAV with implications for ARDS pathogenesis.

Authors

Amber Elitz, Sharlene Fernandes, Kathleen C.S. Cook, Helen I. Warheit-Niemi, Barbara Zhao, Andrea Toth, Amanda L. Zacharias, William J. Zacharias

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Figure 2

Temporal dynamics and cellular specificity of IAV infection in AEOs.

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Temporal dynamics and cellular specificity of IAV infection in AEOs.
(A)...
(A) Schematic of method for liberation and treatment of AEOs with IAV. (B) AEOs treated with H1N1 develop progressively increased influenza infection as measured by nuclear expression of H1N1 NP across 24 hpi. (C) Quantification of NP+ nuclei at each time point of infection. (D) Cell-type-specific infection in AEOs. More AT2 cells are infected than AT1 by 8 hpi and thereafter. Scale bars: 50 μm. SPC, surfactant protein C (AT2 marker); AGER, advance glycosylation end-product–specific receptor (AT1 marker); NP, IAV nucleoprotein (infected cell marker); SNA, Sambuccus nigra agglutinin (flu binding motif α-2,6-sialic acid). *P < 0.05; **P < 0.01; **P < 0.001; ****P < 0.0001 by ANOVA with prespecified multiple comparisons; 1-way ANOVA (C); 2-way ANOVA (D).

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

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