Pulmonary immunostimulation with MALP-2 in influenza virus-infected mice increases survival after pneumococcal superinfection

Infect Immun. 2015 Dec;83(12):4617-29. doi: 10.1128/IAI.00948-15. Epub 2015 Sep 14.


Pulmonary infection with influenza virus is frequently complicated by bacterial superinfection, with Streptococcus pneumoniae being the most prevalent causal pathogen and hence often associated with high morbidity and mortality rates. Local immunosuppression due to pulmonary influenza virus infection has been identified as a major cause of the pathogenesis of secondary bacterial lung infection. Thus, specific local stimulation of the pulmonary innate immune system in subjects with influenza virus infection might improve the host defense against secondary bacterial pathogens. In the present study, we examined the effect of pulmonary immunostimulation with Toll-like receptor 2 (TLR-2)-stimulating macrophage-activating lipopeptide 2 (MALP-2) in influenza A virus (IAV)-infected mice on the course of subsequent pneumococcal superinfection. Female C57BL/6N mice infected with IAV were treated with MALP-2 on day 5 and challenged with S. pneumoniae on day 6. Intratracheal MALP-2 application increased proinflammatory cytokine and chemokine release and enhanced the recruitment of leukocytes, mainly neutrophils, into the alveolar space of IAV-infected mice, without detectable systemic side effects. Local pulmonary instillation of MALP-2 in IAV-infected mice 24 h before transnasal pneumococcal infection considerably reduced the bacterial number in the lung tissue without inducing exaggerated inflammation. The pulmonary viral load was not altered by MALP-2. Clinically, MALP-2 treatment of IAV-infected mice increased survival rates and reduced hypothermia and body weight loss after pneumococcal superinfection compared to those of untreated coinfected mice. In conclusion, local immunostimulation with MALP-2 in influenza virus-infected mice improved pulmonary bacterial elimination and increased survival after subsequent pneumococcal superinfection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Coinfection
  • Female
  • Hypothermia / prevention & control
  • Immunity, Innate
  • Immunization
  • Immunologic Factors / pharmacology*
  • Influenza A Virus, H1N1 Subtype / drug effects
  • Influenza A Virus, H1N1 Subtype / immunology
  • Influenza A Virus, H1N1 Subtype / pathogenicity
  • Lipopeptides / pharmacology*
  • Lung / drug effects*
  • Lung / immunology
  • Lung / microbiology
  • Lung / virology
  • Macrophage Activation / drug effects
  • Mice
  • Mice, Inbred C57BL
  • Neutrophil Infiltration / drug effects
  • Neutrophils / drug effects
  • Neutrophils / immunology
  • Neutrophils / microbiology
  • Neutrophils / virology
  • Orthomyxoviridae Infections / drug therapy*
  • Orthomyxoviridae Infections / immunology
  • Orthomyxoviridae Infections / mortality
  • Orthomyxoviridae Infections / virology
  • Pneumonia, Pneumococcal / drug therapy*
  • Pneumonia, Pneumococcal / immunology
  • Pneumonia, Pneumococcal / microbiology
  • Pneumonia, Pneumococcal / mortality
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / immunology
  • Streptococcus pneumoniae / pathogenicity
  • Survival Analysis
  • Weight Loss / drug effects


  • Immunologic Factors
  • Lipopeptides
  • macrophage stimulatory lipopeptide 2