PMID- 23154286
OWN - NLM
STAT- MEDLINE
DCOM- 20140102
LR  - 20211021
IS  - 2150-5608 (Electronic)
IS  - 2150-5594 (Print)
IS  - 2150-5594 (Linking)
VI  - 3
IP  - 7
DP  - 2012 Nov 15
TI  - Pathology in euthermic bats with white nose syndrome suggests a natural 
      manifestation of immune reconstitution inflammatory syndrome.
PG  - 583-8
LID - 10.4161/viru.22330 [doi]
AB  - White nose syndrome, caused by Geomyces destructans, has killed more than 5 
      million cave hibernating bats in eastern North America. During hibernation, the 
      lack of inflammatory cell recruitment at the site of fungal infection and erosion 
      is consistent with a temperature-induced inhibition of immune cell trafficking. 
      This immune suppression allows G. destructans to colonize and erode the skin of 
      wings, ears and muzzle of bat hosts unchecked. Yet, paradoxically, within weeks 
      of emergence from hibernation an intense neutrophilic inflammatory response to G. 
      destructans is generated, causing severe pathology that can contribute to death. 
      We hypothesize that the sudden reversal of immune suppression in bats upon the 
      return to euthermia leads to a form of immune reconstitution inflammatory 
      syndrome (IRIS). IRIS was first described in HIV-infected humans with low helper 
      T lymphocyte counts and bacterial or fungal opportunistic infections. IRIS is a 
      paradoxical and rapid worsening of symptoms in immune compromised humans upon 
      restoration of immunity in the face of an ongoing infectious process. In humans 
      with HIV, the restoration of adaptive immunity following suppression of HIV 
      replication with anti-retroviral therapy (ART) can trigger severe immune-mediated 
      tissue damage that can result in death. We propose that the sudden restoration of 
      immune responses in bats infected with G. destructans results in an IRIS-like 
      dysregulated immune response that causes the post-emergent pathology.
FAU - Meteyer, Carol U
AU  - Meteyer CU
AD  - National Wildlife Health Center, US Geological Survey, Madison, WI, USA.
FAU - Barber, Daniel
AU  - Barber D
FAU - Mandl, Judith N
AU  - Mandl JN
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20121115
PL  - United States
TA  - Virulence
JT  - Virulence
JID - 101531386
SB  - IM
MH  - Animals
MH  - Chiroptera
MH  - Immune Reconstitution Inflammatory Syndrome/pathology/*veterinary
MH  - Mycoses/pathology/*veterinary
MH  - North America
MH  - Nose/*pathology
PMC - PMC3545935
OTO - NOTNLM
OT  - Geomyces destructans
OT  - Myotis lucifugus
OT  - cave-hibernating bats
OT  - hibernation-induced immune suppression
OT  - immune cell trafficking
OT  - immune reconstitution inflammatory syndrome (IRIS)
OT  - white nose syndrome
EDAT- 2012/11/17 06:00
MHDA- 2014/01/03 06:00
PMCR- 2012/11/15
CRDT- 2012/11/17 06:00
PHST- 2012/11/17 06:00 [entrez]
PHST- 2012/11/17 06:00 [pubmed]
PHST- 2014/01/03 06:00 [medline]
PHST- 2012/11/15 00:00 [pmc-release]
AID - 22330 [pii]
AID - 2011VIRULENCE0119R [pii]
AID - 10.4161/viru.22330 [doi]
PST - ppublish
SO  - Virulence. 2012 Nov 15;3(7):583-8. doi: 10.4161/viru.22330. Epub 2012 Nov 15.