Topical Steroid Withdrawal Diagnostic Criteria Defined by NIH Researchers

Topical steroid withdrawal (TSW) results in dermatitis that is distinct from eczema and is caused by an excess of NAD+, an essential chemical compound in the body, according to a new study from NIAID researchers.

Contact

Submit a Media Request

Contact the NIAID News & Science Writing Branch.

301-402-1663
niaidnews@niaid.nih.gov
All Media Contacts

Chung Park, M.S., Ph.D.

Section or Unit Name
B-Cell Molecular Immunology Section
Exclude from directory
Off
Section/Unit: Location
This Researcher/Clinician’s Person Page
Parent Lab/Program
Program Description

Philosophy - Advancing Human Health Through Immunological Research:

  • Enhance understanding of immune system regulation in health and disease
  • Provide mechanistic insights into disease pathology to inform therapeutic strategies
  • Support translational research to develop targeted treatments for immune-related disorders

Secondary Lymphoid Organ Remodeling and Pathogen-Immune cell Interactions:

  • Investigate structural remodeling of lymph nodes in immune responses
  • Examine chemokine receptor sensitivity modulation by RGS proteins
  • Characterize cellular networks facilitating virus envelope protein transfer

Extracellular Signaling, GPCR Signal Transduction and Immune Modulation:

  • Investigate chemokine receptor-mediated signaling in immune cell regulation
  • Examine heterotrimeric G-protein activation in lymphocyte function
  • Study molecular mechanisms of G-protein-coupled receptor (GPCR) signaling
  • Analyze how GPCR signaling orchestrates immune responses and cell dynamics

Experimental Approaches:

  • Utilize genetically engineered murine models
  • Employ intravital two-photon laser scanning microscopy (TP-LSM) and high-throughput flow cytometry
Selected Publications

Park C, Hwang IY, Yan SL, Vimonpatranon S, Wei D, Van Ryk D, Girard A, Cicala C, Arthos J, Kehrl JH. Murine alveolar macrophages rapidly accumulate intranasally administered SARS-CoV-2 Spike protein leading to neutrophil recruitment and damage. Elife. 2024 Mar 20;12:RP86764.

Park C, Kehrl JH. An integrin/MFG-E8 shuttle loads HIV-1 viral-like particles onto follicular dendritic cells in mouse lymph node. Elife. 2019 Dec 6;8:e47776.

Guzzo C, Ichikawa D, Park C, Phillips D, Liu Q, Zhang P, Kwon A, Miao H, Lu J, Rehm C, Arthos J, Cicala C, Cohen MS, Fauci AS, Kehrl JH, Lusso P. Virion incorporation of integrin α4β7 facilitates HIV-1 infection and intestinal homing. Sci Immunol. 2017 May 12;2(11):eaam7341.

Park C, Arthos J, Cicala C, Kehrl JH. The HIV-1 envelope protein gp120 is captured and displayed for B cell recognition by SIGN-R1(+) lymph node macrophages. Elife. 2015 Aug 10;4:e06467.

Park C, Hwang IY, Sinha RK, Kamenyeva O, Davis MD, Kehrl JH. Lymph node B lymphocyte trafficking is constrained by anatomy and highly dependent upon chemoattractant desensitization. Blood. 2012 Jan 26;119(4):978-89.

Sinha RK*, Park C*, Hwang IY, Davis MD and Kehrl JH. B lymphocytes Exit Lymph Nodes through Cortical Lymphatic Sinosoids Near to Lymph Nodes Follicles by a Mechanism Independent of S1P-Mediated Chemotaxis. Immunity. 2009 Feb 18. [Epub ahead of print] (*Co-first publication)

Visit PubMed for a complete publication listing.

Major Areas of Research
  • Lymphocyte trafficking and cellular migration dynamics from homeostasis to pathological conditions
  • B-cell signaling, G-protein signaling pathways, and the regulatory role of RGS proteins  
  • Mechanisms underlying complex cellular immune responses induced by diverse antigens and pathogens 

Fengkai Zhang, M.D., M.Math.

Section or Unit Name
Computational Systems Biology Section
Exclude from directory
Off
Section/Unit: Location
This Researcher/Clinician’s Person Page
Program Description

A range of methodologies is utilized in systems biology to simulate biological pathways, uncovering the intricate ways molecules function within living organisms and enabling hypotheses about potential interactions and reaction rate ranges without relying on traditional experimental measurements. Among these, rule-based modeling abstracts similar reactions into rules that summarize the characteristics and binding states of individual molecular components within large molecular complexes. This approach offers a distinct advantage by simplifying the representation of molecular reactions, organizing entities within hierarchical structures that align with biological formats at both the molecular and sub-molecular levels, such as domains and binding sites. Furthermore, the rule-based modeling approach can address the combinatorial complexity inherent in biological systems.

Simmune is a software suite that uses rule-based modeling to simulate biological pathways. It constructs models of biological reactions through its unique icon-based modeling language from single reactions and provides a flexible, high-level network view for model inspection. Simmune can simulate models in well-stirred environments, efficiently explore large parameter spaces, and help users identify the most relevant parameters, offering insights into the relationships between different parameters. Additionally, Simmune supports the simulation of spatially resolved models in discrete grid morphologies and 3D environments, with the ability to analyze and visualize results at fine-grained subcellular levels.

Simmune supports the Multistate, Multicomponent, and Multicompartment Species Package for SBML Level 3 (SBML-Multi) to exchange rule-based models. This standard is part of an initiative by the COmputational Modeling in BIology NEtwork (COMBINE) community standards and formats for computational models. Our group leads the effort for the SBML-Multi standard.

Simmune is built with technologies including C/C++, Qt, VTK, CMake, Python, SQL, MongoDB, Boost, version control, Sundials, and parallel computing, providing a powerful, flexible modeling tool that remains user-friendly for biological researchers with limited computing expertise. Our group collaborates with researchers in immunology, proteomics, computational modeling, and systems biology.

Selected Publications

Xu X, Quan W, Zhang F, Jin T. A systems approach to investigate GPCR-mediated Ras signaling network in chemoattractant sensing. Mol Biol Cell. 2022 Mar 1;33(3):ar23.

Zhang F, Smith LP, Blinov ML, Faeder J, Hlavacek WS, Juan Tapia J, Keating SM, Rodriguez N, Dräger A, Harris LA, Finney A, Hu B, Hucka M, Meier-Schellersheim M. Systems biology markup language (SBML) level 3 package: multistate, multicomponent and multicompartment species, version 1, release 2. J Integr Bioinform. 2020 Jul 6;17(2-3):20200015.

Keating SM, Waltemath D, König M, Zhang F, Dräger A, Chaouiya C, Bergmann FT, Finney A, Gillespie CS, Helikar T, Hoops S, Malik-Sheriff RS, Moodie SL, Moraru II, Myers CJ, Naldi A, Olivier BG, Sahle S, Schaff JC, Smith LP, Swat MJ, Thieffry D, Watanabe L, Wilkinson DJ, Blinov ML, Begley K, Faeder JR, Gómez HF, Hamm TM, Inagaki Y, Liebermeister W, Lister AL, Lucio D, Mjolsness E, Proctor CJ, Raman K, Rodriguez N, Shaffer CA, Shapiro BE, Stelling J, Swainston N, Tanimura N, Wagner J, Meier-Schellersheim M, Sauro HM, Palsson B, Bolouri H, Kitano H, Funahashi A, Hermjakob H, Doyle JC, Hucka M; SBML Level 3 Community members. SBML Level 3: an extensible format for the exchange and reuse of biological models. Mol Syst Biol. 2020 Aug;16(8):e9110.

Cheng HC, Angermann BR, Zhang F, Meier-Schellersheim M. NetworkViewer: visualizing biochemical reaction networks with embedded rendering of molecular interaction rules. BMC Syst Biol. 2014 Jun 16;8:70.

Zhang F, Angermann BR, Meier-Schellersheim M. The Simmune Modeler visual interface for creating signaling networks based on bi-molecular interactions. Bioinformatics. 2013 May 1;29(9):1229-30.

Angermann BR, Klauschen F, Garcia AD, Prustel T, Zhang F, Germain RN, Meier-Schellersheim M. Computational modeling of cellular signaling processes embedded into dynamic spatial contexts. Nat Methods. 2012 Jan 29;9(3):283-9.

Major Areas of Research
  • Design and development of systems biology simulation applications
  • Development of a standard of the Multistate, Multicomponent and Multicompartment Species Package for SBML Level 3 to exchange rule-based models
  • Simulating and analyzing well-stirred and spatially resolved computational models for signaling processes

Rahul K. Suryawanshi, Ph.D.

Section or Unit Name
Neurovirology Unit
Exclude from directory
Off
Section/Unit: Year Established
Section/Unit: Location
This Researcher/Clinician’s Person Page
Program Description

The Neurovirology Unit conducts research on the acute and long-term complications associated with human alphaherpesvirus infections and pulmonary infections caused by coronaviruses and influenza.

Using transgenic animal models and integrating approaches from molecular virology, neurobiology, and immunology, we investigate the mechanisms underlying viral pathogenesis in the central nervous system, which particularly involves analyzing roles of immunomodulatory host factors to understand their roles in pathogenesis, neuroprotection, and potentiating antiviral immunity. While studying different aspects of antiviral immunity, we also focus on understanding the neurological regulation of antiviral immunity, neuroinflammation, and the long-term manifestations of viral infection, such as neurodegeneration and cognitive decline using machine learning-based behavioral approaches.

Additionally, the Neurovirology Unit explores the interactions between viral proteins, host factors, and immune responses that drive differential disease severity observed in humans, paving the way for innovative therapeutic strategies. We are also committed to advancing human brain and lung organoid models to recapitulate disease phenotypes in humans and thereby enhance our understanding of viral disease mechanisms.

Selected Publications

Suryawanshi RK, Chen IP, Ma T, Syed AM, Brazer N, Saldhi P, Simoneau CR, Ciling A, Khalid MM, Sreekumar B, Chen PY, Kumar GR, Montano M, Gascon R, Tsou CL, Garcia-Knight MA, Sotomayor-Gonzalez A, Servellita V, Gliwa A, Nguyen J, Silva I, Milbes B, Kojima N, Hess V, Shacreaw M, Lopez L, Brobeck M, Turner F, Soveg FW, George AF, Fang X, Maishan M, Matthay M, Morris MK, Wadford D, Hanson C, Greene WC, Andino R, Spraggon L, Roan NR, Chiu CY, Doudna JA, Ott M. Limited cross-variant immunity from SARS-CoV-2 Omicron without vaccination. Nature. 2022 Jul;607(7918):351-355.

Ryu JK, Yan Z, Montano M, Sozmen EG, Dixit K, Suryawanshi RK, Matsui Y, Helmy E, Kaushal P, Makanani SK, Deerinck TJ, Meyer-Franke A, Rios Coronado PE, Trevino TN, Shin MG, Tognatta R, Liu Y, Schuck R, Le L, Miyajima H, Mendiola AS, Arun N, Guo B, Taha TY, Agrawal A, MacDonald E, Aries O, Yan A, Weaver O, Petersen MA, Meza Acevedo R, Alzamora MDPS, Thomas R, Traglia M, Kouznetsova VL, Tsigelny IF, Pico AR, Red-Horse K, Ellisman MH, Krogan NJ, Bouhaddou M, Ott M, Greene WC, Akassoglou K. Fibrin drives thromboinflammation and neuropathology in COVID-19. Nature. 2024 Sep;633(8031):905-913.

Suryawanshi RK, Patil CD, Agelidis A, Koganti R, Ames JM, Koujah L, Yadavalli T, Madavaraju K, Shantz LM, Shukla D. mTORC2 confers neuroprotection and potentiates immunity during virus infection. Nat Commun. 2021 Oct 14;12(1):6020.

Suryawanshi RK, Patil CD, Agelidis A, Koganti R, Yadavalli T, Ames JM, Borase H, Shukla D. Pathophysiology of reinfection by exogenous HSV-1 is driven by heparanase dysfunction. Sci Adv. 2023 Apr 28;9(17):eadf3977.

Suryawanshi RK, Jaishankar P, Correy GJ, Rachman MM, O'Leary PC, Taha TY, Zapatero-Belinchón FJ, McCavittMalvido M, Doruk YU, Stevens MGV, Diolaiti ME, Jogalekar MP, Richards AL, Montano M, Rosecrans J, Matthay M, Togo T, Gonciarz RL, Gopalkrishnan S, Neitz RJ, Krogan NJ, Swaney DL, Shoichet BK, Ott M, Renslo AR, Ashworth A, Fraser JS. The Mac1 ADP-ribosylhydrolase is a Therapeutic Target for SARS-CoV-2. eLife14:RP103484.

Suryawanshi R, Ott M. SARS-CoV-2 hybrid immunity: silver bullet or silver lining?. Nat Rev Immunol. 2022 Oct;22(10):591-592.

Major Areas of Research
  • Acute and post-acute neuropathies of virus infections
  • Impact of genetics on disease severity
  • Host-virus interactions and its effect on antiviral immunity
  • Human brain and lung organoid models to study virus infection

Fabiano Oliveira, M.D., Ph.D.

Section or Unit Name
Vector Molecular Biology Section

Highlight

Exclude from directory
Off
Section/Unit: Location
This Researcher/Clinician’s Person Page
Program Description

Our research focuses on the complex interactions between the human immune system and insect-derived molecules, and how these interactions can influence the outcomes of vector-borne diseases such as dengue, Zika, Chikungunya, and leishmaniasis. When an insect bites, it injects hundreds of arthropod molecules into the host's skin, alerting our immune system to these foreign agents. If the insect is infected with a pathogen, the microorganism is delivered along with these insect-derived molecules. Our immune response to these molecules over time can either help or hinder pathogen establishment, ultimately affecting the disease outcome.

Our work is conducted at two primary locations: the Laboratory of Malaria and Vector Research (LMVR) in Rockville, which is equipped with cutting-edge technologies, and the NIAID International Center of Excellence in Research (ICER) in Cambodia, where we conduct field observations and studies.

At LMVR-Rockville, we use advanced technologies and methodologies to explore the molecular and immunological mechanisms underlying the human response to arthropod bites and the pathogens they transmit. In Cambodia, at the NIAID ICER, we engage in extensive fieldwork to gather critical data and observations directly from affected populations. By integrating field data with laboratory findings, we aim to develop robust hypotheses that can lead to effective strategies for disease mitigation and control.

Our multidisciplinary approach allows us to bridge the gap between laboratory research and field applications. By understanding how the human immune system responds to arthropod molecules, we can identify potential targets for vaccines, therapeutics, and diagnostic tools. Additionally, our research contributes to the development of innovative vector control strategies that can reduce the incidence of these debilitating diseases.

Through collaboration with local communities, healthcare providers, and international partners, we strive to translate our scientific discoveries into practical solutions that can improve public health outcomes. Our ultimate goal is to reduce the burden of vector-borne diseases and enhance the quality of life for people living in endemic regions.

Our research aims to improve dengue prevention and treatment strategies for U.S. travelers, personnel in endemic areas, and regions with reported dengue cases, such as Hawaii, Florida, Texas, Puerto Rico, the U.S. Virgin Islands, and Guam. Enhanced predictive, management, diagnostic, and preventive measures for dengue outbreaks are particularly crucial for these at-risk regions. The development and use of prophylactic therapeutics targeting specific immune responses to mosquito bites could reduce the transmission of arboviruses, including eastern equine encephalitis, Jamestown Canyon, La Crosse, Powassan, St. Louis encephalitis, and West Nile viruses. Improved diagnostic capabilities for vector-borne diseases and emerging infections will lead to better patient outcomes. 

Selected Publications

Manning JE, Chea S, Parker DM, Bohl JA, Lay S, Mateja A, Man S, Nhek S, Ponce A, Sreng S, Kong D, Kimsan S, Meneses C, Fay MP, Suon S, Huy R, Lon C, Leang R, Oliveira F. Development of Inapparent Dengue Associated With Increased Antibody Levels to Aedes aegypti Salivary Proteins: A Longitudinal Dengue Cohort in Cambodia. J Infect Dis. 2022 Oct 17;226(8):1327-1337.

Guerrero D, Vo HTM, Lon C, Bohl JA, Nhik S, Chea S, Man S, Sreng S, Pacheco AR, Ly S, Sath R, Lay S, Missé D, Huy R, Leang R, Kry H, Valenzuela JG, Oliveira F, Cantaert T, Manning JE. Evaluation of cutaneous immune response in a controlled human in vivo model of mosquito bites. Nat Commun. 2022 Nov 17;13(1):7036.

Chea S, Willen L, Nhek S, Ly P, Tang K, Oristian J, Salas-Carrillo R, Ponce A, Leon PCV, Kong D, Ly S, Sath R, Lon C, Leang R, Huy R, Yek C, Valenzuela JG, Calvo E, Manning JE, Oliveira F. Antibodies to Aedes aegypti D7L salivary proteins as a new serological tool to estimate human exposure to Aedes mosquitoes. Front Immunol. 2024 May 1;15:1368066.

Guimaraes-Costa AB, Shannon JP, Waclawiak I, Oliveira J, Meneses C, de Castro W, Wen X, Brzostowski J, Serafim TD, Andersen JF, Hickman HD, Kamhawi S, Valenzuela JG, Oliveira F. A sand fly salivary protein acts as a neutrophil chemoattractant. Nat Commun. 2021 May 28;12(1):3213.

Oliveira F, Rowton E, Aslan H, Gomes R, Castrovinci PA, Alvarenga PH, Abdeladhim M, Teixeira C, Meneses C, Kleeman LT, Guimarães-Costa AB, Rowland TE, Gilmore D, Doumbia S, Reed SG, Lawyer PG, Andersen JF, Kamhawi S, Valenzuela JG. A sand fly salivary protein vaccine shows efficacy against vector-transmitted cutaneous leishmaniasis in nonhuman primates. Sci Transl Med. 2015 Jun 3;7(290):290ra90.

Manning JE, Oliveira F, Coutinho-Abreu IV, Herbert S, Meneses C, Kamhawi S, Baus HA, Han A, Czajkowski L, Rosas LA, Cervantes-Medina A, Athota R, Reed S, Mateja A, Hunsberger S, James E, Pleguezuelos O, Stoloff G, Valenzuela JG, Memoli MJ. Safety and immunogenicity of a mosquito saliva peptide-based vaccine: a randomised, placebo-controlled, double-blind, phase 1 trial. Lancet. 2020 Jun 27;395(10242):1998-2007.

Visit PubMed for a complete publication listing.

Major Areas of Research
  • Characterization of human immune response to ticks, mosquito, and sand fly saliva in the context of medically significant vector-borne diseases (Lyme disease, Powassan, dengue, malaria, and leishmaniasis)
  • Clinical and field epidemiology of the impact of mosquito saliva immunity on the outcome of dengue, Zika, and other diseases carried by mosquitos
  • Strategies to block vector-borne diseases by targeting the arthropod vector and interruption transmission to the human host

Influenza A Viruses Adapt Shape in Response to Environmental Pressures

Influenza A virus particles strategically adapt their shape – to become either spheres or larger filaments – to favor their ability to infect cells depending on environmental conditions, a new NIAID study published in Nature Microbiology reveals. This previously unrecognized response could help explain how influenza A and other viruses persist in populations, evade immune responses, and acquire adaptive mutations. The scientists designed the study to determine why many influenza A virus particles exist as filaments, which requires more energy to form than a sphere.

Contact

Submit a Media Request

Contact the NIAID News & Science Writing Branch.

301-402-1663
niaidnews@niaid.nih.gov
All Media Contacts

Vaccine Protective Against H5N1 Influenza from Cattle

NIAID Now |

An experimental vaccine designed against the highly pathogenic avian influenza H5N1 (HPAI H5N1) virus circulating in U.S. cattle was fully protective in research mice in a new study published in Nature Communications. NIAID scientists at Rocky Mountain Laboratories (RML) in Hamilton, Montana, led the animal study with colleagues from HDT Bio in Seattle who developed the replicating RNA vaccine (repRNA) platform.

Along with confirming that a single immunization with the experimental vaccine was effective against the new flu type in cattle (HPAI A H5N1 clade 2.3.4.4b), the study also allowed scientists to evaluate the vaccine method for “cross protection.” Would it work against the new virus if designed with components used in stockpiled vaccines from an older H5N1 virus (A/Vietnam/1203/2004)? They found that when the test vaccine used a design from the older H5N1 virus, protection was diminished. The findings suggest that the HPAI H5N1 circulating in the U.S. may be able to evade immunity from older H5N1 viruses.

Scientists designed the repRNA vaccine to express the protective vaccine components, as well as the RNA replication machinery derived from an alphavirus. This allows for robust expression of the protective vaccine components upon delivery with LION™, a proprietary nanoparticle formulation. The repRNA/LION technology is the basis of a vaccine that received emergency use authorization in India for COVID-19. Additional applications of repRNA/LION are advancing toward clinical trials for other serious viral diseases after showing effectiveness against several different viruses in the lab.

Scientists at RML and HDT Bio are continuing to develop the vaccine platform, and evaluations in animal models developed at RML are ongoing.

Reference: D Hawman, et al. Clade 2.3.4.4b but not historical clade 1 HA replicating RNA vaccine protects against bovine H5N1 challenge in mice. Nature Communications DOI: https://doi.org/10.1038/s41467-024-55546-7 (2025).
 

Contact Information

Contact the NIAID Media Team.

301-402-1663
niaidnews@niaid.nih.gov

Search NIAID Blog

NIAID Study Describes Successful Treatment Regimen for Person with Multidrug-Resistant HIV

NIAID Now |

Although antiretroviral therapy (ART) is safe and highly effective at treating HIV, some HIV variants do not respond to most ART regimens. Those HIV variants are known as multidrug-resistant (MDR) HIV. People who acquire or develop MDR HIV have few treatment options and a greater likelihood of experiencing or dying from HIV-related complications. A study from NIAID researchers published in Nature Medicine found that a novel treatment regimen including an investigational monoclonal antibody (mAb) called UB-421 (semzuvolimab), and the Food and Drug Administration (FDA)-approved antiretroviral drugs (ARVs) including lenacapavir, suppressed HIV in a person with MDR HIV. This finding could pave the way for further research and development on a novel treatment approach for people with MDR HIV.

MDR HIV can occur in people who have been prescribed an ART regimen that does not fully suppress HIV replication, had a lapse in treatment, or acquired MDR HIV directly. While MDR HIV is relatively uncommon in high-resource settings, it is an increasing threat to people with limited access to quality health care. In the new study, the researchers aimed to identify a regimen that could be used to manage MDR HIV in people with limited treatment options. UB-421 was included in the regimen because prior studies have shown that it may be effective against drug-resistant HIV variants. The regimen also included lenacapavir, which is currently used for the treatment of MDR HIV, and the ARVs tenofovir and emtricitabine. Because drug-resistant HIV variants continue to emerge, the researchers are investigating new avenues of treatment for people with MDR HIV.

The study was led by Tae-Wook Chun, Ph.D., chief of the HIV Immunology Section in NIAID’s Laboratory of Immunoregulation, and conducted at the Institute’s HIV Outpatient Clinic. The regimen was evaluated in a man with MDR HIV and Kaposi sarcoma (KS), a rare cancer that occurs in people with suppressed immune systems. The 58-year-old participant had taken several ART regimens over three decades living with HIV and developed resistance to all available antiretroviral drugs. Analysis of virus from the participant indicated that it was also resistant to nearly all currently licensed and investigational mAbs except for UB-421. During the 70-week treatment period, the participant received UB-421 and lenacapavir-based ART to suppress HIV replication, as well as the antibiotics trimethoprim/sulfamethoxazole and azithromycin, and chemotherapy and immunotherapy drugs for KS.

Within two weeks of beginning the regimen, the levels of HIV in the participant’s blood rapidly decreased. HIV levels continued to decrease at a lower rate for the next 30 weeks. The researchers also found that the participant experienced an increase in the levels of immune cells called CD4+ T cells, indicating a recovery in the patient’s immune system. UB-421 acts by attaching to the surface of the T cells at the CD4+ T-cell receptor, preventing HIV from binding and thus blocking a critical step in HIV infection. Examination of the participant’s T cells found that UB-421 fully blocked the CD4 receptors during the majority of the treatment period. The regimen suppressed replication of MDR HIV in the patient, lowering the level of virus in the blood serum below the detection limit of 20 particles per milliliter after one year of treatment.

This study lays the groundwork for possible new treatments for people with MDR HIV for whom treatment options are limited. The authors note that UB-421 is a promising therapeutic alongside ART regimens for MDR HIV. These findings also support the evaluation of the study treatment regimen in a larger group of people. 

Reference:

Contact Information

Contact the NIAID Media Team.

301-402-1663
niaidnews@niaid.nih.gov

Search NIAID Blog

Subclinical Disease in Monkeys Exposed to H5N1 by Mouth and Stomach

NIAID Now |

Subclinical Disease in Monkeys Exposed to H5N1 by Mouth and Stomach

A new study published in Nature found that highly pathogenic H5N1 avian influenza virus (HPAI H5N1) administered directly into the mouth and stomach of research monkeys caused self-limiting infection with no recognizable clinical signs of disease. By comparison, other routes of transmission resulted in mild or severe disease. The findings suggest that drinking raw milk contaminated with H5N1 virus can result in infection but may be less likely to lead to severe illness. Nevertheless, exposure by raw milk – which is a source of several foodborne illnesses – should be avoided to prevent H5N1 infection and potential further spread.

The research team, from NIH’s National Institute of Allergy and Infectious Diseases (NIAID), exposed cynomolgus macaques to the same clade 2.3.4.4b HPAI H5N1 virus circulating in U.S. cattle. Transmission routes included via the nose, windpipe (trachea) or directly into the mouth and stomach to mimic infection routes in people. Animals exposed via the nose and windpipe became infected, developed pneumonia and had varying degrees of disease. Animals infected in a manner that mimicked drinking had a more limited infection with no obvious disease signs. To what extent this work mirrors human infection remains unclear.

The study does suggest that infection through contaminated liquids like raw milk represents a risk for HPAI H5N1 infection of primates. The work cites the “local environment” in the stomach as potentially inactivating the virus and thus, possibly reducing the exposure dose. Scientists at NIAID’s Rocky Mountain Laboratories in Hamilton, Montana, led the work.

They exposed six animals each via the nose to mimic an upper-respiratory tract infection; the windpipe to mimic a lower-respiratory tract infection; and in the mouth and stomach to mimic consuming contaminated products. They used a dose of virus close to what has been found in contaminated raw milk. Researchers regularly monitored and examined animals for up to 14 days.

Animals exposed in the mouth and stomach became infected but showed no signs of influenza illness throughout the study. Animals exposed in the nose showed mild respiratory disease, peaking at day 10. Animals exposed in the windpipe showed severe respiratory illness within a week.

Reference: K Rosenke, A Griffin, F Kaiser, et al. Pathogenesis of bovine H5N1 clade 2.3.4.4b infection in Macaques. Nature DOI: 10.1038/s41586-025-08609-8 (2025).

Contact Information

Contact the NIAID Media Team.

301-402-1663
niaidnews@niaid.nih.gov

Search NIAID Blog

Michael S. Abers, M.D.

Section or Unit Name
Opportunistic Bacterial Pathogenesis Unit (OBPU)
Exclude from directory
Off
Section/Unit: Year Established
Section/Unit: Location
This Researcher/Clinician’s Person Page
Program Description

The Opportunistic Bacterial Pathogenesis Unit is interested in Nocardia infections. Our bench-to-bedside research program incorporates immunology, microbiology, genetics, and bioinformatics to investigate the pathogenesis of nocardiosis. A major goal of our research is to identify the key immunological mechanisms that control Nocardia. Insights from this work will inform future efforts to develop host-directed therapies for nocardiosis. Another area of interest is host- and pathogen-specific factors that determine patterns of dissemination and patient outcomes.

Selected Publications

Visit PubMed for a complete publication list.

Additional Information
Major Areas of Research
  • Inherited and acquired susceptibility to Nocardia infections (nocardiosis)
  • Host defense mechanisms that protect against nocardiosis
  • Development of host-directed therapies for Nocardia infection