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From the * Herman B Wells Center for Pediatric Research, Department of Pediatrics (Hematology-Oncology),
James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis,
Indiana 46202; and Mice with X-linked chronic granulomatous disease (CGD) generated by targeted disruption of
the gp91phox subunit of the NADPH-oxidase complex (X-CGD mice) were examined for their
response to respiratory challenge with Aspergillus fumigatus. This opportunistic fungal pathogen
causes infection in CGD patients due to the deficient generation of neutrophil respiratory burst oxidants important for damaging A. fumigatus hyphae. Alveolar macrophages from X-CGD
mice were found to kill A. fumigatus conidia in vitro as effectively as alveolar macrophages from
wild-type mice. Pulmonary disease in X-CGD mice was observed after administration of doses
ranging from 105 to 48 spores, none of which produced disease in wild-type mice. Higher
doses produced a rapidly fatal bronchopneumonia in X-CGD mice, whereas progression of
disease was slower at lower doses, with development of chronic inflammatory lesions. Marked
differences were also observed in the response of X-CGD mice to the administration of sterilized Aspergillus hyphae into the lung. Within 24 hours of administration, X-CGD mice had
significantly higher numbers of alveolar neutrophils and increased expression of the proinflammatory cytokines IL-1
Physiology Program, Department of Environmental Health, Harvard School of
Public Health, Boston, Massachusetts 02115
and TNF-
relative to the responses seen in wild-type mice. By one
week after administration, pulmonary inflammation was resolving in wild-type mice, whereas
X-CGD mice developed chronic granulomatous lesions that persisted for at least six weeks.
This is the first experimental evidence that chronic inflammation in CGD does not always result from persistent infection, and suggests that the clinical manifestations of this disorder reflect
both impaired microbial killing as well as other abnormalities in the inflammatory response in
the absence of a respiratory burst.
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