Recurrent Respiratory Syncytial Virus Infection in a CD14-Deficient Patient

Sjanna B. Besteman, Emily Phung, Henriette H.M. Raeven, Gimano D. Amatngalim, Matevž Rumpret, Juliet Crabtree, Rutger M. Schepp, Lisa W. Rodenburg, Susanna G. Siemonsma, Nile Verleur, Rianne van Slooten, Karen Duran, Gijs W. van Haaften, Jeffrey M. Beekman, Lauren A. Chang, Linde Meyaard, Tjomme van der Bruggen, Guy A.M. Berbers, Nicole Derksen, Stefan NierkensKaitlyn M. Morabito, Tracy J. Ruckwardt, Evelyn A. Kurt-Jones, Douglas Golenbock, Barney S. Graham, Louis J. Bont

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


BACKGROUND: Recurrent respiratory syncytial virus (RSV) infection requiring hospitalization is rare and the underlying mechanism is unknown. We aimed to determine the role of CD14-mediated immunity in the pathogenesis of recurrent RSV infection. METHODS: We performed genotyping and longitudinal immunophenotyping of the first patient with a genetic CD14 deficiency who developed recurrent RSV infection. We analyzed gene expression profiles and interleukin (IL)-6 production by patient peripheral blood mononuclear cells in response to RSV pre- and post-fusion (F) protein. We generated CD14-deficient human nasal epithelial cells cultured at air-liquid interface (HNEC-ALI) of patient-derived cells and after CRISPR-based gene editing of control cells. We analyzed viral replication upon RSV infection. RESULTS: Sanger sequencing revealed a homozygous single-nucleotide deletion in CD14, resulting in absence of the CD14 protein in the index patient. In vitro, viral replication was similar in wild-type and CD14-/- HNEC-ALI. Loss of immune cell CD14 led to impaired cytokine and chemokine responses to RSV pre- and post-F protein, characterized by absence of IL-6 production. CONCLUSIONS: We report an association of recurrent RSV bronchiolitis with a loss of CD14 function in immune cells. Lack of CD14 function led to defective immune responses to RSV pre- and post-F protein without a change in viral replication.

Original languageEnglish
Pages (from-to)258-269
Number of pages12
JournalThe Journal of infectious diseases
Issue number2
Publication statusPublished - 24 Aug 2022
Externally publishedYes


  • CD14
  • epithelium
  • monocyte
  • respiratory syncytial virus
  • Toll-like receptor
  • Lipopolysaccharide Receptors/deficiency
  • Cytokines
  • Humans
  • Respiratory Syncytial Virus, Human
  • Leukocytes, Mononuclear/metabolism
  • Respiratory Syncytial Virus Infections


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