Extracorporeal Membrane Oxygenation–Dependent Fulminant Melioidosis From Caspase 4 Mutation Reversed by Interferon Gamma Therapy

Author:

Amali Aseervatham Anusha1,Ravikumar Sharada1,Chew Wei Leong23,Tan Zhaohong1,Sam Qi Hui13,Chen Kaiwen W45,Boucher Dave6,MacLaren Graeme78,Chai Louis Yi Ann139ORCID

Affiliation:

1. Division of Infectious Diseases, Department of Medicine, National University Health System , Singapore

2. Genome Institute of Singapore, Agency for Science, Technology and Research , Singapore

3. Synthetic Biology for Clinical and Technological Innovation, National University of Singapore , Singapore

4. Immunology Programme, Life Sciences Institute, National University of Singapore , Singapore

5. Immunology Translational Research Programme, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore

6. Department of Biology, York Biomedical Research Institute, University of York , York , United Kingdom

7. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore , Singapore

8. Cardiothoracic Intensive Care Unit, National University Heart Centre, National University Hospital , Singapore

9. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore , Singapore

Abstract

Abstract We describe bedside-to-bench immunological and genetic elucidation of defective pyroptosis attributable to novel caspase 4 defect mediating pathogen-triggered inflammatory programmed cell death, in the setting of severe pneumonia and abscess-forming melioidosis in an overtly healthy host failing to clear Burkholderia pseudomallei infection, and how targeted adjunctive biological therapy led to a successful outcome.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference16 articles.

1. Melioidosis, Singapore, 2003–2014;Pang;Emerg Infect Dis,2018

2. Melioidosis cases and selected reports of occupational exposures to Burkholderia pseudomallei—United States, 2008–2013;Benoit;MMWR Surveill Summ,2015

3. Melioidosis;Wiersinga;Nat Rev Dis Primers,2018

4. Inflammatory caspases: toward a unified model for caspase activation by inflammasomes;Ross;Annu Rev Immunol,2022

5. Cleavage of GSDMD by inflammatory caspases determines pyroptotic cell death;Shi;Nature,2015

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