Influenza A virus infection induces muscle wasting via IL-6 regulation of the E3 ubiquitin ligase atrogin-1

Kathryn A. Radigan, Trevor Nicholson, Lynn C. Welch, Monica Chi, Luciano Amarelle, Martín Angulo, Masahiko Shigemura, Atsuko Shigemura, Constance E. Runyan, Luisa Morales-Nebreda, Harris Perlman, Ermelinda Ceco, Emilia Lecuona, Laura A. Dada, Alexander V. Misharin, Gokhan M. Mutlu, Jacob I. Sznajder*, G. R. Scott Budinger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Muscle dysfunction is common in patients with adult respiratory distress syndrome and is associated with morbidity that can persist for years after discharge. In a mouse model of severe influenza A pneumonia, we found the proinflammatory cytokine IL-6 was necessary for the development of muscle dysfunction. Treatment with a Food and Drug Administration–approved Ab antagonist to the IL-6R (tocilizumab) attenuated the severity of influenza A–induced muscle dysfunction. In cultured myotubes, IL-6 promoted muscle degradation via JAK/STAT, FOXO3a, and atrogin-1 upregulation. Consistent with these findings, atrogin-1 +/2 and atrogin-1 2 / 2 mice had attenuated muscle dysfunction following influenza infection. Our data suggest that inflammatory endocrine signals originating from the injured lung activate signaling pathways in the muscle that induce dysfunction. Inhibiting these pathways may limit morbidity in patients with influenza A pneumonia and adult respiratory distress syndrome.

Original languageEnglish (US)
Pages (from-to)484-493
Number of pages10
JournalJournal of Immunology
Issue number2
StatePublished - Jan 15 2019

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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