High expression of interleukin-18 receptor alpha correlates with severe respiratory viral disease and defines T cells with reduced cytotoxic signatures

A Aira F. Cabug J Jeremy Chase Crawford H Hayley A. McQuilten (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) I Isabelle J. H. Foo L Lilith F. Allen (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) D Deborah Gebregzabher R Robert C. Mettelman T Tanya Novak J Janet Chou L Louise C. Rowntree (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) R Ruth R. Hagen (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) A Abby J. Thomson G Genevieve E. Martin B Brad Gilbertson M Michael NT Souter F Fiona James E Emma Goodall S Simone Rizzetto (School of Biomedical Sciences, University of New South Wales) T Tim Flerlage X Xiaoxiao Jia L Lee-Ann Van de Velde S So Young Chang F Fabio Luciani (School of Biomedical Sciences, University of New South Wales) R Ryan S. Thwaites (National Heart and Lung Institute, Imperial College London) J Jason A. Trubiano (Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) T Tom C. Kotsimbos (Department of Respiratory Medicine, The Alfred Hospital) A Allen C. Cheng (School of Public Health and Preventive Medicine, Monash University) A Adrienne G. Randolph P Paul G. Thomas J Jianqing Xu (Shanghai Public Health Clinical Centre and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University) Z Zhongfang Wang T Thi H. O. Nguyen (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity) B Brendon Y. Chua L Lukasz Kedzierski K Katherine Kedzierska (Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity)

Abstract

Abstract Hyperactivated immunity underpins severe outcomes of respiratory viral infections, yet specific immune perturbations are ill-defined. Our recent findings identified OLAH (oleoyl-ACP-hydrolase) as a driver of life-threatening viral diseases. In the same patient cohorts, we now identify the gene encoding IL-18Rα chain ( IL18R1 ), as being highly expressed in life-threatening influenza, COVID-19, RSV and multisystem inflammatory syndrome in children (MIS-C) and demonstrate markedly elevated surface protein IL-18Rα expression on CD8 T cells in these infections. Using a mouse model of severe influenza, we further show that high IL-18Rα expression on effector T cells is associated with increased disease severity. We find that IL-18Rα expression on CD8 T cells is inversely associated with cytotoxicity-related genes, including granzyme A, granzyme B, perforin, Eomes, and KLRG-1. Our study demonstrates that IL-18Rα is associated with severe and fatal respiratory disease outcomes and proposes the use of IL-18Rα as a potential biomarker for severe respiratory viral disease.

Article Details

Volume / Issue Vol. 16, Issue 1
Published November 24, 2025
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (35)

A

Aira F. Cabug

J

Jeremy Chase Crawford

H

Hayley A. McQuilten

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

I

Isabelle J. H. Foo

L

Lilith F. Allen

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

D

Deborah Gebregzabher

R

Robert C. Mettelman

T

Tanya Novak

J

Janet Chou

L

Louise C. Rowntree

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

R

Ruth R. Hagen

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

A

Abby J. Thomson

G

Genevieve E. Martin

B

Brad Gilbertson

M

Michael NT Souter

F

Fiona James

E

Emma Goodall

S

Simone Rizzetto

School of Biomedical Sciences, University of New South Wales

T

Tim Flerlage

X

Xiaoxiao Jia

L

Lee-Ann Van de Velde

S

So Young Chang

F

Fabio Luciani

School of Biomedical Sciences, University of New South Wales

R

Ryan S. Thwaites

National Heart and Lung Institute, Imperial College London

J

Jason A. Trubiano

Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

T

Tom C. Kotsimbos

Department of Respiratory Medicine, The Alfred Hospital

A

Allen C. Cheng

School of Public Health and Preventive Medicine, Monash University

A

Adrienne G. Randolph

P

Paul G. Thomas

J

Jianqing Xu

Shanghai Public Health Clinical Centre and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University

Z

Zhongfang Wang

T

Thi H. O. Nguyen

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity

B

Brendon Y. Chua

L

Lukasz Kedzierski

K

Katherine Kedzierska

Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity