Mathematical model of antiviral immune response. III. Influenza A virus infection.

We present an approach to studying theoretically the regularities and the kinetic characteristics of influenza A virus (IAV) infection in man. The estimates of the "numbers" (Zinkernagel et al., 1985) characterizing evolutionary established interferon and immune responses in uncomplicated IAV infection are explored by developing a multiparameter mathematical model which allows direct quantitative references to the biological reality. The system of equations of the mathematical model of antiviral immune response, applied earlier to acute hepatitis B virus infection (Marchuk et al., 1991a, b), is modified and extended to describe the joint reaction of the interferon and immune systems in IAV infection. Macrophages infiltrating the airway's epithelium are considered to be the principal source of interferon that induces antiviral resistance in lung epithelial cells. The model is formulated as a delay-differential system with about 60 parameters characterizing the rates of various processes contributing to the typical course of IAV infection. The key aspect of the adjustment between the model and various data on the immunity to influenza is the derivation of a consistent data set--the generalized picture of uncomplicated IAV infection. It serves as a consistent theoretical definition of the structure of the normal course of the infection and the antiviral immune response suitable for model fitting. The parameter estimates for the processes considered in the model are carefully discussed. The quantitative model is used to study the organization and dynamic properties of the processes contributing to IAV infection. The threshold condition for immune protection of virus-free host to infection with IAV is analyzed. The relative roles of humoral, cellular and interferon reactions for the kinetics of the uncomplicated IAV infection are studied. The contribution of parameters of virus-sensitive tissue, interferon and IAV-specific immune processes to the variations of duration and severity of the infection is quantitatively estimated by sensitivity studies. It is shown that the variations in the parameters of a virus-epithelial cell system are more influential on the severity of the infection rather than that of the antiviral immune response. The need for fine co-ordination of the kinetics of the non-specific interferon response and the adaptive antigen-specific immune reactions to provide recovery from the infection is illustrated.