Pandemic Influenza Infection Persists in Cardiac Tissue and Leads to MLKL-Dependent Proteome and Phosphoproteome Remodeling During Convalescence

Influenza-related cardiac complications have been increasingly defined in the clinical setting. Recent reports support a direct link between laboratory-confirmed influenza infection and adverse cardiac events. Here, we define candidate molecular mediators underlying influenza virus-induced cardiac pathogenesis after the resolution of pulmonary infection, as well as the potential role of necroptosis in this process using mice deficient in its effector molecule MLKL. Global proteome and phosphoproteome analyses using high resolution accurate mass-based LC-MS/MS and label-free quantitation was used. Both the global proteome and the phosphoproteome profiles were significantly altered in IAV-infected mouse hearts, with significantly altered expression of mitochondrial and muscle contraction protein levels and phosphorylation states. Intriguingly, necroptosis deficient mice showed partial protection from IAV-mediated proteomic changes. We confirmed changes in energy state and mitochondrial dysfunction in vitro and define molecular candidates for therapeutics targeting necroptosis and oxidative stress in cardiac tissue after influenza infection.