Aberrant STAT signaling and T cell dysregulation define a targetable pediatric sepsis endotype

Clinical Research and Public HealthClinical ResearchImmunologyInflammation Open Access | 10.1172/JCI202867

Robert B. Lindell,1,2 Samir U. Sayed,3 Jose S. Campos Duran,3 Sydney A. Sheetz,3,4 Apoorva Babu,5 Montana S. Knight,5 Andrea A. Mauracher,3 Ceire A. Hay,3 Peyton E. Conrey,3 Julie C. Fitzgerald,1 Nadir Yehya,1 Stephen T. Famularo III,4 Teresa Arroyo,4 Richard Tustin III,3 Hossein Fazelinia,5 Edward M. Behrens,6 David T. Teachey,7 Lisa R. Forbes Satter,8 Alexandra F. Freeman,9 Jenna R.E. Bergerson,9 Steven M. Holland,9 Jennifer W. Leiding,10 Scott L. Weiss,11 Mark W. Hall,12 Deanne M. Taylor,13,14 Rui Feng,15 E. John Wherry,2,16 Nuala J. Meyer,2,17 and Sarah E. Henrickson2,18,19

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Lindell, R. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

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1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

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1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

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1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Babu, A. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Knight, M. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Mauracher, A. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Hay, C. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Conrey, P. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Fitzgerald, J. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Yehya, N. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Famularo, S. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Arroyo, T. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Tustin, R. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

11Division of Critical Care, Department of Pediatrics, Nemours Children’s Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA.

12Division of Critical Care, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

14Department of Pediatrics,

15Department of Biostatistics, Epidemiology, and Informatics,

16Department of Systems Pharmacology and Translational Therapeutics, and

17Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

18Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

19Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address correspondence to: Robert B. Lindell, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA. Phone: 215.590.1000; Email: LindellR@chop.edu.

Find articles by Fazelinia, H. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical Care, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

2Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

3Division of Allergy and Immunology, Department of Pediatrics,

4Division of Critical Care Medicine, Department of Anesthesia and Critical Care, and

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

6Division of Rheumatology, Department of Pediatrics and

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA.

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA.

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine and Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, USA.

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