Supplementary Material for: Highly Pathogenic Influenza Viruses Inhibit Inflammatory Response in Monocytes via Activation of Rar-Related Orphan Receptor RORa

Infections with highly pathogenic avian influenza viruses (HPAIV) in humans lead to systemic disease associated with cytokine storm and multiorgan failure. In this study we aimed to identify the role of monocytes for the host response to HPAIV infection. Using genome-wide microarray analysis, we surprisingly demonstrate a reduced immune response of human monocytes to HPAIV H5N1 compared to human influenza A viruses. In bioinformatic analyses we could reveal a potential role of the Rar-related orphan receptor alpha (RORa) for the gene expression pattern induced by H5N1. RORa is known as an inhibitor of NF-κB signaling. We provide evidence that in monocytes RORa is activated by H5N1, resulting in inhibited NF-κB signaling. Using murine Hoxb8-immortalized RORa<sup>-/-</sup>, monocytes rescued NF-κB signaling upon H5N1 infection, confirming the biological relevance of RORa as an H5N1-induced mediator of monocytic immunosuppression. In summary, our study reveals a novel RORa-dependent escape mechanism by which H5N1 prevents an effective inflammatory response of monocytes blocking NF-κB-dependent gene expression.