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Journal of Virology, August 1999, p. 6380-6386, Vol. 73, No. 8
0022-538X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Neutrophils Aid in Protection of the Vaginal
Mucosae of Immune Mice against Challenge with Herpes Simplex Virus
Type 2
Gregg N.
Milligan*
Division of Infectious Diseases, Children's
Hospital Medical Center, and Department of Pediatrics, University
of Cincinnati College of Medicine, Cincinnati, Ohio 45229
Received 24 February 1999/Accepted 3 May 1999
 |
ABSTRACT |
Large numbers of polymorphonuclear leukocytes (PMNs) infiltrated
the murine vaginal mucosa within 24 h after intravaginal inoculation with an attenuated strain of herpes simplex virus type 2 (HSV-2). The role of these cells in resolution of a primary genital
infection and in protection of HSV-immune animals against challenge
with a fully virulent HSV-2 strain was investigated. Depletion of
greater than 95% of the PMNs at the vaginal mucosal surface prior to
intravaginal inoculation with an attenuated HSV-2 strain resulted in
significantly higher virus titers on days 3 to 7 but only slightly
delayed resolution of the primary genital infection. These results
suggest that neutrophils helped control the infection but that other
immune mechanisms ultimately cleared the virus. Interestingly,
depletion of PMNs from HSV-immune mice prior to challenge with a fully
virulent HSV-2 strain resulted in a rise in virus titers to levels
comparable to those of nonimmune mice and a more pronounced diminution
of virus clearance from the vaginal mucosa despite the presence of
HSV-specific B and T cells. Levels of gamma interferon (IFN-
) and
HSV-specific antibody were comparable in neutrophil-depleted and
control-treated immune mice following HSV-2 challenge, suggesting that
RB6-8C5 treatment did not impair T- and B-cell function. Therefore,
these results suggest that neutrophils play a role in limiting and
clearing HSV-2 vaginal infections and that they are, in association
with HSV-specific B and T cells, an important component in immune
protection of the vaginal mucosa.
 |
INTRODUCTION |
Herpes simplex virus type 2 (HSV-2)
typically initiates infection of humans at mucosal membranes. The virus
replicates within epithelial cells, ascends sensory neurons, and
establishes a latent infection within the sensory ganglia, thereby
ensuring a lifelong infection of its host (10, 33). Periodic
reactivation of latent HSV-2 may result in clinical disease with the
formation of recurrent lesions at the epithelial surface or
asymptomatic shedding, which increases the chances of spread to new
individuals (34). The lesions which develop following
symptomatic genital HSV-2 infection are not only painful but can also
serve as portals of entry for other sexually transmitted pathogens,
such as human immunodeficiency virus (11, 40). Effective
vaccines are clearly needed to protect the genital mucosa and sensory
ganglia from infection in order to prevent the establishment of latent
HSV-2 infections and spread of HSV disease. However, much remains to be
learned about the immune mechanisms which protect these sites.
In experimental animals, genital inoculation with attenuated strains of
HSV-2 results in immune protection against subsequent HSV-2 exposure
and serves as a useful model for examining the immune mechanisms
protecting the vaginal mucosa and sensory ganglia (16, 20, 24,
31). Using a mouse model of genital inoculation with a thymidine
kinase-deficient strain of HSV-2 (HSV-2 TK
) as a paradigm
for an effective vaccine, we have previously shown that clearance of
HSV-2 from the vaginal mucosae of normal mice is T cell dependent and
is mediated primarily by mechanisms involving CD4+ T cells
(18, 19). Although virus clearance is likely influenced by
several cytokines, including gamma interferon (IFN-
) (19, 20), the exact mechanisms responsible for resolution of HSV-2 genital infections are not well understood.
Polymorphonuclear leukocytes (PMNs) have long been recognized as a
first line of defense in protection against pyogenic bacteria and
fungi. However, their role in the resolution of infections involving
facultative intracellular bacteria (6, 38) and viruses
(35, 36) is also increasingly appreciated. Neutrophils represent the predominant leukocyte population in the vaginal epithelium (21), and they have been suggested to play a role in protection against genital infection with sexually transmitted pathogens, such as Chlamydia trachomatis (1). In
this study, we demonstrated that large numbers of PMNs (primarily
neutrophils) infiltrated the vaginal mucosa by 24 h after HSV-2
inoculation. Depletion of neutrophils prior to primary genital HSV-2
inoculation resulted in significantly higher virus titers over a period
of 4 days but only slightly delayed resolution of the infection. In
contrast, depletion of neutrophils from HSV-immune mice prior to
challenge resulted in a more dramatic decrease in the ability to clear
HSV-2 from the vagina, despite the presence of HSV-specific T and B
cells. These results provide evidence that neutrophils play a role in
clearance of HSV-2 from the genital mucosa. Further, the surprising
dependence of HSV-immune mice on neutrophil-mediated protection during
the first few days after challenge highlights the interactions among
many cell types, both adaptive and innate, in immune protection of the
genital tract against viral pathogens.
 |
MATERIALS AND METHODS |
Virus.
The thymidine kinase-deficient HSV-2 strain 333 (HSV-2 TK
) (30) and the fully virulent HSV-2
strain 186 were obtained originally from Lawrence Stanberry
(Children's Hospital Medical Center, Cincinnati, Ohio). Working stocks
of both strains were prepared by infection of Vero cell monolayers at a
multiplicity of infection of 0.01, release of virus by three cycles of
freeze-thaw, and storage of the clarified virus preparation at
70°C
as described previously (18).
Mice.
Six- to 8-week-old outbred Swiss Webster mice were
obtained from Harlan Sprague-Dawley (Indianapolis, Ind.) and housed in sterile microisolator cages. The Children's Hospital Research Foundation animal facility is approved by the American Association for
the Accreditation of Laboratory Animal Care.
Intravaginal inoculation of mice.
Mice were immunized by
intravaginal inoculation with 5 × 105 PFU of HSV-2
TK
or challenged intravaginally with 5 × 104 PFU of HSV-2 186 by a modification of the procedure
described previously (20). The vaginal epithelium was
prepared for inoculation by injecting the mice subcutaneously twice in
a 1-week period with 3.0 mg of medoxyprogesterone acetate (The Upjohn
Company, Kalamazoo, Mich.). Mice under sodium pentobarbital anesthesia were inoculated by swabbing with a calcium alginate swab followed by
instillation of 20 µl of medium containing the desired HSV-2 inoculum
into the vaginal lumen.
In vivo depletion of neutrophils.
Mice were depleted of
neutrophils by intraperitoneal injection of 0.5 mg of the
granulocyte-specific monoclonal antibody RB6-8C5 (9)
(obtained from Robert Coffman, DNAX Research Institute, Palo Alto,
Calif.). The antibody was partially purified as described previously
(19, 20) by ammonium sulfate precipitation of serum-free hybridoma culture supernatants. For neutrophil depletion during primary
vaginal infection, antibody treatments began either the day prior to
(day
1) or 2 days after (day +2) virus inoculation and continued
every other day through day 8 postinoculation. For neutrophil depletion
in HSV-immune mice, antibody treatments began 2 days prior to virus
challenge and continued every other day through day 8 postchallenge.
Control mice received 0.5 mg/dose of the isotype-matched
rat-immunoglobulin G (IgG) monoclonal antibody SFR8-B6 (anti-HLA-Bw6).
Neutrophil depletion at the vaginal mucosal surface was assessed by
determining viable and differential cell counts of leukocytes obtained
by vaginal lavage. Briefly, the vaginal vault was washed three times
with 60 µl of Hank's balanced salt solution with 5% newborn calf
serum. Viable leukocyte numbers were obtained from hemocytometer counts
of lavage cells which excluded the viable strain trypan blue. To obtain
differential cell counts, an aliquot of the lavage fluid was spun onto
glass slides and stained with a differential stain kit (Hema 3; Fisher Scientific Co., Pittsburgh, Pa.). A minimum of 100 cells/slide were
counted to obtain the percentages of neutrophils, monocytes, and
lymphocytes in the vaginal-lavage sample. Total numbers of viable
neutrophils were estimated by the following formula: total number of
viable lavage cells × percentage of lavage cells comprised of
neutrophils = total viable neutrophils.
Quantification of HSV-specific IgG antibody.
Mice under
methoxyflurane anesthesia were bled via the retroorbital plexus to
obtain serum for antibody analysis. Vaginal secretions were collected
by three successive washes of the vaginal vault with 60 µl of
phosphate-buffered saline. Samples were stored frozen at
20°C and
clarified by centrifugation prior to antibody quantification. For
antibody quantification, a standard curve was prepared on each plate by
plating a series of twofold dilutions of purified mouse IgG (Sigma, St.
Louis, Mo.) in wells coated previously with anti-mouse immunoglobulin
(Caltag, San Francisco, Calif.). A series of fivefold dilutions of
serum samples beginning at 1:50 for immune sera or 1:20 for nonimmune
sera were plated on wells coated previously with glycoprotein
preparations from HSV-2-infected or uninfected cells (20).
For quantification of vaginal antibody, a series of threefold dilutions
of vaginal wash were plated on glycoprotein-coated wells. The plates
were incubated at ambient temperature for 1 h, washed, and then
developed by sequential additions of biotinylated anti-mouse IgG
antibody (Southern Biotechnology, Birmingham, Ala.),
peroxidase-conjugated goat anti-biotin antibody (Vector Laboratories,
Birlingame, Calif.) and o-phenylenediamine
dihydrochloride-hydrogen peroxide (Sigma). The optical density at 490 nm (OD490) was determined on a Thermo Max microplate reader
(Molecular Devices, Sunnyvale, Calif.). Standard curves were generated,
and antibody levels in unknown samples were calculated with the Softmax
software program (Molecular Devices).
Quantification of IFN-
in vaginal secretions.
Vaginal
secretions were collected by vaginal lavage and the IFN-
present was
quantified by specific enzyme-linked immunosorbent assay as described
previously (19, 20). Briefly, 96-well plates were coated
with 50 µl of purified anti-IFN-
(R4-6A2) at 5 µg/ml in
carbonate buffer (pH 8.8) and incubated overnight at 4°C. After the
plates were blocked with phosphate-buffered saline plus 5% bovine
serum albumin, a series of twofold dilutions of recombinant IFN-
(Sigma) or undiluted vaginal lavage samples were plated in duplicate
and incubated overnight at 4°C. The plates were washed and incubated
with rabbit anti-murine IFN-
antibody (Biosource International,
Camarillo, Calif.) followed by peroxidase-conjugated goat anti-rabbit
IgG (United States Biochemical, Cleveland, Ohio). The plates were
washed and developed with o-phenylenediamine
dihydrochloride-peroxide in citrate buffer, followed by determination
of the OD490. The limit of detection of the assay was
considered to be the last concentration of recombinant IFN-
standard
which gave an OD490 value greater than the mean
OD490 plus 3 standard deviations of at least 12 wells
receiving only diluent and was less than 0.5 U/ml.
Statistical analysis.
The data were analyzed by one-way
analysis of variance with the Bonferroni correction for multiple groups.
 |
RESULTS |
We previously used a murine model of intravaginal inoculation with
a TK
strain of HSV-2 to examine the immune mechanisms
which protect the genital mucosa. Although intravaginal inoculation
with fully virulent HSV-2 normally results in death due to
encephalitis, HSV-2 TK
does not replicate well in neurons
(30) and is cleared from the vaginae of nonimmune mice
within 6 to 7 days of inoculation (19). Mice immunized
intravaginally with HSV-2 TK
develop immune responses
which do not prevent reinfection but do result in rapid clearance of
fully virulent HSV-2 strains from the vagina (16, 20, 24).
Virus clearance is T cell dependent and is primarily mediated by
Th1-type CD4+ T cells. IFN-
is important in rapid
clearance of HSV-2 TK
from the vaginae of normal mice as
well as in the protection of the vaginal mucosae of HSV-immune mice
(19, 20), although the exact mechanism responsible for this
protection is not understood.
Neutrophil infiltration into the vaginal mucosae of nonimmune mice
following intravaginal inoculation with HSV-2 TK
.
We
previously showed that HSV-specific T cells infiltrated the vaginal
mucosae of nonimmune mice by day 5 after inoculation (18).
In the present studies we examined the vaginal mucosa at earlier times
after HSV-2 TK
inoculation to identify other cell types
which may be involved in the immune protection of the vaginal mucosa. A
small, naturally occurring population of leukocytes was detected at the
vaginal surfaces of normal mice prior to virus inoculation (day 0).
However, within 24 h after inoculation, a large population of
leukocytes had migrated to the vaginal surface (Fig.
1A). This cellular response was
maintained through day 4 and then decreased to preinoculation levels by
day 6. The majority (>95%) of leukocytes at the vaginal surfaces of
uninfected mice were identified as neutrophils (Fig. 1B). The initial
influx of cells at 24 h after HSV-2 inoculation was also
predominantly neutrophils. However, by 48 h after inoculation the
number of monocytes had increased such that approximately equal numbers
of monocytes and neutrophils were present at the vaginal surface.
Neutrophils predominated in the cellular response thereafter as the
number of monocytes diminished and the vaginal mucosa returned to a
preinoculation state. Lymphocytes were detected in the vaginal lavage
by day 2 after inoculation but never constituted more than 10% of the
leukocytes present in vaginal-lavage cells.

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FIG. 1.
Composition of vaginal lavage cells following primary
inoculation with HSV-2 TK . Leukocytes were collected by
vaginal lavage from six Swiss Webster mice on the indicated day
relative to intravaginal inoculation with HSV-2 TK .
Viable cell counts (A) were obtained by trypan blue exclusion, and the
percentages of neutrophils, monocytes, and lymphocytes were determined
by differential staining (B). The results from one experiment of two
performed are shown.
|
|
Role of neutrophils in resolution of a primary genital HSV-2
TK
infection.
The role of neutrophils in resolution
of a primary genital HSV-2 infection was examined by in vivo depletion
with the granulocyte-specific monoclonal antibody RB6-8C5
(9). Outbred Swiss Webster mice were injected
intraperitoneally with RB6-8C5 or control rat IgG beginning either the
day before (day
1) or 2 days after (day +2) intravaginal HSV-2
TK
inoculation. The number of neutrophils at the vaginal
surface rapidly increased in control IgG-treated mice following HSV-2 inoculation, remained high through day 5, and fell to preinoculation levels after day 7 as the infection was resolved (see Fig. 3). In
contrast, vaginal neutrophil numbers in RB6-8C5-treated mice remained
extremely low through day 9 (Fig. 2).
Vaginal neutrophils in mice treated beginning day
1 were
significantly reduced compared to those in control-treated mice on days
1 (P < 0.02), 3 (P < 0.01), and 5 (P < 0.001). Similarly, a significant reduction was observed on days 3 (P < 0.05), 5 (P < 0.001), and 7 (P < 0.05) in mice treated
beginning day +2.

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FIG. 2.
Depletion of neutrophils from the vaginal mucosa by
injection of RB6-8C5 antibody. Groups of eight Swiss Webster mice were
treated with monoclonal antibody RB6-8C5 or control rat IgG (SFR8-B6;
anti-HLA-Bw6) beginning the day prior to (day 1) intravaginal
inoculation with HSV-2 TK or with RB6-8C5 beginning 2 days after intravaginal inoculation (day +2). Vaginal leukocytes were
collected by lavage on the days indicated relative to intravaginal
HSV-2 TK inoculation, and the number of neutrophils was
determined from viable and differential cell counts as described in
Materials and Methods. Neutrophil counts from mice treated with RB6-8C5
on day +2 were obtained only on days 3 to 9. Values marked with an
asterisk are significantly different than values from control
IgG-treated mice (P < 0.05). SD, standard deviation.
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|
Vaginal swabs were taken daily from these mice after inoculation to
assess the effect neutrophil depletion had on resolution
of the primary
genital infection. Results of earlier studies (
20,
23) have
shown that nonimmune mice pretreated with progesterone
are susceptible
to vaginal HSV-2 infection as detected by the
presence of HSV-2 in the
vagina through at least day 6 postinoculation.
In contrast, no virus is
detected at times greater than 24 h in
mice inoculated during the
estrous phase of the reproductive cycle,
indicating that the infection
does not take and the original inoculum
does not remain viable in the
mouse vagina (
17). Therefore,
virus titers at 24 h
represent replicating virus and not the original
inoculum. Vaginal
HSV-2 titers in mice treated with RB6-8C5 beginning
day

1 were
comparable to those in control IgG-treated mice on
the first 2 days
after inoculation but were significantly higher
than those in controls
on days 3 to 6 (
P < 0.001) (Fig.
3). In
fact, the titers were
approximately 100-fold higher on days 4
and 5 compared to those in
control mice. However, resolution of
the infection was delayed by only
3 days. RB6-8C5 treatment could
be delayed until day 2 after
inoculation and still delay the resolution
of the infection. Virus
titers in mice depleted of neutrophils
beginning day +2 were
significantly higher than those in control
IgG-treated mice on days 3 and 5 to 7. Although neutrophils remained
depleted in these mice
through day 9 (Fig.
2), the virus was ultimately
cleared in 7 of 8 RB6-8C5-treated mice by day 9.

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FIG. 3.
Resolution of primary genital HSV-2 infection in
neutrophil-depleted Swiss Webster mice. Groups of eight Swiss Webster
mice were treated with a control rat IgG monoclonal antibody or RB6-8C5
beginning 1 day before or 2 days after intravaginal HSV-2
TK inoculation. Vaginal swabs were taken daily, and mean
HSV-2 titers from each group were determined by titration on Vero cell
monolayers. The values marked with asterisks differ significantly from
control IgG group values (P < 0.05). The results shown
are from a representative experiment of three performed. SEM, standard
error of the mean.
|
|
Role of neutrophils in protection of the vaginal mucosae of
HSV-immune mice.
Mice immunized by intravaginal inoculation of
HSV-2 TK
exhibit rapid virus clearance upon challenge
with fully virulent strains of HSV-2 (16, 20, 24). The
involvement of neutrophils in this protection of the vaginal mucosae of
immune mice was examined. A rapid influx of leukocytes into the vaginal
tract was detected following intravaginal challenge of HSV-immune mice
and was similar in magnitude and cellular composition to that observed
following primary inoculation of nonimmune mice (Fig.
4A). As shown previously for uninoculated
mice, low numbers of leukocytes were present at the vaginal surfaces of
HSV-immune mice prior to rechallenge. The number of viable leukocytes
in challenged HSV-immune and nonimmune mice began increasing by 24 h postinoculation and then rose sharply by day 2. After a 2-day
plateau, cell numbers rose again after day 4 in nonimmune mice. In
contrast, vaginal leukocytes decreased to prechallenge levels in
HSV-immune mice after day 3 as virus was cleared from the vaginal
tissue (Fig. 5, experiment 1). As demonstrated previously for nonimmune mice (Fig. 1B), the cellular infiltrate in HSV-immune mice was composed primarily of neutrophils on
day 1 (Fig. 4B). An influx of monocytes was detected on days 2 to 3 in
HSV-immune mice, which declined through day 8 as the infection was
cleared. Few lymphocytes were detected in the vaginal lumen on any day
after challenge.

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FIG. 4.
Magnitude and composition of the leukocyte infiltrate in
the vaginae of HSV-immune mice after rechallenge with HSV-2. Vaginal
washes were taken from groups of four HSV-immune or nonimmune Swiss
Webster mice on the days indicated relative to HSV-2 challenge. The
number of viable vaginal leukocytes (A) was obtained by trypan blue
exclusion, and the percentage of vaginal leukocytes composed of
neutrophils, monocytes, or lymphocytes in HSV-2-rechallenged immune
mice (B) was determined by differential staining. Swelling of vaginal
tissue in nonimmune mice challenged with HSV-2 strain 186 prevented
taking accurate samples after day 6. The results from one experiment of
two performed are shown. SD, standard deviation.
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FIG. 5.
Effect of neutrophil depletion on protection of the
vaginal mucosae of HSV-immune mice against HSV-2 reinfection. Swiss
Webster mice were immunized by intravaginal inoculation with HSV-2
TK . Four weeks later, groups of eight immune mice were
treated with RB6-8C5 or control rat IgG monoclonal antibody. These mice
and age-matched nonimmune mice were challenged intravaginally 2 days
later with 5 × 104 PFU of HSV-2 186. Daily vaginal
swabs were taken to quantitate HSV-2. Values marked with asterisks
differ significantly from those for control IgG-treated HSV-immune mice
(P < 0.001). Results from two of four experiments
performed are shown. SEM, standard error of the mean.
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We have shown that T lymphocytes play a very important role in the
resistance of HSV-immune mice within 24 h after HSV-2 challenge
(
20). HSV-immune mice were depleted of neutrophils to
determine
if these cells were involved in this early
T-cell-orchestrated
protection of the vaginal mucosa. The mice were
immunized by intravaginal
inoculation with HSV-2 TK

. Four
weeks later, immune mice were depleted of neutrophils or
control
treated prior to challenge with fully virulent HSV-2 strain
186. Neutrophil depletion was consistently less complete over
time in
HSV-immune mice. Although treatment of immune mice with
RB6-8C5
resulted in depletion of greater than 95% of vaginal neutrophils
on
the day of virus challenge, only a 68% depletion of vaginal
neutrophils was observed on day 8. As shown in Fig.
5, HSV-2 titers
in
the vaginae of immune mice were reduced greater than 90% on
the first
day after challenge compared to those in nonimmune mice,
and virus was
cleared from the genital mucosae by day 6. In contrast
to the delay in
neutrophil participation in HSV-2 clearance observed
in nonimmune mice
(Fig.
3), neutrophils from HSV-immune mice apparently
played a role in
virus clearance as soon as 24 h after HSV-2 challenge,
as virus
titers in neutrophil-depleted mice were significantly
higher
(
P < 0.01) at this time than those in control-treated
mice.
Although HSV-2 was cleared from the vaginal mucosae of
neutrophil-depleted
HSV-immune mice by day 8, virus titers remained
high through day
6 after challenge and exceeded those of nonimmune mice
on days
3 to
5.
Effect of neutrophil depletion on HSV-specific B- and T-cell
responses.
To test if RB6-8C5 treatment might have negatively
affected the antigen-specific immune mechanisms necessary for rapid
virus clearance in HSV-immune mice, we quantified vaginal HSV-specific antibody and IFN-
levels in neutrophil-depleted and control-treated immune mice as a measure of B- and T-cell function. HSV-specific serum
and vaginal IgG levels were comparable in neutrophil-depleted and
control-treated HSV-immune mice on the day of HSV-2 challenge (P > 0.05) and titers in both groups increased through
day 8 (Table 1). RB6-8C5 treatment did not diminish the local antibody
response during the infection, as HSV-specific vaginal IgG levels were higher in neutrophil-depleted mice than in control-treated mice on day
8 after challenge (Table 1).
We have previously shown that T-cell-secreted IFN-

could be detected
in the vaginal secretions of HSV-immune mice by 24 h
after HSV-2
challenge and that this IFN-

was important for rapid
clearance of
virus (
20). In the present experiments, IFN-

was
not
detected in vaginal secretions of immune mice prior to HSV-2
challenge
(day 0) whereas comparable levels of IFN-

were detected
in vaginal
secretions of neutrophil-depleted and control-treated
HSV-immune mice
on days 1 and 2 after challenge (Fig.
6).
IFN-
levels in the control-treated group fell thereafter as the
virus
was cleared (Fig.
5, experiment 1). However, IFN-

levels
continued
to rise through day 5 in RB6-8C5-treated mice, suggesting
that
antibody treatment did not interfere with T-cell-mediated IFN-
production during the infection. Interestingly, HSV-2 titers remained
high in the vaginal tissue of neutrophil-depleted immune mice
(Fig.
5)
despite the presence of high levels of IFN-

in vaginal
secretions
(Fig.
6).

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FIG. 6.
Production of IFN- in vaginal tracts of HSV-immune
mice following HSV-2 rechallenge is unaffected by depletion of
neutrophils. Swiss Webster mice were immunized by intravaginal
inoculation with HSV-2 TK . After 4 weeks, groups of eight
mice were treated with RB6-8C5 or control rat IgG. Two days later,
HSV-immune groups and age-matched nonimmune mice were challenged
intravaginally with 5 × 104 PFU of HSV-2 186. Vaginal
washes were taken on the indicated days relative to HSV-2 challenge,
and the concentration of IFN- in vaginal secretions was determined
by enzyme-linked immunosorbent assay. Swelling of vaginal tissue in
nonimmune mice challenged with HSV-2 186 prevented taking accurate
samples after day 6. The results marked with asterisks are
significantly different from those of control IgG-treated mice
(P < 0.05). The results of a representative experiment
of three performed are shown. SEM, standard error of the mean.
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 |
DISCUSSION |
Neutrophils are the most common leukocytes present in the vaginal
epithelia of normal mice (5, 21). Sonoda et al.
(29) demonstrated neutrophil migration into the vaginal
epithelia during the metestrus-2 phase of the murine reproductive
cycle, resulting from local production of the murine interleukin-8
homologue protein, macrophage inflammatory protein 2. In agreement with
these findings, we detected a leukocyte population consisting
predominantly of neutrophils in the vaginal lavage of
progesterone-treated, uninfected mice. Additionally, large numbers of
neutrophils infiltrated the vaginal mucosa within 24 h of
intravaginal HSV-2 inoculation and were maintained until virus was
cleared from the mucosa.
Treatment of Swiss Webster mice with RB6-8C5 antibody prior to
intravaginal inoculation with an attenuated HSV-2 strain severely depleted the number of neutrophils present at the vaginal mucosal surface and resulted in significantly higher HSV-2 titers over a 4-day
period compared to those in control-treated animals. Our results
suggest that neutrophils contributed to the resolution of a primary
HSV-2 genital infection in normal mice only after the second day
postinoculation (Fig. 3). It seems unlikely that this reflects
insufficient neutrophils at the site of infection during this time,
since large numbers of vaginal neutrophils were detected in
control-treated animals during the first 48 h of infection (Fig. 1
and 2). It is possible that this delay reflects a requirement for
optimal neutrophil activation by cytokines produced by the macrophages
and lymphocytes which infiltrate the vaginal mucosa later after HSV-2
inoculation (18). Interestingly, the infection was
eventually cleared even though vaginal neutrophil numbers remained
extremely low, suggesting that neutrophils were not strictly required
for virus clearance and that other immune mechanisms resolved the
infection. These results are consistent with a model in which HSV-2
infection of the vaginal epithelia initiates the early infiltration of
neutrophils and macrophages into vaginal tissue followed later by
antigen-specific T cells (18). Optimal neutrophil activation
may require local production of cytokines, such as IFN-
, tumor
necrosis factor alpha, and granulocyte-monocyte colony-stimulating
factor by infiltrating T cells and macrophages. Virus clearance and
resolution of the primary infection may then be mediated, at least in
part, by activated neutrophils. Although such a mechanism may be
important for quick resolution of the infection, alternative immune
mechanisms mediated by macrophages or HSV-specific CD4+ and
CD8+ T lymphocytes ultimately eliminate the infection.
The delay in clearance of HSV-2 from the vaginal mucosae of
neutrophil-depleted mice is similar to the results of Tumpey et al.
(36) and Thomas et al. (35), in which replication
of HSV-1 was prolonged in the corneas of neutrophil-depleted BALB/c
mice. The rapid neutrophil infiltration documented in this study
extends their results to suggest that migration of neutrophils to
HSV-infected tissue is a common event not dependent on the inoculation
site. Interestingly, Thomas et al. (35) documented two
distinct phases of neutrophil infiltration into the eye following HSV-1
inoculation. Although the first phase provided protection, the second
influx of neutrophils was implicated along with CD4+ T
cells in tissue destruction. While the results of the current study
demonstrate the protective function of vaginal neutrophils against
HSV-2 infection, the occurrence and extent of any coincidental genital-tissue damage due to the presence of large numbers of activated
granulocytes was not determined. Perineal scarring is a relatively
common event following resolution of primary HSV-2 infection in mice
(39, 42). The extent to which neutrophils may be involved in
this damage of perivaginal or other genital tissue is not known and
will be the subject of future investigation.
Although neutrophil depletion diminished the ability of nonimmune mice
to resolve a primary HSV-2 TK
infection, these cells
appeared to be very important for protection of the vaginal mucosae of
immune mice against challenge with a fully virulent HSV-2 strain.
Importantly, virus in neutrophil-depleted immune mice quickly
replicated to levels comparable to those in nonimmune mice despite the
presence of HSV-specific antibody and IFN-
in vaginal secretions at
levels comparable to those in control-treated immune mice. These
results strongly suggest that the diminished protection was directly
due to a loss of neutrophil effector function rather than an
unintentional alteration of antigen-specific B- or T-cell function. The
exact mechanism by which neutrophils clear HSV-2 is currently unknown
but may include phagocytosis of free virions or virus-infected cells
(2, 37), release of antiviral cytokines (3) or
defensins (7, 8), and antibody-dependent cell-mediated
cytolysis of HSV-infected cells (22, 28). Additionally, given the ability of human neutrophils to secrete cytokines, including interleukin-12 (4) and IFN-
(43), local
release of these cytokines by tissue neutrophils may help bias immune
responses towards the development of protective Th1 responses.
The depletion of vaginal neutrophils decreased over time in HSV-immune
mice, ranging from 95% on the day of challenge to 68% on day 8. It is
possible that the clearance of virus in RB6-8C5-treated immune mice was
ultimately due to either the presence of increasing numbers of
neutrophils or an influx of antigen-specific effector T cells.
Therefore, a strict requirement for neutrophils to completely resolve
the infection in HSV-immune mice remains speculative. Nonetheless, the
presence of 100- to 1,000-fold-higher HSV-2 titers in
neutrophil-depleted mice than in control-treated mice during the first
few days after challenge demonstrates the importance of these cells in
protection of the vaginal mucosa and underscores the importance of the
innate arm of the immune response in protection against viral pathogens.
HSV-2 titers remained high in neutrophil-depleted, HSV-immune mice even
in the prolonged presence of high concentrations of IFN-
in the
vaginal tract (Fig. 5 and 6). These results suggest that the main
protective effect of IFN-
in this model was most likely due to its
ability to activate immune cells such as infiltrating neutrophils
rather than to a direct antiviral effect (14). Other cytokines known to activate PMNs, such as tumor necrosis factor alpha
and granulocyte-monocyte colony-stimulating factor (32), are
most likely also involved in activation of neutrophils in this model.
Release of these cytokines by HSV-specific memory T cells following
recognition of HSV antigens may fully activate infiltrating
neutrophils, resulting in increased oxygen metabolism and production of
microbicidal enzymes (27, 41), increased phagocytosis
(13, 15, 26), expression of high-affinity Fc receptors
(25), and increased cytotoxicity (25). In this
regard, we have shown that HSV-specific memory T cells reside in the
vaginal mucosa following intravaginal inoculation with HSV-2
TK
(18). The release of activating cytokines
by memory T cells soon after virus challenge may explain why
neutrophils were active early after challenge of immune mice (Fig. 5)
but not nonimmune mice (Fig. 3).
The significance of neutrophils in defense against human genital HSV-2
infection is not well understood. Neutrophils have been detected as
part of the immune cell infiltrate into herpetic lesions
(12). Further, degraded virions were detected by electron microscopy in the lysosomes of human neutrophils present within a
recurrent lesion (2). Therefore, it seems possible that
neutrophils play an active role in HSV-2 clearance or in limiting the
spread of virus in humans. In the murine model of genital HSV-2
infection, it is possible that the neutrophil-dependent protection we
observed is one manifestation of the protection orchestrated by
HSV-specific T cells. Given the quick onset of neutrophil-dependent
protection in immune mice following HSV-2 challenge (Fig. 5), these
cells may help restrict virus spread and mediate virus clearance prior to the arrival of large numbers of effector T lymphocytes from the
regional lymph nodes. As a result, less virus may gain access to the
sensory neurons and therefore the number of latently infected neurons
may be limited. In this regard, neutrophils have been suggested to
restrict HSV access to the peripheral and central nervous systems after
HSV-1 ocular inoculation (35, 36). Studies are under way to
further elucidate the role of these cells in protection of the genital
tract and the mechanisms by which they exert their antiviral activity.
 |
ACKNOWLEDGMENTS |
I thank Kristen Dudley for expert technical assistance and Nigel
Bourne and Lawrence Stanberry for critical review of the manuscript.
This work was supported by the Gamble Center for Infectious Diseases
and National Institutes of Health Grant AI 42815.
 |
FOOTNOTES |
*
Mailing address: Division of Infectious Diseases,
Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH
45229. Phone: (513) 636-7677. Fax: (513) 636-7655. E-mail:
millg0{at}chmcc.org.
 |
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