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Journal of Virology, February 2000, p. 1908-1918, Vol. 74, No. 4
0022-538X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Measles Virus Spread between Neurons Requires Cell
Contact but Not CD46 Expression, Syncytium Formation, or
Extracellular Virus Production
Diane M. P.
Lawrence,
Catherine E.
Patterson,
Tracy L.
Gales,
Joseph L.
D'Orazio,
Melinda M.
Vaughn, and
Glenn
F.
Rall*
The Fox Chase Cancer Center, Philadelphia,
Pennsylvania 19111
Received 27 August 1999/Accepted 15 November 1999
 |
ABSTRACT |
In patients with subacute sclerosing panencephalitis (SSPE), which
is associated with persistent measles virus (MV) infection in the
brain, little infectious virus can be recovered despite the presence of
viral RNA and protein. Based on studies of brain tissue from SSPE
patients and our work with MV-infected NSE-CD46+ mice,
which express the measles receptor CD46 on neurons, several lines of
evidence suggest that the mechanism of viral spread in the central
nervous system differs from that in nonneuronal cells. To examine this
alternate mechanism of viral spread, as well as the basis for the loss
of normal transmission mechanisms, infection and spread of MV Edmonston
was evaluated in primary CD46+ neurons from transgenic mice
and differentiated human NT2 neurons. As expected, unlike that between
fibroblasts, viral spread between neurons occurred in the absence of
syncytium formation and with minimal extracellular virus. Electron
microscopy analysis showed that viral budding did not occur from the
neuronal surface, although nucleocapsids were present in the cytoplasm
and aligned at the cell membrane. We observed many examples of
nucleocapsids present in the neuronal processes and aligned at
presynaptic neuronal membranes. Cocultures of CD46+ and
CD46
neurons showed that cell contact but not CD46
expression is required for MV spread between neurons. Collectively,
these results suggest that the neuronal environment prevents the normal
mechanisms of MV spread between neurons at the level of viral assembly
but allows an alternate, CD46-independent mechanism of viral
transmission, possibly through the synapse.
 |
INTRODUCTION |
After the clearance of acute measles
virus (MV) infection in children, a persistent infection of the brain
can occur which, after several years, results in the progressive
neurological disease subacute sclerosing panencephalitis (SSPE). The
symptoms of SSPE consist of gradual deterioration of cognitive and
motor functions, and in virtually all cases, the disease is fatal
(22). Brain biopsies or postmortem brain analyses from SSPE
patients show evidence of astrogliosis, neuronal loss, degeneration of
dendrites, demyelination, neurofibrillary tangles, and infiltration of
inflammatory cells (2).
Despite the long interval between the acute infection and symptoms of
SSPE, there is evidence that MV infection of the brain occurs soon
after the acute infection, with subsequent spread throughout the brain
(3, 19). However, in contrast to MV infection of nonneuronal
cells, which is cytopathic and spreads both by extracellular virus and
by cell fusion resulting in multinucleated syncytia, little
extracellular infectious virus can be recovered from brains of SSPE
patients unless tissues are cocultured with permissive fibroblasts
(22). Furthermore, high levels of neutralizing antibody are
present in the serum and cerebrospinal fluid of SSPE patients
(37). Together, these results suggest that extracellular virus might not be responsible for MV spread in the central nervous system (CNS). In support of this hypothesis, extensive point mutations within envelope-associated viral gene products which affect fusion, viral assembly, and budding have been detected in virus recovered from
SSPE brain tissues (4, 8, 10, 40). However, it has not been
established whether these mutations are a reflection of a novel
mechanism of MV spread in the CNS.
An obstacle to the study of measles pathogenesis has been the lack of a
small animal model, because rodents do not express CD46, the human MV
receptor used by wild-type and vaccine strains of virus (15, 26,
28). Previous reports of MV infection in mouse, rat, or hamster
brains (1, 20, 24) have utilized rodent-adapted measles
strains which differ from wild-type and vaccine strains in sequence,
receptor usage, and cell tropism (24, 25, 33). In addition,
some studies of MV infection in the rodent CNS show evidence of
substantial extracellular virus production (24), which is
typical of nonneuronal MV infection but contrasts with the findings for
human brain infection.
To study neuronal infection that more closely parallels human CNS
disease in an animal model system, we have previously utilized transgenic mice which express the human MV receptor, CD46, under the
transcriptional control of the neuron-specific enolase (NSE) promoter
(23, 31). MV Edmonston infection of NSE-CD46 mice or primary
neurons cultured from these mice demonstrated the spread of neuronal
infection over time (31), as evidenced by the increased detection of viral RNA and protein in many brain regions, including the
hippocampus, cortex, striatum, and thalamus. However, similar to human
CNS infection with MV, little infectious virus was recovered from
CD46+ brain tissue or from cultured CD46+
hippocampal neurons (31). Thus, in our mouse model, it again seemed possible that MV spread in the CNS occurred via a novel pathway.
To establish the mechanism by which interneuronal MV transmission
occurs, we have examined two types of neuronal cultures that can be
infected with MV Edmonston: primary hippocampal neurons isolated from
embryonic NSE-CD46 transgenic mice and differentiated human NT2
neurons. With these cultures, spread occurred between neurons in direct
physical contact but did not require the presence of CD46 or involve
the formation of multinucleated syncytia. Moreover, ultrastructural
analysis of neurons provided evidence for defective viral budding,
which accounted for the lack of extracellular virus in these cultures.
Electron microscopy (EM) also showed that nucleocapsids could be found
within neuronal processes and aligned with synaptic membranes,
suggesting that interneuronal MV spread may occur through synaptic
connections. These results are discussed in the context of the
pathogenesis of persistent human CNS infections.
 |
MATERIALS AND METHODS |
Cells and virus.
Vero and HeLa fibroblasts were maintained
in Dulbecco's modified Eagle media (DMEM) (Gibco/BRL, Grand Island,
N.Y.) supplemented with 10% fetal calf serum, 2 mM
L-glutamine, 100 U of penicillin per ml, and 100 ng of
streptomycin per ml. Undifferentiated NT2 cells, a generous gift of
Robert Doms (University of Pennsylvania), were maintained in Opti-Mem
media (Gibco/BRL) with 5% fetal calf serum and the supplements
described above. Differentiation of NT2 neuroepithelial cells into the
neuronal phenotype followed the protocol of Cook and colleagues
(12), involving 5 weeks of culture in supplemented DMEM plus
3 µg of retinoic acid (Sigma Chemical Co., St. Louis, Mo.) per ml,
followed by two 10-day steps of replating in supplemented DMEM
containing mitotic inhibitors (240 ng each of cytosine
-D-arabinofuranoside, 5-fluoro-2'-deoxyuridine, and
uridine [Sigma] per ml). The same compounds were used for mitotic
inhibition experiments with Vero, HeLa, and undifferentiated NT2 cells.
Primary hippocampal neurons were obtained from day 16 embryonic mice,
as described previously (5, 30, 31), except that the cells
were maintained in Neurobasal media (Gibco/BRL) containing 4 µg of
glutamate per ml, in the absence of an astrocyte feeder layer. MV
Edmonston was purchased from the American Type Culture Collection
(Manassas, Va.) and was passaged and titered in Vero fibroblasts.
For antibody inhibition experiments, cells grown on coverslips were
washed once with phosphate-buffered saline (PBS) immediately after
infection, and then media alone or media containing human SSPE immune
serum (1:100) was added to appropriate samples for the duration of the
experiment. After 1 or 3 days postinfection (d.p.i.) samples were
collected and stained by immunohistochemistry (see below) to determine
the proportion of infected cells. Data were analyzed by comparison of
95% confidence intervals.
Immunohistochemistry.
Cells grown on glass coverslips were
fixed with methanol/acetone (1:1), blocked with 2% (vol/vol) goat
serum in PBS, further blocked with avidin and biotin (Vector
Laboratories, Burlingame, Calif.), and stained for MV antigens with
human SSPE immune serum (1:2,000; Vasquez), followed by incubation with
a biotinylated goat anti-human immunoglobulin G (IgG) (1:300; Vector
Laboratories), the ABC Elite kit (Vector Laboratories), and
diaminobenzidine (0.7 mg/ml in 60 mM Tris) with
H2O2 (1.6 mg/ml; Sigma Chemical Co.). Cells
were also counterstained with hematoxylin to visualize nuclei.
Immunofluorescence detection of MV antigens utilized the same primary
antisera but with a fluorescein-conjugated goat anti-human IgG
secondary antibody (1:500; Vector Laboratories). Nucleoprotein (NP) of
lymphocytic choriomeningitis virus (LCMV) was detected with LCMV
ascites (1:2,000; American Type Culture Collection) and rhodamine
red-X-conjugated goat anti-mouse IgG (1:1,000; Molecular Probes,
Eugene, Oreg.). Fluorescent images were obtained with a Bio-Rad MRC 600 laser scanning confocal microscope paired to a Nikon Optiphot II. The
image obtained was a composite of 0.5-µm-thick optical sections taken
through a 100× objective with a 2× electronic magnification. Each
pixel was 0.072 µm2.
Viral RNA transcript analysis.
Vero fibroblasts and primary
CD46+ neurons were infected with MV Edmonston (multiplicity
of infection [MOI] = 1) and harvested 2 d.p.i. by scraping into
Tri-Reagent (Sigma Chemical Co.). Total RNA was isolated according to
manufacturer's instructions and resuspended in diethyl
pyrocarbonate-treated water. To determine the proportion of infected
cells in some experiments, cells on coverslips included in the cultures
were fixed at the time of harvesting and immunostained for the presence
of MV antigen, and positive cells were counted. The RNA samples,
equivalent to 4,000 infected cells, were added to a final concentration
of 48% formamide and 6.6% formaldehyde and then incubated at 68°C
for 15 min. Samples were then chilled on ice and diluted twofold with
20× SSC (1× SSC is 0.15 M NaCl plus 0.015 M sodium citrate). The RNA
samples were applied to a nylon membrane with a slot blot apparatus;
the membrane was UV cross-linked and hybridized with a radioactive probe at 68° for 1 h. Probes were DNA-labeled by a random
priming kit (Prime-It II; Stratagene, La Jolla, Calif.) in the presence of [32P]dCTP (Dupont NEN, Boston, Mass.). DNA fragments
from peN1, peM2, peF1, peH1, and peL-45 (9, 35) were used as
templates for hybridization to N, M, F, H, and L, respectively. The
signal intensity of radioactive slots was quantified by phosphorimager
analysis (Fuji).
Transmission EM.
Vero fibroblasts (300 cells/mm2) or primary neurons (500 cells/mm2)
were grown on polycarbonate membranes in cell culture well inserts. The
membranes were rinsed with PBS, fixed for 1 h with 2%
glutaraldehyde in 0.1 M cacodylate buffer (pH 7.2), and then removed
from the inserts and cut into 1- by 3-mm strips. The strips were
postfixed in 1% osmium tetroxide, stained en bloc with uranyl acetate,
dehydrated in serial alcohols, and embedded in epon (Embed 812;
Electron Microscopy Sciences, Fort Washington, Pa.). Thin sections were cut at 80 nm on a Reichert Ultracut E ultramicrotome, collected on
naked copper grids, and stained with lead citrate. Grids were viewed on
a Philips 400T electron microscope at 80 kV.
 |
RESULTS |
Spread of MV infection in neurons without syncytium formation.
Previously, we showed that spread of MV in neurons occurred over time
both in NSE-CD46+ mice and in primary hippocampal neurons
isolated from those mice (31). To determine whether
interneuronal spread of MV occurs by the same mechanisms as in
nonneuronal cells, syncytium formation and infectious virus production
were compared in permissive fibroblasts (HeLa or Vero), primary
hippocampal neurons from NSE-CD46 mice, and human NT2 neuronal
cultures. Cells were plated at the same density on coverslips, infected
with MV Edmonston (MOI = 1), collected at various times
postinfection, and immunostained for MV antigens.
In the primary CD46
+ neuronal cultures, the extent of
infection increased with time, consistent with previous results
(
31).
At 1 d.p.i. a low proportion of neurons (5% or
less) showed evidence
of infection, but by 3 d.p.i. the proportion
of infected cells
averaged 10 to 20%, increasing to 40 to 50% by
5 d.p.i. Nonrandom
groups of infected neurons and infected
processes connecting them
were observed (Fig.
1A), suggesting that the infection was
spreading
in focal clusters. Infected neurons did not form syncytia in
culture;
this was particularly evident within clusters of neuronal cell
bodies (Fig.
1B). We also did not observe virus-induced cell death
within infected primary neurons, as measured by terminal
deoxynucleotidyltransferase-mediated
dUTP-biotin nick end
labeling (TUNEL) (data not shown). In contrast,
syncytium
formation in permissive nonneuronal cells, such as Vero
cells (Fig.
1C), was observed as early as 1 to 2 d.p.i. By 3 d.p.i.
when
100% of Vero cells were infected, more than 50% of nuclei
were
contained within syncytia, compared to none from infected
neurons.

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FIG. 1.
Immunoperoxidase staining of MV antigen in neurons and
fibroblasts. (A) MV-infected primary CD46+ neurons at
4 d.p.i. (MOI = 1), showing focal clusters of infection.
Magnification, × 70. (B) Contact between infected and uninfected
primary neurons in the absence of fusion at 3 d.p.i. (MOI = 1). Magnification, ×280. (C) Syncytium formation in MV-infected Vero
fibroblasts at 2 d.p.i. (MOI = 1). Magnification, × 70. (D)
MV-infected differentiated NT2 neurons at 1 d.p.i. (MOI = 1),
showing contact between infected and uninfected cells in the absence of
fusion. Magnification, × 280. (E) Syncytium formation in infected
undifferentiated NT2 neuroepithelial cells at 1 d.p.i. (MOI = 1). Magnification, ×70.
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Human NT2 neuronal cells, differentiated and separated from their
neuroepithelial precursors and grown as more-than-95%-pure
cultures
(
12), were susceptible to infection by MV Edmonston
to a
much greater degree than the transgenic primary neurons.
Approximately
30% of the differentiated NT2 neurons and their
processes were
infected by 1 d.p.i. and this proportion increased
over time to
nearly 100% infection by 3 d.p.i. However, as for
the primary
mouse neurons, syncytium formation was not observed;
in clusters of NT2
neurons, individually infected cells were found
within groups of
uninfected cells (Fig.
1D), again suggesting
a lack of membrane fusion.
In contrast, the undifferentiated NT2
neuroepithelial progenitors
showed marked evidence of syncytium
formation as early as 1 d.p.i.
(Fig.
1E). Thus, the phenomenon
of MV spread without syncytium
formation was not restricted to
primary mouse neurons and was not
explained by a low proportion
of infected
cells.
Reduced extracellular virus production by MV-infected neurons.
Another mechanism of MV spread in nonneuronal cells is the production
of extracellular virus, in which the virion acquires its envelope upon
budding from the plasma membrane. However, a characteristic of neuronal
MV infection in SSPE tissues is the nearly complete lack of infectious
virus (22). To determine whether infection of mouse neurons
with a CD46-dependent strain of MV results in extracellular progeny, we
compared supernatant titers from MV-infected CD46+ primary
mouse neurons, CD46+ fibroblasts, NT2 neurons, and
undifferentiated NT2 precursors by plaque assay.
As shown in Table
1, primary
CD46
+ mouse neurons infected with MV Edmonston (MOI = 1) produced at least 1,000-fold fewer PFU
per milliliter than Vero
cultures and 100-fold less virus than
HeLa cultures plated at the same
density and infected with the
same MOI. Similar results were observed
in at least four subsequent
experiments. When the data were corrected
for both the lower proportion
of infected neurons and the increased
number of Vero and HeLa
cells due to cell division, neuronal virus
production per 1,000
infected cells was still substantially lower than
that observed
for fibroblasts (Table
1). The highest titer detected
from primary
neurons in any experiment was 400 PFU/ml (equivalent to
<10 PFU/1,000
infected cells), after 7 days of infection (data not
shown). This
small amount of extracellular virus may reflect release of
cell-associated
virus upon neuronal death, since the viability of our
uninfected
cultures generally declines by 6 to 7 days postculture.
We also compared supernatant viral titers from human NT2-derived
neurons and from undifferentiated NT2 progenitor cells. Infection
of
differentiated NT2 neurons (~97% pure) also yielded minimal
extracellular virus by 2 and 3 d.p.i. compared to the infected
neuroepithelial progenitors (Table
1). Collectively, our findings
indicate that neither human-derived nor CD46-expressing murine
neurons
are permissive for the usual mechanisms of MV
spread.
Absence of cell division does not explain lack of extracellular
virus production and syncytium formation in neurons.
It was
possible that the differences we observed between viral infection of
neurons and fibroblasts were due to the fact that neurons are
terminally differentiated and normally do not divide, either in culture
or in vivo. To test whether MV-induced syncytium formation and virus
production were affected by a lack of cell division, Vero and HeLa
fibroblasts as well as undifferentiated NT2 cells were infected while
in the presence of mitotic inhibitors. To confirm that these cultures
were not dividing, uninfected cell cultures were plated at 2 × 105 cells/well and counted each day after plating. As
expected, the mitotic inhibitors prevented cell division in all three
cell lines (Fig. 2A), and no pronounced
effects on cell viability were noted except after 4 days, when the
number of undifferentiated NT2 cells was reduced fivefold compared to
the previous day. In subsequent experiments, cells were plated at
105 cells/coverslip and grown for 24 h in mitotic
inhibitors, followed by infection with MV Edmonston (MOI = 1) and
continued culturing in mitotic inhibitors. At 1, 2, or 3 d.p.i.
supernatants were collected to test infectious virus titers, and
coverslips included with the cultures were collected for
immunohistochemical staining of MV proteins. Figure 2B shows that for
each cell line, the presence of mitotic inhibitors did not
significantly affect the levels of extracellular virus production at
any time point tested. In addition, syncytia were still present in all
cultures with mitotic inhibitors, despite a reduced total cell
population (Fig. 2C), compared to standard cultures (Fig. 2D). Thus,
the absence of syncytium formation and the reduced infectious virus
production by neurons cannot be explained by a lack of cell division.

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FIG. 2.
Extracellular virus production and syncytium formation
in nonneuronal cells treated with mitotic inhibitors. Vero, HeLa, and
undifferentiated NT2 cells were plated and cultured with or without
mitotic inhibitors. Cells were infected with MV Edmonston (MOI = 1) at 1 day postplating. , Vero cells; , Vero cells plus mitotic
inhibitors; , HeLa cells; , HeLa cells plus mitotic inhibitors;
, undifferentiated NT2 cells; , undifferentiated NT2 cells plus
mitotic inhibitors; ×, primary neurons; , NT2 neurons. (A)
Trypsinized cells were counted by Trypan blue exclusion at the
indicated times postplating. Data are the mean cell numbers ± the
standard errors of the means from at least two experiments. (B)
Infectious virus production from plaque assay of clarified culture
supernatants collected at 1, 2, or 3 d.p.i. Data are the mean
PFU/ml ± the standard errors of the means from two or three
experiments performed in duplicate. (C) Syncytium formation in
MV-infected HeLa cells cultured with mitotic inhibitors (2 d.p.i.).
Magnification, ×64. (D) Syncytium formation in MV-infected HeLa cells
cultured in standard media (2 d.p.i.). Magnification, ×64.
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Absence of extracellular virus in neurons is attributed to defects
in viral maturation.
To determine whether the impairment in
neuronal virus production was a result of differences in viral gene
expression, we next examined MV RNA transcript levels in infected
primary neurons and Vero cultures. Total RNA samples from identical
numbers of infected cells were hybridized with individual MV gene
probes, as described in Materials and Methods. Slot blot analysis
showed that both nucleocapsid-specific (N and L) and envelope-specific (F, H, and M) RNA levels were similar in primary neurons and Vero cultures at 2 d.p.i. (Fig. 3),
indicating that the reduced viral titers from neurons could not be
attributed to reductions in viral gene expression.

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FIG. 3.
Viral RNA levels in MV-infected Vero cell and primary
neuron cultures. Total RNA samples from equivalent numbers of infected
Vero cells or primary CD46+ neurons (2 d.p.i.) were applied
to a slot blot and hybridized with DNA probes recognizing MV
nucleocapsid transcripts N or L, or envelope transcripts F, M, or H. Data are the percentages of phosphorimager pixel values of each MV
transcript from neurons, relative to values obtained from Vero cells
(set at 100% for each transcript).
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We also used transmission EM to compare viral assembly and budding in
primary CD46
+ neurons and fibroblasts. Whereas uninfected
Vero cells had a
smooth surface (Fig.
4A), the surface of MV-infected cells was
highly irregular, with viral particles in different stages of
budding,
from immature bulges to mature buds (100 to 300 nm in
diameter)
separated from the cell surface, as shown in Fig.
4B.
These findings
are consistent with classic EM studies of MV infection
in Vero cells
(
16,
32). In addition, within the cytoplasm
of infected
cells were fuzzy nucleocapsids (Fig.
4B) with a diameter
of 25 nm,
indicating the presence of P and M viral proteins attached
to 17- to
18-nm-diameter viral RNA helices (
29). Similarly,
within
primary transgenic neurons, fuzzy viral nucleocapsids were
present in
the cytoplasm (Fig.
5A). Unlike
fibroblasts, however,
MV-infected neurons had a smooth cell surface
with little evidence
of budding, and cell membranes between infected
cells were intact
(Fig.
5A). These results were confirmed by evaluation
at higher
magnification. In addition, at higher magnification there was
evidence for nucleocapsid alignment beneath electron-dense regions
of
the cell surface, but only immature stages of budding were
detected as
slight bulges of the membrane (Fig.
5B). These findings
are consistent
with the lack of extracellular virus production
and syncytium formation
in neurons (Fig.
1; Table
1).

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FIG. 4.
Ultrastructural comparison of uninfected and MV-infected
Vero cells. Cultures grown on coverslips were infected 1 day
postplating with MV Edmonston (MOI = 1) or mock infected and then
fixed 3 d.p.i. with glutaraldehyde and processed for EM. (A)
Uninfected Vero cell, showing smooth cell surface. Magnification,
×7,560. Bar = 2 µm. (B) MV-infected Vero cell, showing several
viral buds at cell surface (arrows) and cytoplasmic fuzzy nucleocapsids
(MV). Magnification, ×7,560. Bar = 2 µm. N, nucleus; rER, rough
endoplasmic reticulum; G, Golgi; M, mitochondria.
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FIG. 5.
Incomplete budding at surface of MV-infected neurons.
Primary CD46+ neuron cultures were infected with MV
Edmonston (MOI = 1) or mock infected, fixed at 3 d.p.i. with
glutaraldehyde, and processed for EM. (A) Two adjacent neuronal cell
bodies containing cytoplasmic fuzzy nucleocapsids (MV) but few buds at
the cell surface. Arrows indicate intact cell membranes separating the
two cells. Magnification, ×7,560. Bar = 2 µm. (B) Higher
magnification of infected neuron shows smooth nucleocapsid alignment at
the cell surface, but only at the immature stage of budding.
Magnification, ×96,600. Bar = 200 nm. Closed large arrows,
cross-sectional view of nucleocapsid; open large arrow, longitudinal
view of nucleocapsid; N, nucleus; M, mitochondria; R with small arrows,
ribosomes.
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MV spread in neurons is dependent on cell contact but not on CD46
expression.
To determine whether viral spread in neurons required
either cell contact or CD46 receptor expression, the following two
primary neuron populations were isolated: neurons from
NSE-CD46+ mice expressing the MV receptor and neurons from
NSE-NP+ mice, which express the NP protein from LCMV but
lack CD46. The NP molecule cannot be used for viral entry, but it can
be identified by immunohistochemistry, allowing its use as a marker for
distinction from the CD46+ cells. CD46 labeling was not
used for identification because CD46 levels are typically downregulated
by MV infection (36). CD46+ neurons were
infected in suspension and washed extensively (four times over a serum
cushion), and supernatants from the last wash were subsequently tested
by plaque assay to retrospectively confirm that no extracellular virus
remained when the cells were plated. As depicted in the experimental
outline (Fig. 6A), the infected CD46+ neurons were plated either on coverslips together
with uninfected NP+ neurons (ratio = 1:1) or on
separate coverslips, sharing the same media but without direct contact.
At multiple times postplating (postinfection), coverslips were
collected and stained by immunofluorescence, using
fluorescein-conjugated antibodies to detect MV proteins and
rhodamine-conjugated antibodies to detect the LCMV-NP protein.

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FIG. 6.
(A) Diagram of neuron coculture experiments, showing
infected CD46+ cells (green with checkerboard, indicating
staining for MV antigen with fluorescein isothiocyanate) and
NP+ cells (red stripe, indicating staining for NP with
rhodamine red-X) cultured together or on separate coverslips. The NP
transgene was detected only on approximately 50% of transgenic
neurons. (B) Mixture of CD46+ and NP+ cells on
the same coverslip, 3 d.p.i., fluorescently immunostained for MV
antigen with fluorescein isothiocyanate (green) and for NP protein with
rhodamine red-X (red). Colocalization, shown by yellow (arrow),
indicates MV infection of NP+ cells. Bar = 25 µm.
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Our results showed that when infected CD46
+ neurons and
uninfected NP
+ neurons were grown on the same coverslip,
colocalization of MV
(green) and NP (red) occurred, but only after 3 days of culture
(Fig.
6B), consistent with the kinetics of spread
reported in
Fig.
1. In each of four experiments, between 2 and 5% of
neurons
stained for NP were also positively stained for MV; the number
of infected NP neurons was always greater at 4 d.p.i. than at
3 d.p.i. Importantly, MV-infected NP
+ neuronal cell
bodies did not appear to be in direct contact with
other infected
cells, although in most cases, there were infected
processes that
appeared to link the infected NP
+ neurons to other infected
neurons. When the two cell populations
were grown on separate
coverslips, colocalization was never detected
(data not shown),
indicating that the infection did not spread
through the media.
However, when infected CD46
+ neurons and uninfected Vero
cells were cultured separately, occasional
clusters and syncytia of
infected Vero cells were detected (data
not shown), consistent with the
presence of a small amount of
infectious extracellular virus production
by neurons. The fact
that this amount was unable to infect the
NP
+ neurons indicated a need for cell contact to achieve
CD46-independent
infection. In addition, when uninfected
CD46
+ neurons were grown separately but sharing the same
media with
infected fibroblasts, neurons did become infected (data not
shown).
Thus, because NP
+ neurons only became infected when
in direct contact with infected
CD46
+ neurons on the same
coverslip, but in the apparent absence of
syncytium formation, we
hypothesized that viral spread in neurons
occurs by MV traveling
through the axon and across synaptic connections
rather than through
extracellular virus-cell interactions and
that this mechanism of spread
can occur in the absence of
CD46.
This hypothesis was confirmed by the addition of neutralizing antibody
to cultures of infected neurons and fibroblasts. As
shown in Table
2, viral spread (determined as the
increase in
the proportion of infected neurons from 1 to 3 d.p.i.)
was not
significantly affected when anti-MV antibody was added to the
culture media immediately following inoculation. This antibody
treatment was sufficient to completely inhibit viral spread in
the
infected HeLa cells. This result indicates that extracellular
virus was
not responsible for the spread of neuronal infection.
Consequently, we used EM to determine if viral nucleocapsids could be
detected at neuronal termini. Figure
7A
shows a presynaptic
terminal, defined by the presence of synaptic
vesicles of 50 to
75 nm in diameter, and the electron-dense material in
the synaptic
cleft, containing multiple synapses with the postsynaptic
cell.
As indicated by the larger arrows, there were several end-on
nucleocapsids
visible, aligned inside the presynaptic membrane. These
nucleocapsids
were identified by having a diameter of 18 nm and a
hollow core
of approximately 5 nm, consistent with other reports of
isolated
MV nucleocapsids (
17,
41). In the synaptic contact
shown in
Fig.
7B, a longitudinal view of a MV nucleocapsid was
visualized
along the presynaptic membrane. The nucleocapsid helix again
had
a diameter of 18 nm, a pitch (periodicity) of 5.5 nm, and a length
of approximately 400 nm. These values are consistent with classic
studies of isolated MV nucleocapsids, reported to be 1 to 2 µM
in
length (
11,
17,
29,
41). Taken together, these findings
provide evidence that MV nucleocapsids can travel from the cell
body to
align with synaptic membranes, suggesting that there may
be specific
mechanisms that allow nucleocapsid transport across
the synapse.

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|
FIG. 7.
Viral nucleocapsid alignment at the presynaptic
membrane. (A) Smooth nucleocapsids in cross section (large arrows)
along the membrane within a presynaptic neuronal process (top),
characterized by the presence of presynaptic vesicles (pSV with small
arrows). Several synapses with the adjacent cell body (bottom) are
visible. Magnification, ×56,280. Bar = 200 nm. (B) Higher
magnification of presynaptic neuron terminal (top) showing a
longitudinal view of a smooth nucleocapsid (large arrows) aligned with
the presynaptic membrane. Magnification, ×92,460. Bar = 200 nm.
pSV and small arrows, presynaptic vesicles; MT, microtubules; M,
mitochondria; ER, endoplasmic reticulum; N, nucleus.
|
|
 |
DISCUSSION |
In this report, we demonstrate that efficient MV Edmonston spread
in viral receptor-positive neurons occurs independently of syncytium
formation and extracellular virus production, implicating an
alternative mechanism of transmission between neurons. The fact that
neurons are nondividing did not account for the 1,000-fold lower levels
of virus production or the lack of syncytium formation compared to
nonneuronal cells, because treatment of Vero, HeLa, or undifferentiated
NT2 cells with mitotic inhibitors did not reduce either viral yields or
cell fusion. The neuronal restriction of these classical mechanisms of
MV spread was supported by EM analysis, which showed a lack of viral
budding from the neuronal cell surface. In addition, the presence of
neutralizing antibody did not inhibit the spread of infection in
primary neuron cultures, confirming that MV budding does not contribute
to interneuronal viral spread. Coculture experiments combining infected
CD46+ neurons with uninfected neurons lacking CD46
indicated that cell contact was required to allow viral spread between
neurons but that the CD46 receptor for MV was dispensable. EM analysis
of neurons showed no evidence of fusion between infected cell bodies, but there were several examples of presynaptic nucleocapsid
localization; thus, it is likely that MV can spread between neurons via
synaptic connections in the absence of cell fusion.
Our finding that neuronal MV infection could spread without a
requirement for extracellular virus production and cell fusion leading
to syncytium formation implied that two events were occurring. First,
the virus-host cell interactions that allow cell fusion and synthesis
of infectious virus must be inhibited or absent in neurons. Second, the
virus must overcome this block by using a unique mechanism that allows
interneuronal spread.
To address the first issue of how normal mechanisms of MV spread are
inhibited in neurons, we compared infected neurons and fibroblasts for
differences in the viral life cycle, including the viral
replication-transcription stage, as well as the later stages of
assembly and budding. Cattaneo and colleagues (7) have
reported that reduced levels of MV transcription in SSPE patients may
account for the lack of viral budding in neurons. In our study, levels
of viral RNAs encoding both envelope and nucleocapsid proteins were not
reduced, and comparative transmission EM analysis showed similar
cytoplasmic nucleocapsid accumulation in both neurons and Vero cells,
indicating that replication was normal. However, our EM studies
indicated that the reduced yield of infectious virus was due to a block
in viral budding from the neuron. While infected Vero cells contained
smooth nucleocapsids aligned with the cell membrane in various stages
of budding, consistent with early EM studies of infection with Halle
and Edmonston strains of MV (16, 32), CD46+
neurons showed minimal evidence of cell-surface budding or cell fusion.
Nucleocapsids were aligned with electron-dense areas of the cell
membrane in the cell body as well as in axonal and dendritic processes,
but only immature stages of budding were detected as slight bulges at
the surface. This finding is consistent with EM studies of brain
samples from SSPE patients (6, 21) and of persistent
infection in human prostate cells by an SSPE strain of MV (Mantooth)
(17). Our current efforts are aimed at determining whether
viral protein synthesis is intact in infected neurons and whether viral
budding is blocked because of defective envelope protein expression at
the neuronal cell surface.
Our results with NT2 cultures are in contrast to those reported by
McQuaid and colleagues (27), who reported that infection of
differentiated neurons with the CAM strain of MV occurred only when
these cells were in direct contact with infected undifferentiated precursors in mixed cultures. Furthermore, no infectious virus was
detected in these cultures, suggesting an inability of both the
undifferentiated and the differentiated NT2 cells to produce extracellular virus. In our study, both differentiated and
undifferentiated NT2 cells could be infected when grown separately,
although the undifferentiated cells produced titers equivalent to 130 PFU/1,000 infected cells after 2 d.p.i., while differentiated
neurons produced approximately 1 infectious particle/1,000 infected
cells at the same time postinfection. The basis for the differences
between our study and that of McQuaid et al. could be attributable to differences in the clone of NT2 cells used or to differences in the
strain of virus used. Interestingly, it was also found that CD46 was
downregulated on differentiated neurons (27), which lends
support to the hypothesis that interneuronal MV spread occurs independently of the expression of CD46.
Our conclusion that the neuronal environment alters the mechanism of
viral spread is one that has been reached with other virus model
systems. For example, LCMV, which normally buds from the cell surface
during an acute infection (13, 39), is associated only with
ribosomes and not cell membranes during a persistent neuronal infection
in vivo (34). In nerve growth factor-differentiated PC12
neuronal cells a 1,000-fold reduction in infectious LCMV yield compared
to that in undifferentiated PC12 chromaffin cells was also found
(14), and in persistently infected cell lines, a reduction
in LCMV NP protein production was associated with reduced virus
production (42). The fact that other neurotropic viruses
result in persistent, noncytolytic infections lends support to the
speculation that neurons, which are an essential nonrenewable cell
population, may have evolved ways to block the devastating consequences
of cytolytic infections.
To address the second issue of cell fusion- and extracellular
virus-independent viral transmission, we examined whether MV could
spread to neurons that lacked CD46 receptor expression. Our results
showed that CD46
neurons could be infected, but only when
in contact with CD46+ neurons, indicating that the
mechanism of MV spread in neurons depends on cell contact, but not on
receptor expression. A possible explanation for contact-dependent viral
spread in the apparent absence of syncytium formation is that
infectious particles or nucleocapsids travel across synaptic
connections. In an EM study of persistent mouse brain infection with
the hamster-adapted HNT strain of measles, nucleocapsids were detected
in postsynaptic regions (38). This finding, combined with
our observations that nucleocapsids are aligned at the presynaptic
membrane, lends support to the hypothesis that interneuronal viral
transmission occurs via the synapse.
If viral particles or nucleocapsids alone can migrate across the
synapse, either they might utilize existing synaptic machinery to be
secreted into the synaptic cleft and taken up by the postsynaptic cell
or they may travel passively between cells by localized fusion at the
point of synaptic contact. A recent study (18) showed that
MV can spread from a persistently infected cell line to HeLa fibroblasts in a contact-dependent manner, although an inhibitor of MV
fusion did not completely block transfer of viral proteins. The authors
proposed that "microfusion events" at sites of cell-cell contact,
possibly involving viral glycoprotein interaction with CD46 on target
cells, allowed virus release and entry (18). It is possible
that in our system, similar focal fusion events occur independently of
CD46 expression to allow nucleocapsid transfer across the synapse.
Regardless of the precise manner by which MV traverses the synapse, we
hypothesize that the primary route of interneuronal transmission of MV
in neurons is transsynaptic, which may account for the absence of
extracellular (infectious) virus and the apparent slow rate of
transmission in brains of SSPE patients. Moreover, we do not detect
increased neuronal cell death in our primary cultures following MV
infection, which suggests that this mechanism of viral transmission may
be a strategy by the neuron to protect itself from cytolytic MV replication.
In conclusion, our results suggest that the outcome of an infection is
predicated on both viral and host determinants. In a fibroblast
environment, MV results in a highly productive infection that causes
cytolysis, giant cell formation, and high titers of extracellular
virus. In the neuron, despite the spread of virus, there is little
evidence of MV-induced cell death, syncytium formation, or infectious
virus production. Given the immediate appearance of this modification
in our neuron cultures, the dramatic change in the mechanism of viral
spread is most likely due to a property of the neurons rather than to
the accumulation of viral mutations. In summary, an alternate mechanism
of spread, requiring cell contact but not the MV receptor, is used by
MV to maintain a persistent neuronal infection. The consequence of this
phenomenon, which may be the case for many neurotropic infections, is
to protect the host from critical damage resulting from neuronal death.
 |
ACKNOWLEDGMENTS |
We thank Michal Jarnik, director of the EM core facility, for
assistance with ultrastructural analysis and Jonathan Boyd of the cell
imaging facility for assistance with the confocal microscopy experiments. We also thank the laboratory of Robert Doms (University of
Pennsylvania) for assistance with NT2 cell culture techniques. Finally,
we are most appreciative of the constructive comments made by Bill
Mason and Kerry Campbell regarding the manuscript.
This work was supported by Public Health Service grants MH56951,
AI07429, and CA06927, as well as by a grant from the Kirby Foundation.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Virology and
Immunology, Fox Chase Cancer Center, 7701 Burholme Ave., Philadelphia, PA 19111. Phone: (215) 728-3617. Fax: (215) 728-2412. E-mail: gf_rall{at}fccc.edu.
 |
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