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Journal of Virology, December 2001, p. 12446-12451, Vol. 75, No. 24
0022-538X/01/$04.00+0 DOI: 10.1128/JVI.75.24.12446-12451.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Contribution of the Human Parainfluenza Virus Type
3 HN-Receptor Interaction to Pathogenesis In Vivo
Gregory A.
Prince,1
Martin G.
Ottolini,2 and
Anne
Moscona3,*
Virion Systems, Inc., Rockville,
Maryland,1 and Department of
Pediatrics, F. Edward Hébert School of Medicine, The Uniformed
Services University of the Health Sciences, Bethesda, Maryland,
20814,2 and Department of Pediatrics,
Mount Sinai School of Medicine, New York, New York
100293
Received 2 August 2001/Accepted 27 September 2001
 |
ABSTRACT |
The envelope of human parainfluenza virus type 3 (HPF3) contains
two viral glycoproteins, the hemagglutinin-neuraminidase (HN) protein
and the fusion (F) protein. In a previous study, highly fusogenic
variant HPF3 viruses were isolated, including two, C-0 and C-22, that
exhibit increased avidity for sialic acid receptors due to single amino
acid changes in the HN protein and one, C-28, that has decreased
neuraminidase activity relative to that of the wild type (wt) and is
delayed in the release of virus particles into the supernatant fluid.
These variants form very large plaques and destroy a cell monolayer
more rapidly than does wt HPF3 in cell culture. These variant viruses
allowed us to formulate hypotheses about the roles of HN in
pathogenesis. We investigated the behavior of wt HPF3 and the three
variant viruses in the cotton rat model. In the cotton rat, there was no delayed clearance of any of the variant viruses compared to that of
the wt. The variant plaque morphology was preserved in vivo, and there
was no reversion to the wt phenotype in the infected animals. In spite
of a slight advantage of wt virus in viral titer, there were no
differences in the severities of peribronchiolitis between wt
viruses and the variants. However, there were marked differences in
severities in alveolitis and interstitial pneumonitis when each
of the three variants was compared to the wt, with the variants causing
enhanced disease. Thus, despite similar or lower viral titers and
similar clearance rates, the variants caused more extensive disease in
the lung. The results show that mutations in HN conferring altered
fusion properties in cell culture also confer striking differences in
the ability of HPF3 to cause extensive disease in the cotton rat lung
and that this effect is dissociated from any effect on viral replication.
 |
TEXT |
The
Paramyxoviridae family is comprised of several
important agents of human pathology, including measles, mumps,
respiratory syncytial, and human parainfluenza viruses. Human
parainfluenza virus type 3 (HPF3) is the second leading cause of infant
and childhood respiratory disease, and no vaccine or antiviral therapy for this agent is currently available.
The envelope of HPF3 contains two viral glycoproteins, the
hemagglutinin-neuraminidase (HN) protein and the fusion (F) protein. Infection of cells by HPF3 is initiated by attachment of the virus to
the host cell through interaction of the HN glycoprotein with a sialic
acid-containing cell surface receptor. Penetration and uncoating of the
virus result from F protein-mediated fusion of the viral envelope with
the plasma membrane of the cell, which leads to the release of the
viral nucleocapsid into the cytoplasm. For fusion to occur, both
interaction of the viral HN glycoprotein with its sialic acid receptor
and the presence of the viral F glycoprotein are required (5, 6,
8, 11, 12). By virtue of its neuraminidase activity, HN also has
a receptor-destroying potential that plays a role in the spread of
infection (7).
The hallmark cytopathic effect of acute infection with HPF3 in vitro is
extensive cell fusion resulting in syncytium formation, which involves
the interaction of F and HN proteins expressed on the surface of an
infected cell with the membrane of an adjacent uninfected cell. In a
previous study, variant HPF3 viruses that have a greatly increased
ability to fuse cells in culture were isolated; this offered a new
approach to understanding the mechanism of paramyxovirus-induced cell
fusion and the role of the HN protein in this process. The two highly
fusogenic variants of HPF3 that were isolated, C-0 and C-22, exhibited
increased avidity for sialic acid receptors due to single amino acid
changes in the HN protein (12). These studies demonstrated
that a key component of HN's function in promoting fusion in cell
culture is its avidity of binding to sialic acid-containing receptors.
In continuing to study the role of neuraminidase in the life cycle and
pathogenesis of HPF3, we isolated a variant of HPF3 (C-28) that has
decreased neuraminidase activity relative to that of the wild type (wt)
(7). Analysis of the growth properties of this variant
revealed a delay (of 7 h) in the release of virus particles into
the supernatant; the addition of exogenous neuraminidase to the culture
corrected this delay. These findings implicated the neuraminidase
activity of HN in the release of HPF3 virus particles from the surface
of the infected cell, thus beginning a new round of infection
(7).
In order to analyze the factors affecting pathogenesis of HPF3 in vivo
and the contribution of HN's functions to pathogenesis, previous
studies have now been extended to the animal model. We wanted to
determine whether the avidity of virus-receptor interaction and the
receptor-destroying neuraminidase activity are major determinants of
virulence and/or pathogenesis in the lung. With the use of the cotton
rat, we were able to assess whether the cell culture findings
translated into pathogenic mechanisms in the lung. The cotton rat is an
excellent model for HPF3 lower respiratory infection (18);
experimental infection leads to bronchiolitis and interstitial pneumonia, mimicking human disease. Experiments using the cotton rat
model for respiratory syncytial virus (RSV) have been used to predict
disease outcome in humans, in that RSV pneumonia was prevented by RSV
immune globulin (4, 20, 21). Such evidence for
experimental relevance to humans is not yet available for HPF3 in the
cotton rat because the data regarding therapy for HPF3 obtained in the
cotton rat model (19) have not yet been tested in clinical
trials. However, the pulmonary disease seen during cotton rat infection
with HPF3, unlike that with the mouse model, corresponds to that seen
during human infection, making this a useful model for elucidating the
basis for HPF3 disease.
Use of receptor-binding and neuraminidase variants of HPF3 in the
cotton rat.
The hypothesis tested in the present study was that
functions of HN that determine cytopathic effects in cell culture are important determinants of HPF3 pathogenesis in the lung of the cotton
rat. Two of the variants used in this study, C-0 and C-22, exhibited
higher avidity than wt HPF3 for the sialic acid-containing cellular
receptor. The variants are highly fusogenic by several criteria:
plaques form more rapidly and are much larger than wt virus plaques,
and infection of a monolayer results in much more rapid and widespread
cell fusion. Both variants have the wt F gene sequence. Each variant
has one point mutation in the HN gene corresponding to a single amino
acid change in the HN glycoprotein; in C-0, an A-to-G mutation converts
threonine 193 to an alanine, while in variant C-22, a T-to-G mutation
converts histidine 552 to a glutamine (12). Growth
characteristics of the variant viruses in cell culture do not differ
from those of the wt in that the rates of viral replication and the
rates of viral protein synthesis are similar in wt- and
variant-infected cells. The amount of HN and the ratio of HN to NP
protein in wt- and variant-infected cells are similar. Activity levels,
substrate specificities, and pH optima of the neuraminidase of C-0 and
C-22 were not significantly different from those of the wt.
We also determined whether the neuraminidase activity of HN, which is
critical to the outcome of infection in cell culture, is a determinant
of the outcome of infection in the lung, by using variant C-28, which
has 40% of wt neuraminidase activity (7). C-28, with no
alterations in the F protein sequence, has a single point mutation in
the HN protein, i.e., a G-to-A mutation at nucleotide 724 that converts
aspartic acid 216 to asparagine. C-28 shows an initial growth delay in
cell culture due to slow release but then catches up and causes more
widespread fusion than does the wt. The increased fusogenicity of C-28
is attributable to its low neuraminidase activity, which leaves more
cellular sialic acid receptor available to bind HN.
Viral replication.
Inbred young adult cotton rats
(Sigmodon hispidus) of both genders were obtained from the
breeding colony at Virion Systems, Inc., housed in large polycarbonate
cages, and fed a diet of standard rodent chow and water. The animals
were seronegative for adventitious paramyxoviruses, RSV, and other
common rodent pathogens.
The rats were infected intranasally with 100 µl containing two
different input doses for each virus, 10
5.5 and
10
6.5 PFU. The animals were sacrificed for study at 2, 4, 6, 8, and
10 days after infection to obtain a time course of viral
replication
and disease progression in the lung. The time points were
selected
based on the following rationale. At 2 days after infection,
C-22,
C-0, and C-28 exhibit large plaques in a cell monolayer. Four
days represents the peak of wt HPF3 replication in the lung, and
6 days
is the time of the peak lung inflammatory response with
wt HPF3
(
18). The 8- and 10-day time points were chosen in an
effort to look for delayed clearance of the variant
viruses.
Following sacrifice of the animals by carbon dioxide inhalation, nasal
and lung tissues from each animal were bisected (the
other half being
used for histologic analysis) and homogenized
separately as described
previously (
18), and then they were
stored at

70°C
until assayed. Virus titers were determined by
plaque assay on MA104
African green monkey kidney cells and calculated
as PFU per gram of
tissue.
Wild-type virus replicated to a titer that was similar to or slightly
higher than those of the three variants in the lungs
and nose (Fig.
1). The differences were most pronounced
in the
case of C-0, where peak titers were significantly lower
(
P 
0.05,
t test of summary data)
than wt titers in the lungs (days 2 and
4) and nose (day 2), and in the
case of C-22, where peak titers
were significantly lower than
those of the wt in the nose (days
2 and 4). There were no significant
differences in the kinetics
of replication, with wt and variant viruses
being cleared by day
6 in the lungs and day 8 in the nose. Of note, for
each of the
three variants, the plaque morphology of the variant
viruses was
preserved in vivo, with no apparent reversion to the wt
phenotype.
All the plaques from viruses derived from variant-infected
animals
showed the typical large, round plaques characteristic of each
variant (
7,
12).

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FIG. 1.
Geometric mean virus titers in lung and nasal tissues
from cotton rats on days 2, 4, 6, 8, and 10 after infection with C-28,
C-22, C-0, and wt HPF3. Each point represents eight (lungs) or four
(noses) animals. On days 2 and 4, some titers for C-22 and C-0, as
indicated in the text, were significantly lower (P 0.05) than those for the wt.
|
|
Histopathology of lung tissue.
Lungs were inflated
intratracheally with 10% neutral buffered formalin in order to
maintain the pulmonary architecture. Two uninfected rats were
sacrificed at each time point for comparison of tissue pathologies.
Following paraffin embedding, 4-µm sections were cut and then stained
with hematoxylin and eosin. Three parameters of pulmonary inflammatory
changes were scored in each lung section: peribronchiolitis
(inflammatory cells, primarily lymphocytes, surrounding a bronchiole),
alveolitis (inflammatory cells within alveolar spaces), and
interstitial pneumonitis (increased thickness of alveolar walls
associated with inflammatory cells). Each of these parameters was
scored separately for each histologic section. Prior to scoring, all of
the slides were examined to determine the range of pathologies for each
of the three parameters. A semiquantitative assessment was made of each
type of inflammation, based on the range of lesions seen within this
experiment and on extensive prior studies of cotton rat pulmonary
pathology. The absence of inflammation was given a score of 0, the
theoretical maximum based on the above criteria was given a score of
100, and the score for inflammation falling between the two extremes
was estimated while the tissues were viewed under the low-power
objective of a microscope. The slides were randomized and scored
blindly. Although each of the three types of inflammation was scored
with the same scale, the scores are relative and valid only for
comparing the same parameter in different sections, not for comparing
different parameters.
Histopathologic changes did not correlate with viral titers in any of
the three parameters that we measured in the lungs.
Peribronchiolitis
(Fig.
2) was a prominent finding in all
four
groups, with slight differences (
P < 0.05) on
some days between
variants and wt but no consistent trends. All three
variants caused
significant (
P 
0.05) alveolitis
(Fig.
2) and interstitial pneumonitis
(data not shown), whereas no such
pathologic changes were produced
by the wt virus, despite the fact that
the wt achieved higher
titers than did the variants. Figure
3 shows representative examples
of the
histopathology that was seen. Figure
3A shows wt-infected
lung tissue
with peribronchiolitis but neither alveolitis nor
interstitial
pneumonitis. Figure
3B shows alveolar tissue from
wt-infected lung
tissue with no evidence of disease. Figure
3C
shows C-0
variant-infected lung tissue with peribronchiolitis
that is
indistinguishable from that caused by wt. Figure
3D shows
alveolar
tissue from C-0 variant-infected lung tissue with striking
alveolitis
(cells within air spaces) and interstitial pneumonitis
(thickened
alveolar walls).

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FIG. 2.
Arithmetic mean pulmonary pathology scores (plus
standard errors) for severity of peribronchiolitis and alveolitis.
Interstitial pneumonitis showed the same pattern as alveolitis and is
not included in this figure. Asterisks indicate values that are
significantly higher than values for the wt for the same day
postinfection. Each group consisted of eight animals.
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FIG. 3.
Representative examples of lung tissue histopathology.
(A) wt virus-infected lung tissue showing peribronchiolitis.
Magnification, ×64. (B) wt virus-infected lung showing no evidence of
alveolar or interstitial pathology. Magnification, ×128. (C)
C-0 variant-infected lung showing peribronchiolitis. Magnification,
×64. indistinguishable from that caused by wt. (D) C-0
variant-infected lung showing striking alveolitis (cells within air
spaces) and interstitial pneumonitis (thickened alveolar walls).
|
|
Histopathology of nasal tissue.
For examination of nasal
tissues, each rat skull was placed in 10% formalin and then
decalcified prior to sectioning. Multiple coronal sections, at 1-mm
intervals, were prepared for each animal. Three parameters were scored
separately for each specimen: epithelial cell damage, epithelial
infiltration (primarily neutrophils), and exudate (humoral or cellular)
into the nasal airspace.
None of the four viruses caused significant pathologic changes in any
of the three parameters that we examined (data not shown),
a finding
consistent with earlier observations on wt HPF3 infection
in cotton
rats (
18).
Implications of enhanced disease caused by receptor-binding and
neuraminidase variants of HPF3.
In this study, we investigated the
behavior of wt HPF3 and three variant viruses in the cotton rat model,
i.e., the high-affinity variant viruses C-22 and C-0 (12)
and the low-neuraminidase variant C-28 (7). Since these
highly fusogenic variants form very large plaques and destroy a cell
monolayer more rapidly than does wt HPF3 in cell culture, we wanted to
determine whether this would translate into increased virulence in an
animal. The results showed no delay in clearance of any of the variant
viruses compared to that of the wt. The variant viruses, while being
cleared at the same time as for the wt, took longer to reach their peak
titers. The variant plaque morphology was preserved in vivo, with the viruses that emerged from the infected animals showing the typical large plaques characteristic of these variants, and there was no
apparent reversion to the wt phenotype in the infected animals. In
spite of the slight advantage of the wt virus in viral titer, there
were no differences in the severity of peribronchiolitis between the wt
and the variants. However, there were marked differences in the
severities of alveolitis and interstitial pneumonitis when each of the
three variants was compared to the wt. Thus, despite similar or lower
viral titers and similar clearance rates, the variants caused more
extensive disease in the lung. There was no significant nasal pathology
in any of the infected animals, a finding consistent with the previous
studies of HPF3 disease in the cotton rat (18).
The C-22 and C-0 variants cause increased fusion in cell culture due to
an increased avidity of HN for its sialic acid-containing
receptor
(
12). We found that while C-22 and C-0 have no advantage
in terms of replication in the lung, and in fact replicate to
a
slightly lower titer than does the wt virus, they cause enhanced
pathology. The altered HN, with increased avidity for its receptor,
is
thus one determinant of pathogenesis in the
lung.
C-28 has only approximately 40% of the neuraminidase activity of wt
HPF3, causing an initial growth delay due to slow release
from the
surface of the infected cell. The C-28 variant's release
eventually
catches up to that of the wt, as accumulated virions
allow for adequate
neuraminidase activity. Another characteristic
of this variant is that
it causes more widespread fusion in cell
culture than does the wt,
since lower neuraminidase activity leaves
more receptors available on
adjacent cells to interact with HN.
It was of great interest,
therefore, to determine whether this
virus causes less disease due to
the initial growth lag or whether
its higher fusogenicity, seen in cell
culture, results in more
severe disease in the
lung.
It has been proposed that for influenza virus, the neuraminidase
activity may be important for removing respiratory tract
mucin sialic
acids, allowing the virus to reach its target cells
(
1).
While research using a neuraminidase-deficient influenza
virus mutant
shows that neuraminidase function is not absolutely
required for
replication in the respiratory tract of mice (
10),
it is
possible that such a mechanism contributes to pathogenesis.
There is a
precedent for decreased virulence as a result of decreased
neuraminidase activity for influenza viruses in animals (
16,
26). It was therefore possible that C-28 might be less virulent
than wt HPF3. In addition to the above-mentioned possibility,
the delay
in release of C-28 virus progeny from the host cell
surface might
prevent the virus from spreading to new cells in
the lung, thus
preventing severe disease. However, our findings
here demonstrate that
C-28, with an HN mutation causing deficiency
of neuraminidase, is
associated with enhanced
pathology.
The possibility that the balance between receptor-binding and
neuraminidase activities might be critical to the life cycle
of HPF3
has been suggested by several lines of evidence. It was
previously
shown (
13) that the level of neuraminidase determines
whether the outcome of an HPF3 infection in culture will be acute
infection with cell fusion or persistent infection without cell
fusion.
Other studies have shown that under the selective pressure
of exogenous
neuraminidase present in an infected cell culture,
which serves to
remove a portion of the available sialic acid
receptors, two distinct
types of viral variants emerge: (i) variants
with decreased
neuraminidase (
7), and (ii) variants with increased
receptor binding avidity (
12,
14). The fact that both
types
of variants emerged under the same selective pressure of receptor
scarcity suggests that a change in either function could compensate
for
receptor
scarcity.
Examination of a temperature-sensitive Newcastle disease virus (NDV)
variant and two sequential revertant viruses revealed
that alterations
in neuraminidase can compensate for alterations
in binding (
24,
25). The original NDV variant, with an amino
acid substitution
at position 129, was deficient in binding erythrocytes;
a second
mutation, at position 175, reduced neuraminidase activity
but restored
binding; the third sequential mutation, at position
193, partially
restored neuraminidase activity. This sequential
evolution suggests
that the balance between the two activities
is the determinant of
selective advantage and survival. While
the recently determined crystal
structure of NDV (
2) suggests
that the catalytic and
binding functions of HN reside in a single
site, other data
suggest that it is possible for individual mutations
to affect one
function without affecting the other (
17).
The C-28 infection of cotton rats in this study has illuminated the
question of whether HPF3 neuraminidase has a role, direct
or
indirect, in HPF3 pathogenesis. The results suggest that C-28
HN's
deficiency in neuraminidase does not cause marked defects
in the
replication ability of the virus but does cause more intense
disease in
the lung. It will be of great interest to test a recently
characterized
variant that is completely neuraminidase deficient;
while C-28 has 40%
of wt neuraminidase activity, this variant
is completely neuraminidase
deficient yet is able to bind and
enter cells efficiently
(
17).
In future studies, we plan to use strategies developed in vitro for
interrupting HPF3 infection to block HPF3 in the lung.
We have recently
identified receptor analog molecules that are
effective in blocking
virus-cell interaction in cell culture (
3,
9), and we hope
to test these analogs for antiviral capacity
in the cotton rat model.
4-Guanidino-Neu5Ac2en (4-GU-DANA; zanamivir)
is a sialic acid
transition state analogue designed for the influenza
virus
neuraminidase catalytic site that possesses antiviral activity
at
nanomolar concentrations in vitro. It has been shown (
3)
that 4-GU-DANA inhibits HN-mediated binding of HPF3 to host cell
receptors as well as HN's neuraminidase activity. 4-GU-DANA reduced
the area of plaques formed by the neuraminidase-deficient variant
C-28a
(
3,
17), confirming that its interference with cell-cell
fusion is unrelated to inhibition of neuraminidase activity. Thus,
for
HPF3, 4-GU-DANA and its analogs have an affinity not only
to the
neuraminidase active site of HN but also to sites important
for
receptor binding and cell fusion. We have recently generated
a
4-GU-DANA-resistant HPF3 virus variant (ZM1) by serial passage
in the
presence of 4-GU-DANA (
15). ZM1 exhibited a markedly
fusogenic plaque morphology and harbored two HN gene mutations,
one
shared with the fusogenic variant C-0 and a second mutation
conferring
the 4-GU-DANA-resistant property. The sensitivity to
4-GU-DANA of the
neuraminidase activity and the receptor binding
potential of ZM1 were
greatly reduced relative to those of the
wt and C-0. ZM1 also retained
infectivity at 15-fold-higher concentrations
of 4-GU-DANA than did the
wt and C-0. We are presently testing
the effect of 4-GU-DANA and analog
compounds on HPF3 replication
and pathogenesis of lung disease in the
cotton rat, by use of
wt and fusogenic variants, and are investigating
the behavior
of this 4-GU-DANA-escape variant ZM1 in the cotton
rat.
An interesting finding of this study is that enhanced disease caused by
the variant viruses does not correlate with an increased
presence of
infectious virus. This is reminiscent of data obtained
for cotton rats
by vaccination with a formalin-inactivated RSV
vaccine followed by
reinfection with wt RSV (
22). Upon reinfection
with the
virus, viral replication was strikingly reduced in the
vaccinated rats;
however, lung pathology was enhanced. The vaccine-enhanced
disease
resulted in alveolitis and interstitial pneumonitis, similar
to the
lesions seen in the present study, and developed in the
face of greatly
reduced viral replication. The enhancement of
disease by vaccine was
abrogated by the use of the adjuvant 3-deacylated
monophosphoryl lipid
A, which altered the pathologic response
to reinfection without
affecting the protective effect in terms
of viral titer
(
23). RSV vaccine disease enhancement is thought
to be an
immunopathologic process, and these studies highlighted
the fact that
reduction in viral titer does not necessarily benefit
the infected
host. In the present study, the alveolitis and interstitial
pneumonitis
developed after infection with the variant viruses,
in the face of
viral titers that are similar to, or lower than,
those of the wt virus.
The results thus show that mutations in
HN conferring altered fusion
properties in cell culture also confer
striking differences in the
ability of HPF3 to cause extensive
disease in the cotton rat lung and
that this effect is dissociated
from any effect on viral
replication.
 |
ACKNOWLEDGMENTS |
This work was supported by Public Health Service grant AI 31971 to
A.M. from the National Institutes of Health.
We thank Richard Peluso and Olga Greengard for helpful discussions.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Department of
Pediatrics, Mount Sinai School of Medicine, 1 Gustave L. Levy Pl., New York, NY 10029. Phone: (212) 241-6930. Fax: (212) 426-4813. E-mail: Anne.moscona{at}mssm.edu.
 |
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Journal of Virology, December 2001, p. 12446-12451, Vol. 75, No. 24
0022-538X/01/$04.00+0 DOI: 10.1128/JVI.75.24.12446-12451.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
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