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Journal of Virology, July 2002, p. 6636-6642, Vol. 76, No. 13
0022-538X/02/$04.00+0 DOI: 10.1128/JVI.76.13.6636-6642.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Departments of Cell Biology,1 Molecular and Experimental Medicine,3 Center for Integrative Molecular Biosciences, The Scripps Research Institute, La Jolla, California 920372
Received 9 January 2002/ Accepted 26 March 2002
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A variety of mechanisms have been proposed for MV-induced immunosuppression, including lymphocyte apoptosis or anergy, disruption in efficient antigen presentation, and cytokine imbalances (19, 35). Recent evidence, however, suggests that targeting of bone marrow (BM) cells and suppression of hematopoiesis by MV may play an important role in immunosuppression. One hallmark of MV immunosuppression is profound lymphopenia (including that involving CD4+ T cells, CD8+ T cells, and B cells), monocytopenia, and neutropenia that persists following virus clearance (2, 20, 33). Interestingly, young children with the highest level of BM output (24, 28) recover most quickly from MV-induced lymphopenia and immunosuppression. Older children and adults with a less robust BM reconstitution capacity require longer periods of time for recovery from MV immunosuppression (33). Additional evidence supporting BM damage by MV is suggested by the abnormally (40-fold) increased mobilization of CD34+ hematopoietic progenitor cells from the BM to the peripheral circulation following MV infection (33). Together, the findings of these studies suggest that viral suppression of mature lymphocytes, in combination with a delay in reconstitution from a damaged BM compartment, could account for the full range of immunosuppression seen in measles.
Given the potential for MV to suppress hematopoietic development, we investigated the susceptibility of hematopoietic cells to wild-type MV infection. We evaluated whether umbilical cord blood (UCB) CD34+ cells, a population which includes hematopoietic stem cells (HSCs) and myeloid, erythroid, and lymphoid progenitors, expressed MV receptors and could be infected with MV. In addition, we evaluated the susceptibility of BM stromal cells to MV. Here we demonstrate that MV infection of both cell types occurred and that inhibition of stromal cell function by MV led to disruption in normal hematopoiesis of CD34+ cells.
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MV infection of CD34+ cells. CD34+ cells were infected with MV strain JW (MV-JW) at an multiplicity of infection (MOI) of 2 for 5 h. Control cells received an equivalent volume of either UV-inactivated MV or virus-free medium. At the time of infection, the phenotype of the cells was determined by three-color flow cytometry using a FACSCalibur apparatus (Becton Dickinson). The cells were stained with CD34-PE, CD38-allophycocyanin (APC), CD33-PE, mIgG1-PE, mIgG1-APC (all purchased from Becton Dickinson), and CD46-FITC (Biodesign, Inc., Saco, Maine). After infection, the cells were transferred to tissue culture plates and maintained in the cytokine-containing medium. The infected cells were analyzed at various time intervals after infection for MV hemagglutinin (HA) expression by flow cytometry using a purified mouse monoclonal antibody (MAb) to HA (25) followed by a secondary donkey anti-mouse antibody conjugated to PE (Jackson ImmunoResearch Laboratory, West Grove, Pa.). MV-JW, a wild-type MV strain that was isolated from peripheral blood of a measles patient in Irvine, California, was grown in primary human peripheral blood mononuclear cells (PBMC) as described previously (9, 25). Virus stocks were filtered through a 0.45-µm-pore-diameter filter and then pelleted at 100,000 x g. To determine virus titer by 50% tissue culture infectious dose (TCID50) assay, serial 10-fold dilutions of the purified virus were overlaid on PBMC or B95-8 B lymphocytes in a 96-well plate in triplicate. Titers were calculated by the Karber method in TCID50/ml. For UV-inactivated MV-JW, virus was plated in a shallow petri dish on ice and exposed to a hand-held short-wave UV source (254 nm) for 1 h.
Bulk-culture LTC-IC assays. Bulk-culture long term culture-initiating cell (LTC-IC) assays were established by plating 10,000 infected or control CD34+ cells per well of human BM stromal cells (irradiated as feeder cells with 1,500 R) and cultured in MyeloCult H5100. Cells were cultured for 5 weeks, and 50% of the medium was replaced weekly and frozen for viral titer on PBMC. For colony-forming cell (CFC) assays, the entire well was then harvested and clonogenic assays were performed by plating 20,000 infected or control CD34+ cells per milliliter of methyl cellulose containing 50 ng of rh-stem cell factor/ml, 10 ng of rh-GM-CSF/ml, 10 ng of rh-IL-3/ml, and 3 U of rh-erythropoietin (StemCell Technologies)/ml. Colonies derived from CFU granulocyte macrophage (CFU-GM) and burst-forming unit erythroid (BFU-E) progenitors were scored visually 14 days later using an inverted microscope as described previously (29). Statistical analysis was performed using Student's t test and Microsoft Excel software.
BM stroma preparation. Human BM was obtained, with Institutional Review Board approval, by aspiration from the posterior iliac crest of fully informed, hematologically normal donors. Stromal cells were isolated by culturing human BM cells in MyeloCult H5100 medium (StemCell Technologies) with the addition of freshly prepared hydrocortisone (Sigma, St. Louis, Mo.) to yield a final concentration of 10-6 M. After 3 days, the suspension cells were removed and the adherent stromal cells were grown to confluency. These cells were removed with 0.05% trypsin-0.53 mM EDTA (Gibco BRL, Grand Island, N.Y.) and passaged three times to expand the cells and remove macrophages. The cells were frozen as described above and later thawed for LTC-IC assays and infection experiments.
MV infection of stromal cells. Human BM stromal cells were thawed in MyeloCult H5100 medium and plated onto glass coverslips. The next day, the cells were infected with MV at an MOI of 0.1. Coverslips were fixed at various times postinfection in 50% ether-50% ethanol for 10 min followed by 100% ethanol for 20 min. Coverslips were stained for MV antigens using a human polyclonal SSPE (1x SSPE is 0.18 M NaCl, 10 mM NaH2PO4, and 1 mM EDTA [pH 7.7]) serum followed by a goat anti-human F(ab')2 antibody conjugated to fluorescein isothiocyanate. Infected cells were visualized using an Olympus fluorescence microscope.
Inhibition of MV infection by antireceptor antibodies. Antibodies against CD46 (E4.3 [26]), MCI20.6 ([32]) and signaling lymphocyte activation marker (SLAM) (Advanced Immunochemical Inc. [40]) or isotype control antibodies from Pharmingen were used. Five micrograms of antibody was incubated with 105 CD34+ cells or stromal cells for 30 min on ice. Following two washes in phosphate-buffered saline, the cells were incubated with 0.1 TCID50/cell of MV-JW for 1 h. After an additional two washes in phosphate-buffered saline, the cells were plated in a single well of a 24-well plate for 4 days, and then the supernatants were harvested and the virus titer in the supernatant was measured by TCID50 assay (25). Statistical analysis was performed using Student's t test.
RT-PCR.
Colonies were dissolved in Tri-Reagent (Molecular Research Center, Cincinnati, Ohio), and total RNA was prepared according to the manufacturer's instructions. cDNA was generated from 500 ng of total RNA using Moloney murine leukemia virus reverse transcriptase (RT) (Promega, Madison, Wis.), oligo(dT) primer (Pharmacia, Piscataway, N.J.), and 40 U of RNasin (Promega)-0.625 mM deoxynucleoside triphosphate-0.6 mM MgCl2. Amplification of the cDNA was performed with Taq DNA polymerase (Boehringer Mannheim Biochemicals). Primers used to detect the MV nucleoprotein gene were N1 (5'-ATCCGCAGGACAGTCGAAGGT-3') and N2 (5'-AGGGTAGGCGGATGTTGTTCT-3') or control primers ß-actin 1 (5'-CCTCCTGGGCATGGAGTCC-3') and ß-actin 2 (5'-CGCTCAGGAGGAGCAATGAT-3'). The MgCl2 concentration was increased to 3.1 mM per reaction. PCR conditions for MV nucleocapsid gene (MV-N) consisted of a 1-min denaturing step at 95°C, 1 min of annealing at 55°C, and 2.5 min of extension at 72°C for a total of 40 cycles. PCR conditions for ß-actin consisted of a 1-min denaturing step at 95°C, 1 min of annealing at 58°C, and 1 min of extension at 72°C for a total of 40 cycles. If PCR products were not directly visible by ethidium bromide staining, samples were transferred to Nytran membranes and probed with a [
-32P]ATP-labeled internal N-specific oligonucleotide (5'-GCCATGGCAGGAATCTCGGAAGAACAAGGCTCAGA-3') (16).
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98% of the CD34+ cells were positive for CD46 (Fig. 1b), less than 2% of the cells expressed SLAM (Fig. 1c). CD34+ cells cultured in a cytokine mixture promoting myeloid development, as well as mature CD14+ monocytes, maintained expression of CD46. Under the same conditions, the level of SLAM expression remained
2% (data not shown). CD34+ cells were infected with the purified wild-type isolate MV-JW. It was previously shown that wild-type MV-JW can utilize CD46 for entry into human PBMC (25), and it has also been shown that MV-JW can utilize SLAM as a receptor (40). For comparison, an equal volume of MV-JW that had been rendered noninfectious by UV irradiation (MV-UV), or mock-infected cells treated with medium alone, served as control. In the first series of experiments, cells were maintained in culture and the proportion of MV-infected cells was determined by flow cytometry by detecting expression of the MV HA glycoprotein on the cell surface. Typically, the percentage of MV-JW-infected cells rose to a maximum of 12% by 5 days postinfection (Fig. 1d). During this period, CD46 expression levels remained constant. The production of infectious MV from the cells in culture was measured, and as seen in Fig. 1e, significant levels of infectious virus could be recovered. These results demonstrate that the UCB CD34+ cells can be productively infected by wild-type MV and maintain expression of CD46 during myeloid development, with little to no SLAM expression during this period. To determine which of the known MV receptors, CD46 or SLAM, was utilized to enter MV-susceptible cells, inhibition studies using MAbs against these receptors were performed (Fig. 1f). CD34+ cells were incubated with an antireceptor MAb previously shown to inhibit MV infection, specifically, either the MCI20.6 anti-CD46 antibody which recognizes CD46 SCR-1 (32), or the IPO-3 MAb which recognizes SLAM (40). Interestingly, neither antibody efficiently inhibited MV infection, with a less than 10-fold reduction in infection seen with the anti-CD46 MAb (P = 0.4) and no reduction in virus titers seen with the anti-SLAM MAb (Fig. 1f). These results suggest that a novel, as yet unidentified, additional receptor is present and utilized for infection of CD34+ cells by MV.
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FIG. 1. Infection of CD34+ cells by wild-type MV. (a) Flow cytometric analysis of CD34+ cells from human UCB with CD34+ and CD38+ fluorochrome-conjugated antibodies. (b) Expression of CD46+ on CD34+ cells from human UCB (unfilled histogram) compared to that from an isotype control (shaded histogram). (c) Expression of SLAM on CD34+ cells from human UCB (unfilled histogram) compared to that from an isotype control (shaded histogram). (d) Infection of CD34+ cord blood cells by MV-JW. Cell surface expression of the MV HA glycoprotein versus that of CD46+ is shown. Left panel: mock-infected control (CTRL); right panel: MV-JW infected. The percentage of double-positive (CD46+/MV-HA+) cells in each sample is noted in the upper-right quadrant of each panel. (e) Production of MV from infected CD34+ cells over a 24-day time course measured by a TCID50 assay. (f) Inhibition of MV infection of CD34+ cells by antibodies against CD46 or SLAM. Inhibition of viral entry by using an isotype control antibody (isotype ctrl Ab), anti-CD46 MAb MCI20.6 (P = 0.4 compared to control), anti-SLAM antibody IPO-3, or both antibodies together (P < 0.2 compared to control) is shown. Virus production in the cell supernatant at 4 days postinfection was measured by TCID50 assay and is expressed as the log TCID50 per milliliter of supernatant. Assays were performed in triplicate and are expressed as means ± standard errors.
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FIG. 2. Suppression of hematopoiesis in bulk culture LTC-IC assay. (a) Titers of MV from supernatants of MV-JW as measured by TCID50 assay. Results are representative of 2 independent experiments. (b) Cell numbers in bulk culture LTC-ICs during 5-week cocultivation with human BM stromal cells. Results of two separate experiments are shown. Filled squares, MV-JW cultures; unfilled circles, control cultures. (c) Quantification of total CFCs (including CFU-GM and BFU-E) harvested from week 5 of bulk culture LTC-IC. CFCs from LTC-IC control and MV-JW are shown. Bars indicate means of triplicate culture results ± 1 standard deviation, P < 0.002. (d to i) Light micrographs of colonies formed from CFCs harvested from bulk LTC-IC cultures. Panel d, control and CFU-GM cells; panel e, control and BFU-E; panel f, MV-JW and CFU-GM; panel g, MV-JW and BFU-E; panel h, UV-MV and CFU-GM; panel I, UV-MV and BFU-E. (j) RT-PCR of colonies from control or MV-JW- or MV-UV-infected LTC-IC culture, detecting either the MV-N message (top) or, as a positive control, human ß-actin message (bottom). dH2O, no template for PCR; MV-ctrl, RNA template prepared from MV-JW infected human PBMC; peN1, control plasmid DNA template carrying MV-N gene.
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No MV-induced CPE were observed in the bulk LTC-IC culture during the 5 weeks of culture. However, in bulk LTC-IC cultures that were further maintained for 7 to 8 weeks, characteristic MV-associated CPE, including syncytium formation and cell lysis, became apparent in the irradiated stromal cell monolayer compared to those in the controls (Fig. 3a to c), and the stromal monolayer was eventually destroyed. The susceptibility of human stroma to wild-type MV was confirmed by infecting nonirradiated human BM stromal cells at an MOI of 0.1 and screening for the presence of MV antigens by indirect immunofluorescence at days 3, 5, and 7 postinfection. Infected cells and syncytium formation were observed by immunofluorescence staining, and infectious virus was produced (data not shown). In addition, while CD46 expression was observed on >95% of the human stromal cells, less than 1% of the stromal cells expressed SLAM (data not shown). Blockade using antibodies against CD46 or SLAM showed complete inhibition with anti-CD46 antibodies (>3 logs), whereas anti-SLAM antibodies gave 2 logs of inhibition. These results would suggest that in contrast to CD34+ cells, CD46 is primarily utilized on stromal cells while SLAM may function as a coreceptor on these cells. These results indicate differential receptor usage by a wild-type MV strain depending on the target cell. Interestingly, usage of CD46 appears to be associated with CPE, as increased cytopathicity and syncytium formation is found on stromal cells compared to CD34+ cells. This effect may be related to the choice of receptor or to the affinity of viral glycoproteins for the cell surface. Our results demonstrate that BM stromal cells support wild-type MV replication and that in contrast to our findings regarding CD34+ committed progenitor cells, wild-type MV produces cytopathicity in stromal cells. These results suggest that MV-mediated loss of stromal support plays a major role in disrupting the development of HSCs.
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FIG. 3. Suppression of hematopoiesis requires MV infection of BM stromal cells. (a to c) Light micrographs depicting CPE observed in bulk LTC-IC cultures at week 8. Panel a, control; panel b, MV-JW infected; panel c, MV-UV infected. (d) RT-PCR detecting MV-N message in bulk culture LTC-IC cocultivated with either human or mouse stroma at week 2 or week 5 postinfection. Top: RT-PCR of MV-N message from mock-infected control (C), MV-UV-infected (UV), and MV-JW-infected (JW) cells. Bottom: positive control PCR for human ß-actin. H2O, no PCR template; peN1, plasmid DNA template carrying MV-N gene. (e) CFC assay demonstrating loss of CFC progenitor cells derived from 5-week bulk culture LTC-IC cocultivated with human stroma (hLTC-IC; P < 0.002) compared to control or mouse stroma (mLTC-IC). Bars indicate means of triplicate cultures ± 1 standard deviation.
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TABLE 1. MV RNA in colonies derived from bulk culture LTC-IC
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A second possibility is that MV infection does not directly affect the ability of HSCs to undergo normal hematopoiesis but that the suppression of HSC development is attributable to either a lack of support or active suppression by MV-infected stroma. The absence of HSC suppression by CD34+ cells grown on mouse stroma (Fig. 3e), together with the gradual increase in the proportion of MV-positive colonies in the absence of suppression (Table 1), is consistent with this interpretation. MV infection and disruption of stromal function have been observed in primary human thymic organ cultures, where the destruction of stromal cells by MV leads to apoptosis of immature thymocytes, although the thymocytes themselves are not infected (3). Other immunosuppressive viruses, such as human cytomegalovirus, dengue virus, murine leukemia virus and human immunodeficiency virus type 1, have been reported to target BM stroma and inhibit hematopoiesis by reducing expression of supportive cytokines such as stem cell factor and/or increasing expression of suppressive cytokines such as transforming growth factor ß (1, 4, 21, 22, 27, 30, 41). Thus, stromal cell targeting may be a common mechanism used by immunosuppressive viruses to induce hematopoietic suppression. Depletion of MV-infected stromal cells and CD34+ cells from the BM could also be mediated by virus-specific cytotoxic T lymphocytes induced during acute measles infection (17). The combination of a suppressive cytokine milieu in the BM with depletion of both stromal and CD34+ populations may significantly impair repopulation of lymphoid precursors following MV-induced lymphopenia. Once MV was cleared, reconstitution of a functional BM microenvironment and HSC populations would require a 1- to 2-month timeframe, consistent with the length of time typically required to resolve lymphopenia and immunosuppression following acute measles (33).
Our results also indicate that cellular receptors for MV may play an important role in differential targeting of MV to specific hematopoietic lineages in vivo and may help to explain disease pathology. SLAM has been proposed to be the primary MV receptor for wild-type viruses (40); however, the lack of SLAM expression for early hematopoietic and myeloid lineage cells shown to be important targets for wild-type MV both in vitro and in vivo suggests otherwise. Our results strongly suggest that MV utilizes neither CD46 nor SLAM to gain entry into CD34+ cells, suggesting the presence of an alternative, as-yet unidentified third receptor. In contrast, stromal cells appear to be infected via the CD46 receptor, with SLAM possibly functioning as a coreceptor. MV targeting of myeloid progenitors in BM may allow an insidious route of immunosuppression, i.e., the propagation of MV, with minimal CPE, throughout myeloid cells during development. MV has been shown to infect monocyte progenitors (14), mature monocytes, and myeloid-derived antigen-presenting cells such as dendritic cells and Langerhans cells in vitro (10). The loss or dysfunction of macrophage and dendritic cell antigen-presenting cells most likely contributes to the generalized impairment of T-cell-mediated immunity by impairing efficient T activation and inducing widespread T-cell apoptosis or anergy (36, 37). Infection of monocytes and macrophages has also been associated with suppression of IL-12 production. This loss of normal IL-12 regulation leads to the skewing of T-cell responses toward T-helper-2 (18), which has been associated with suppression of CMI in other viral models (5). In contrast to myeloid cells, activated T and B cells express both CD46 and SLAM (39, 40). MV may preferentially utilize SLAM to infect and induce apoptosis in activated lymphocytes, resulting in lymphopenia. To further define the precise mechanisms in vivo by which differential MV receptor expression patterns influence measles targeting, replication, and resulting immunosuppression is of critical importance.
Finally, the ability of MV to directly target primitive HSCs indicates that MV may be a useful candidate vector for delivery of foreign genes to these cells. MV can be stably engineered to express foreign genes (34). Our findings suggest that as long as functional stromal support is present, measles efficiently infects primitive hematopoietic cells with no apparent deleterious effects on hematopoiesis. MV-based vectors are likely to be as safe as or safer than other viral gene delivery vectors, since attenuated vaccine strains of MV have routinely been administered to millions of people worldwide. Thus, it will be interesting to determine whether recombinant MV or MV glycoproteins can promote efficient and stable targeting of foreign genes and/or vectors to HSCs.
This work was supported by Public Health Service grants AI41514 and AI46441 (M.M.) and DK49886 and DK54938 (B.E.T.).
This is manuscript number 13548-NP from The Scripps Research Institute. ![]()
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