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Journal of Virology, March 2003, p. 2956-2963, Vol. 77, No. 5
0022-538X/03/$08.00+0 DOI: 10.1128/JVI.77.5.2956-2963.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Department of Immunotherapeutics, Graduate School, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
Received 26 August 2002/ Accepted 26 November 2002
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In cohort studies of HTLV-1 carriers, it appeared that risk factors for ATL may include vertical HTLV-1 infection, gender (male > female), an increase in the number of abnormal lymphocytes that is associated with an increase in the HTLV-1 proviral load, and a low anti-Tax antibody level in serum (10-12). Genetic analysis indicated that ATL and HAM/TSP patients in an area of endemicity show significant segregation of HLA haplotypes (42). These observations indicate that the pathogenesis of HTLV-1 is more likely to be influenced by host factors.
Immunological studies have found a clear difference in HTLV-1-specific T-cell immune responses among HTLV-1-related diseases. HTLV-1-specific cytotoxic T lymphocytes (CTLs) are highly activated in HAM/TSP patients and can also be induced in asymptomatic carriers but only rarely in ATL patients (13, 15, 16, 18, 36). The HTLV-1 core, envelope, polymerase, Tax, Tof, and Rof proteins are known to be recognized by HTLV-1-specific CTLs (3, 14, 36, 37). Of these antigens, HTLV-1 Tax, a viral protein critical for T-cell immortalization, is a most popular target for HTLV-1-specific CTLs found in HTLV-1-infected individuals (13, 14). HTLV-1 Tax-specific CTLs are capable of lysing short-term-cultured ATL cells ex vivo (15, 16). In a recently established rat ATL model, HTLV-1-infected T-cell lymphomas expanded in vivo in the absence of T-cell immunity but regressed following administration of HTLV-1 Tax-specific CTLs (6, 7, 17, 32, 33). These findings strongly indicate that HTLV-1-specific CTLs contribute to anti-tumor surveillance in HTLV-1-infected individuals and suggest that insufficiency of T-cell immune responses to HTLV-1 may be a risk factor for development of ATL.
The exact reasons for the wide variety of levels of immune responses to HTLV-1 among HTLV-1-infected individuals are unclear. Segregation of HLA haplotypes in ATL patients suggests that weak immune responses may be associated with genetic factors (42). Another possibility is that weak immune responses in ATL patients are associated with vertical HTLV-1 infection. This possibility is suggested by the fact that ATL occurs mainly in vertically infected individuals but not in those who are infected later in life (39). Our previous finding that oral administration of HTLV-1 to rats induced much weaker HTLV-1-specific immune responses than intraperitoneal or intravenous infection (17, 20) also suggests that the conditions of primary infection may affect the host immune responses to HTLV-1.
In humans, the routes of HTLV-1 transmission are vertical transmission from mother to child, horizontal transmission from husband to wife, and parenteral transmission via blood transfusion or intravenous injection with contaminated needles (8, 21, 34, 40). Of these, mother-to-child transmission, especially through breast milk, is a major natural route in Japan (8). A number of infantile HTLV-1 carriers stay seronegative for HTLV-1 for a certain period of time (31), suggesting that immunological tolerance to HTLV-1 infection may be established in this period. Most vertically infected children seem to recover from their lack of humoral immunity to HTLV-1 by the age of 3 years (27), although the cellular immune responses of these children have not been carefully studied. It is not known to what extent immune unresponsiveness to HTLV-1 early in infection influences establishment of the HTLV-1-infected cell reservoir in vivo. Since the host immune response is a critical determinant of the control of persistently infecting viruses in vivo, a weaker immune response may result in a greater viral load. We suspect that vertical HTLV-1 infection, a weak T-cell immune response to HTLV-1, and a large HTLV-1 proviral load are closely related to each other.
In this study, using a rat model system, we investigated whether a persistent HTLV-1 proviral load is influenced by differences in host HTLV-1-specific immune responsiveness resulting from differences in conditions at primary HTLV-1 infection. We confirmed that HTLV-1-specific cellular and humoral immune responses of orally infected rats were markedly impaired compared to those of intraperitoneally infected rats. In contrast, we found that the HTLV-1 proviral load of orally infected rats was significantly greater than that of intraperitoneally infected rats. Moreover, subcutaneous reimmunization of orally infected rats with syngeneic HTLV-1-infected cells induced HTLV-1-specific immune responses. Our results strongly suggest that oral HTLV-1 infection induced unresponsiveness of HTLV-1-specific host immunity, which usually restricts the propagation of HTLV-1-infected cells, resulting in an increased proviral load, and that reimmunization with appropriate HTLV-1 antigens could restore HTLV-1-specific immune responses in infected individuals.
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Cell lines. An HTLV-1-producing human T-cell line, MT-2 (29), and an HTLV-1-infected rat T-cell line, FPM1 (26), derived from an F344 n/+ rat were cultured in RPMI 1640 medium (GIBCO Laboratories, Grand Island, N.Y.) with 10% heat-inactivated fetal calf serum (FCS; BioWhittaker, Walkersville, Md.), 100 IU of penicillin per ml, 100 µg of streptomycin per ml, and 2 mg of sodium bicarbonate per ml. G14 (33) is an interleukin-2-dependent, HTLV-1-negative CD8+ T-cell line established from an F344 n/+ rat in our laboratory. G14-Tax (33) is a stable transfectant of G14 with HTLV-1 Tax-expressing plasmids. G14 and G14-Tax were maintained in a medium containing 2-mercaptoethanol (10-5 M) and recombinant human interleukin-2 (Shionogi Pharmaceutical Co., Osaka, Japan) (10 U/ml).
Inoculation of rats with HTLV-1. Various numbers of MT-2 cells were treated with 50 µg of mitomycin C (MMC) per ml at 37°C for 30 min, washed, and administered to 4-week-old female rats either orally or intraperitoneally. For oral infection, MMC-treated MT-2 cells in 0.5 ml of phosphate-buffered saline were directly administered into the esophagus through a feeder tube. For intraperitoneal infection, similarly treated MT-2 cells were percutaneously injected into the abdominal cavity. Peripheral blood samples were collected from all groups every 2 or 4 weeks after inoculation, and the presence of HTLV-1 provirus in peripheral blood cells and levels of antibodies to HTLV-1 in serum were determined. HTLV-1 provirus in the spleen was quantified at necropsy. We confirmed that all MMC-treated MT-2 cells died in 5 days after MMC treatment in vitro.
Detection of HTLV-1 provirus in infected rats. To detect HTLV-1 provirus in peripheral blood cells and spleen, genomic DNA samples prepared from these tissues by sodium dodecyl sulfate-proteinase K digestion, followed by phenol-chloroform extraction, were subjected to nested PCR as described previously (1). The outer set of primers for detection of HTLV-1 provirus was pX1 (5'-CCC ACT TCC CAG GGT TTG GAC AGA GTC TTC-3') and pX4 (5'-GGG GAA GGA GGG GAG TCG AGG GAT AAG GAA-3'), and the inner set of primers was pX2 (5'-CGG ATA CCC AGT CTA CGT GTT TGG AGA CTG T-3') and pX3 (5'-GAG CCG ATA ACG CGT CCA TCG ATG GGG TCC-3'). In the first PCR, a 0.4 µM concentration of a primer set for rat glyceraldehyde-3-phosphate dehydrogenase (GAPDH) (5'-ACC ACA GTC CAT GCC ATC AC-3' and 5'-TCC ACC ACC CTG TTG CTG TA-3') was included in the same reaction mixture as an internal control. The PCR was started from the activation step of Taq DNA polymerase (TOYOBO Inc., Nagoya, Japan) (95°C, 2 min); 35 cycles of denaturation (95°C, 1 min), annealing (60°C, 1 min), and extension (72°C, 1 min) were performed; and the PCR was finalized by elongation of the product (72°C, 5 min). For a nested PCR, an aliquot of the first PCR product was subjected to another 35 PCR cycles with the inner set of primers. The final PCR products were visualized by ethidium bromide staining following 2% agarose gel electrophoresis.
Quantification of HTLV-1 proviral load by LightCycler-based real-time PCR. The HTLV-1 proviral loads in the spleen cells of HTLV-1-infected rats were quantified by real-time PCR on a LightCycler PCR Instrument (Roche Diagnostics, Mannheim, Germany). For each test sample, 500 ng of genomic DNA extracted from the spleen was used as the template. The PCR was performed with the QuantiTect SYBR Green PCR kit (QIAGEN K.K, Tokyo, Japan) in accordance with the manufacturer's instructions. Briefly, 20 µl of a PCR mixture in a capillary tube containing each HTLV-1 pX-specific inner primer pair at 0.5 µM, 1x QuantiTect SYBR Green PCR Master Mix, and 500 ng of genomic DNA was subjected to 50 cycles of denaturation (95°C, 15 s), annealing (55°C, 10 s), extension (72°C, 10 s), and denaturation of primer-dimers (82°C, 10 s) following an initial Taq polymerase activation step (95°C, 15 min). The copy numbers of HTLV-1 provirus in the samples were estimated from the standard regression curve with the LightCycler Software version 3 (Roche Diagnostics). The standard curve for HTLV-1 provirus was obtained by PCR data for 5 x 100 to 5 x 103 copies of pCR-pX1-4 plasmids serially diluted with genomic DNA from the spleen of a naive rat. The pCR-pX1-4 plasmids were constructed by inserting a PCR fragment amplified with pX1 and pX4 from the genomic DNA of MT-2 cells into a pCR2.1 vector (Invitrogen, Groningen, The Netherlands) by TA cloning. To correct for differences among the samples, relative HTLV-1 provirus copy numbers were calculated as raw values divided by the amount of GAPDH in the same sample. The number of HTLV-1 provirus DNA copies in MT-2 cells measured by this method was 12.6 ± 3.0/cell.
Detection of antibodies to HTLV-1 antigens. The titers of antibodies against HTLV-1 antigens in the sera of infected rats were determined by the particle agglutination method using Serodia HTLV-1 (Fuji Rebio Inc., Tokyo, Japan).
Secondary transmission of HTLV-1 in rats. At 20 weeks after oral or intraperitoneal inoculation of MMC-treated MT-2 cells into F344 n/+ rats, splenic T cells isolated from the infected rats were treated with or without MMC and intraperitoneally injected into 4-week-old syngeneic F344 n/+ rats or allogeneic WKA rats, respectively (2 x 107 cells/rat). Spleen cells were collected from these rats at 8 to 10 weeks after inoculation, and genomic DNA samples were extracted from the spleen cells and used as the template for a nested PCR to detect HTLV-1 provirus. The PCR was carried out as described above.
T-cell proliferation assay. Splenic T cells from naive and HTLV-1-infected rats were enriched with a nylon-wool column and used as responder cells. Syngeneic G14 and G14-Tax cells were treated with 1% formalin in phosphate-buffered saline for 30 min, washed, and used as stimulator cells. Responder cells (105/well) and stimulator cells (5 x 104/well) were cultured in medium containing 10% FCS in a 96 well round-bottom culture plate at 37°C for 96 h. These cultures were pulsed with [3H]thymidine at a concentration of 37 kBq/well for the last 12 h to examine T-cell proliferation. Cells were harvested with a Micro 96 Harvester (Skatron, Lier, Norway), and [3H]thymidine incorporation was measured in a microplate beta counter (Micro Beta Plus; Wallac, Turku, Finland). To normalize for differences among experiments, a proliferation index was calculated as counts per minute of the sample well divided by the counts per minute of the control well of naive splenic T cells without stimulator cells in the same experiments. An HTLV-1-specific proliferation index was calculated as (counts per minute of the sample with G14-Tax - counts per minute of the sample with G14)/counts per minute of the control well.
IFN-
production assay.
Splenic T cells (105/well) from naive and HTLV-infected rats were cultured without or with formalin-fixed G14, G14-Tax, or FPM1 cells (5 x 104/well) in a microtiter plate with medium containing 10% FCS for 6 days. The concentrations of gamma interferon (IFN-
) in the supernatants were measured by enzyme-linked immunosorbent assay (ELISA) using Cytoscreen Rat IFN-
ELISA kits (BioSource International, Inc.) in accordance with the manufacturer's instructions.
Statistics analysis. The Mann-Whitney test was used to determine differences between the HTLV-1 proviral loads of orally and intraperitoneally infected rats. The Spearman correlation test was used to examine the relationship between HTLV-1 proviral loads and virus-specific T-cell proliferative responses.
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TABLE 1. Establishment of persistent HTLV-1 infection in rats inoculated with HTLV-1-infected cells
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TABLE 2. Presence of transmissible HTLV-1 in rats infected with MMC-treated MT-2 cellsa
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FIG. 1. HTLV-1 proviral loads of rats intraperitoneally or orally inoculated with HTLV-1. HTLV-1 proviral loads in spleen cells of rats intraperitoneally (i.p.) or orally (p.o.) inoculated with 5 x 101 or 5 x 107 MMC-treated MT-2 cells were quantified by LightCycler-based real-time PCR. The animals analyzed here were the same as those used in experiments 1, 2, and 4 of Table 1. The relative copy number of HTLV-1 proviruses per 105 copies of GAPDH in each rat is indicated. The thick bars show the average proviral loads. The statistical significance of differences was determined with the Mann-Whitney test.
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FIG. 2. HTLV-1-specific antibody responses of rats inoculated with MMC-treated MT-2 cells. F344 n/+ rats at 4 weeks of age were intraperitoneally (i.p.) (a, c) or orally (p.o.) (b, d) inoculated with 5 x 101 (c, d) or 5 x 107 (a, b) MMC-treated MT-2 cells. Anti-HTLV-1 antibody titers in sera were monitored by the particle agglutination method. Each symbol represents an individual rat. An antibody titer of <16 indicates an undetectable response.
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FIG. 3. HTLV-1 Tax-specific T-cell proliferative responses of MMC-treated MT-2-inoculated rats. T-cell-enriched spleen cells from rats intraperitoneally (i.p.) (a, c) or orally (p.o.) (b, d) inoculated with 5 x 107 (a, b) or 5 x 101 (c, d) MMC-treated MT-2 cells were incubated without (open bars) or with formalin-treated G14 (hatched bars) or G14-Tax (closed bars) cells, and [3H]thymidine incorporation was measured. To normalize for differences among four experiments, values are given as proliferation indexes (determined as described in Materials and Methods). The means of triplicate cultures ± the standard deviations are indicated. *, not determined because of accidental death.
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-producing ability of splenic T cells from HTLV-1-infected rats in response to formalin-treated G14, G14-Tax, and FPM1, a syngeneic rat HTLV-1-infected cell line. As shown in Fig. 4, the IFN-
-producing ability of T cells from rats intraperitoneally inoculated with 5 x 107 MMC-treated MT-2 cells was generally high, but they produced marked levels of IFN-
against G14-Tax and FPM1 cells. T cells of rats inoculated with 50 MMC-treated MT-2 cells also produced a low level of IFN-
upon FPM1 stimulation. However, the responses of T cells from rats orally inoculated with 5 x 107 or 50 MMC-treated MT-2 cells were indistinguishable from those in naive rats. Thus, the HTLV-1-specific cellular immune response in orally infected rats resulted in insufficient IFN-
production, as well as in the T-cell proliferative response.
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FIG. 4. HTLV-1-specific IFN- production by T cells in MMC-treated MT-2-inoculated rats. T-cell-enriched spleen cells isolated from rats intraperitoneally (i.p.) or orally (p.o.) inoculated with 5 x 107 or 5 x 101 MMC-treated MT-2 cells were incubated without (open bars) or with formalin-treated G14 (hatched bars), G14-Tax (closed bars), or FPM1 (dotted bars) cells for 6 days, and IFN- produced in the supernatants was measured by ELISA. The means of duplicate cultures ± the standard deviations are indicated. The results shown are representative of two independent experiments.
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FIG. 5. Inverse correlation between HTLV-1 proviral loads and HTLV-1 Tax-specific T-cell proliferative responses. The relationship between the HTLV-1 proviral load and HTLV-1 Tax-specific T-cell proliferative responses of rats inoculated intraperitoneally (circles) or orally (triangles) with 5 x 101 (open symbols) or 5 x 107 (closed symbols) MMC-treated MT-2 cells was examined. The relative copy number of HTLV-1 provirus in spleen cells and the HTLV-1 Tax-specific T-cell proliferation index of each rat are plotted on the vertical and horizontal axes, respectively. The HTLV-1 Tax-specific proliferation index was calculated as described in Materials and Methods. Statistical significance was determined with the Spearman correlation test.
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FIG. 6. Recovery of HTLV-1 Tax-specific T-cell proliferative responses in orally infected rats by reimmunization. Naive control rats (a, d) and rats orally infected with 5 x 107 MMC-treated MT-2 cells 8 weeks previously (b, c) were subcutaneously reimmunized without (a, b) or with (c, d) 2 x 107 MMC-treated FPM1 cells. T-cell-enriched spleen cells from these rats were isolated at 4 weeks after reimmunization, and [3H]thymidine incorporation was measured following inoculation without (dotted bar) or with formalin-treated G14 (hatched bar) or G14-Tax (closed bar) cells. The values shown are mean counts per minute of triplicate cultures ± the standard deviations. Similar results were obtained with three other pairs of orally infected rats with or without reimmunization with FPM1 cells.
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Cellular immunity is a critical mechanism of host defense against viruses and tumors. In our previous study, syngeneic HTLV-1-transformed tumor cells expanded in immunocompetent rats following administration of neutralizing antibodies to CD80 and CD86, which were able to block costimulatory signals necessary for antigen-specific T-cell immune responses (7). Withdrawal of these antibodies induced tumor regression in this model, which was associated with the appearance of active T-cell immunity against HTLV-1. These findings, together with the inverse correlation between HTLV-1-specific cellular immunity and the HTLV-1 proviral load demonstrated in the present study, indicate that HTLV-1-specific T-cell immunity actively controls the expansion of HTLV-1-infected cells in vivo.
Humoral immune responses to HTLV-1 were observed only in rats intraperitoneally inoculated with relatively large amounts of HTLV-1. This is due in part to insufficient expression of HTLV-1 structural proteins in rat HTLV-1-infected cells because of Rex dysfunction (5, 26). However, Tax can be expressed in rat, as well as human, cells. Since Tax is a major target antigen recognized by both human and rat cellular immune systems (6), cellular immune responses should more directly reflect the host immune status against HTLV-1 in rats.
Among intraperitoneally HTLV-1-infected rats, those inoculated with 5 x 101 MT-2 cells exhibited weaker cellular immune responses to HTLV-1 than those inoculated with 5 x 107 MT-2 cells. The viral dose at the primary HTLV-1 infection may be another determinant of host immunity. This raised the possibility that the immune unresponsiveness of rats orally inoculated with 5 x 107 cells might have been due to the small initial amount of HTLV-1 actually absorbed through the intestinal wall. However, the persistent viral loads in the orally infected rats were much greater than those in the rats intraperitoneally inoculated with 5 x 101 cells. Therefore, scarcity of viral antigens in vivo may explain the poor immune responses of intraperitoneally infected rats but not those of orally infected rats. In some of the rats orally inoculated with 5 x 101 cells, high levels of viral persistence were observed. This suggests that even when the initial number of HTLV-1-infected cells was extremely small, once such cells began to grow in vivo, the orally infected hosts might not have been able to control them.
It is known that oral administration of protein antigens induces peripheral tolerance in which host immunity does not respond to challenge administration of the fed antigen (28, 43). In this study, we found that HTLV-1-specific T-cell responses in orally HTLV-1-infected rats were restored by reimmunization with rat HTLV-1-infected syngeneic cells. Therefore, the immune unresponsiveness of orally HTLV-1-infected rats may differ from the typical observed oral tolerance of noninfectious protein antigens. Alternatively, the syngeneic HTLV-1-infected cells used as a challenge immunogen could be antigen-presenting cells strong enough to break T-cell anergy. The precise mechanisms of immune unresponsiveness in oral HTLV-1 infection remain to be clarified.
In humans, infants born to HTLV-1-carrying mothers are fed about 108 HTLV-1-infected cells before weaning (22) and a number of infantile carriers stay seronegative for HTLV-1 for a certain period of time (31). Since most of these HTLV-1-infected individuals exhibit seroconversion in a few years, T-cell immune unresponsiveness to HTLV-1 might also recover spontaneously later in life. In fact, many HTLV-1 carriers exhibit HTLV-1-specific T-cell responses. Once T-cell immunity to HTLV-1 is established, the magnitude of the immune response would positively correlate with the pre-existing viral load in vivo (30, 44). The presence of a large viral load and elevated levels of HTLV-1-specific immunity in HAM/TSP patients might be explained by T-cell immune conversion long after the establishment of a persistent viral load following vertical infection. Nevertheless, a small population of adult HTLV-1-infected individuals exhibits low T-cell responses to HTLV-1 despite an abundant viral load, as seen in ATL patients. Although the exact mechanism of development of ATL is still unclear, our results indicate that immune unresponsiveness to HTLV-1 is one of the risk factors for it and allows expansion of HTLV-1-infected cells. In this regard, reactivation of HTLV-1-specific T-cell immunity by vaccines might be of benefit. In the present study, we showed that HTLV-1-specific cellular immune unresponsiveness associated with oral infection was reversible and could be broken by reimmunization with syngeneic rat HTLV-1-expressing cells, a finding that may encourage the development of prophylactic approaches against ATL development.
In conclusion, oral HTLV-1 infection induced unresponsiveness of HTLV-1-specific host immunity associated with an increased persistent HTLV-1 viral load, a potential risk factor for ATL development. Prophylactic immunization may be one method of evading this risk.
This work was supported in part by grants from the Ministry of Education, Science, Culture and Sports of Japan and the Japan Science and Technology Corporation.
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