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Journal of Virology, May 2004, p. 5523-5527, Vol. 78, No. 10
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.10.5523-5527.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Characterization of Restrictions to Human Immunodeficiency Virus Type 1 Infection of Monocytes
Karine Triques and Mario Stevenson*
Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01605
Received 31 October 2003/
Accepted 7 January 2004

ABSTRACT
Tissue macrophages are an important cellular reservoir for replication
of human immunodeficiency virus type 1 (HIV-1) and simian immunodeficiency
virus. In vitro, the ability of macrophages to support viral
replication is differentiation dependent in that precursor monocytes
are refractory to infection. There is, however, no consensus
as to the exact point at which infection is restricted in monocytes.
We have revisited this issue and have compared the efficiencies
of early HIV-1 replication events in monocytes and in differentiated
macrophages. Although virus entry in monocytes was comparable
to that in differentiated macrophages, synthesis of full-length
viral cDNAs was very inefficient. Relative to differentiated
macrophages, monocytes contained low levels of dTTP due to low
thymidine phosphorylase activity. Exogenous addition of
D-thymidine
increased dTTP levels to that in differentiated macrophages
but did not correct the reverse transcription defect. These
results point to a restriction in monocytes that is independent
of reverse transcription precursors and suggest that differentiation-dependent
cellular cofactors of reverse transcription are rate limiting
in monocytes.

TEXT
The presence of an extravascular reservoir of human immunodeficiency
virus type 1 (HIV-1)-infected macrophages is well established
(
6,
7,
10,
12,
30,
31). The ability of tissue macrophages to
serve as a reservoir for HIV-1 and simian immunodeficiency virus
replication correlates with the ability of monocyte-derived
macrophages to support productive viral infection in vitro (reviewed
in reference
10). Before entering the tissues and differentiating
into macrophages, monocytes briefly circulate in peripheral
blood (
28,
29). Several studies indicate that circulating monocytes
also serve as a viral reservoir in infected individuals (
15-
17,
33). The infection of circulating monocytes in vivo is at odds
with in vitro studies, where monocytes acquire the ability to
support productive viral infection only after their differentiation
to macrophages (
2,
4,
5,
19,
20,
23,
25). While most studies
have suggested that the viral replication cycle in monocytes
is restricted at a point prior to establishment of the provirus,
the exact point of restriction is a matter of debate. Chemokine
receptor expression has been shown to increase during in vitro
differentiation of monocytes, but this did not account fully
for differences in infectibility (
4,
19). Macrophages from different
donors have been shown to support HIV-1 infection to highly
variable degrees, but the ability to support infection was independent
of receptor/coreceptor expression and was manifest at the level
of late reverse transcription (
5). HIV-1 pseudotyped with the
envelope glycoprotein of vesicular stomatitis virus (VSV) was
also restricted in monocytes (
20), suggesting that the block
is independent of viral attachment and receptor/coreceptor factors.
Some studies have indicated that viral cDNA synthesis is extremely
inefficient or completely absent in monocytes (
5,
25). Other
studies using an HIV-1-based vector placed the block between
completion of reverse transcription and nuclear entry of viral
cDNA (
20). In this study we use quantitative entry and postentry
assays to better define the point at which viral replication
is restricted in monocytes.
Culture of fresh monocytes in the presence of monocyte colony-stimulating factor (MCSF) promotes monocyte differentiation (9). To examine the kinetics of monocyte differentiation, fresh elutriated monocytes were plated in the presence of MCSF and immunophenotyped for expression of the lipopolysaccharide (LPS) receptor (CD14), the transferrin receptor (CD71), and the hemoglobin scavenger receptor (CD163). CD14 and CD163, which are expressed on monocytes and macrophages differentiated in the presence of MCSF in vitro (14, 27), were constitutively expressed during monocyte differentiation (Fig. 1a). On the other hand, the percentage of cells expressing the macrophage-specific transferrin receptor, CD71, increased as cells underwent differentiation in culture (Fig. 1a). We examined whether fresh monocytes supported HIV-1 entry using a recently developed ß-lactamase-based HIV-1 entry assay (1, 18). In this assay, the fluorescent substrate of ß-lactamase (CCF2) is loaded into target cells. Cells are then infected with a wild-type virus in which a Vpr-ß-lactamase fusion protein has been packaged. Upon virus binding, fusion, and uncoating, ß-lactamase, which is incorporated into virions through fusion with Vpr, enzymatically cleaves the ß-lactam ring in CCF2, changing its fluorescence emission from green to blue. The assay does not score for virions that have been taken up by endocytosis but depends on the liberation of the Vpr-ß-lactamase fusion protein into the cytoplasm after uncoating. Single-round infection of primary cells by HIV-1 is normally inefficient. Therefore, to increase the number of infection events for analysis, fresh monocytes were infected with VSV-G-pseudotyped and nonpseudotyped HIV-1 (wild-type for Vpr). Both pseudotyped and nonpseudotyped virions were able to infect fresh monocytes, as evidenced by the presence of ß-lactamase activity (Fig. 1b). Similar frequencies of ß-lactamase-positive cells were observed following infection of fresh monocytes and 7-day differentiated macrophages (Fig. 1b). These results were representative of monocytes obtained from independent donors (n = 5). In comparison, quiescent lymphocytes, which do not support productive infection, also supported HIV-1 entry (Fig. 1b). VSV-G pseudotyping increased the frequency of infected cells to similar levels in monocytes and in differentiated macrophages (Fig. 1b). Therefore, events leading up to uncoating appear to progress with similar efficiencies in monocytes and in differentiated macrophages, suggesting that the block to monocyte infection is at a point in the viral replication cycle subsequent to virus binding, fusion, and uncoating.
We next compared the abilities of monocytes and macrophages
to support viral cDNA synthesis. Fresh monocytes were plated
in medium in the presence of MCSF to promote differentiation.
At daily intervals following initiation of the cultures, monocytes
were infected. Early (minus-strand strong-stop cDNA) and late
products of reverse transcription were measured 18, 42, and
66 h following infection by real-time PCR quantitation of late
reverse transcription products as well as two-long-terminal
repeat (2-LTR) circle forms of viral cDNA. The presence of viral
integrants was determined by an Alu-LTR PCR method (
8). In undifferentiated
monocytes early (not shown) and late (Fig.
2) reverse transcripts
were synthesized very inefficiently. As monocytes differentiated
to macrophages, they acquired the ability to support HIV-1 reverse
transcription (Fig.
2). Expression of the macrophage marker
CD-71 became evident after 3 to 4 days in culture (Fig.
1a).
This was also the interval at which reverse transcription, based
on synthesis of late reverse transcripts and 2-LTR circles (Fig.
2a and b), became evident. These late reverse transcripts were
also competent for integration since we were able to detect
the presence of integrated proviruses at these intervals (Fig.
2c). This pattern of reverse transcription in monocytes and
macrophages was extremely consistent in cells from multiple
donors (
n = 6). These results suggest the presence of a reverse
transcription defect in monocytes that is alleviated upon differentiation.
Previous studies have indicated that quiescent peripheral blood
lymphocytes, which are refractory to productive infection, inefficiently
support reverse transcription (
32). While it was originally
suggested that this was due to rate-limiting levels of deoxynucleotide
triphosphates (dNTPs), increasing dNTP levels improved reverse
transcription but did not overcome the infectivity block (
13).
Comparison of dNTP levels in fresh monocytes and in 7-day macrophages
indicated only a twofold difference in dATP, dGTP, and dCTP
levels between monocytes and macrophages (Fig.
3a). However,
dTTP levels in fresh monocytes were low to undetectable and
increased upon culture (Fig.
3a). For monocytes from four independent
donors, dTTP levels in monocytes were close to background and
increased over 10-fold upon macrophage differentiation.
D-Thymidine,
the major biosynthetic precursor of dTTP, is derived from thymine
by the action of thymidine phosphorylase (Fig.
3b). In cells
from independent donors (
n = 3), this enzyme was present at
low to undetectable levels in fresh monocytes and was induced
during differentiation to macrophages (Fig.
3c). We examined
whether artificially increasing dTTP levels in fresh monocytes
would overcome the reverse transcription defect present in these
cells. To increase dTTP levels, fresh and 2-day monocytes were
incubated with several dTTP biosynthetic precursors. Addition
of
D-thymidine to fresh monocytes was sufficient to increase
dTTP concentration to levels exceeding that of differentiated
macrophages (Fig.
4a).
D-Uridine did not influence dTTP levels,
while thymine increased dTTP levels only in 2-day monocytes
(Fig.
4a). This was to be expected since thymidine phosphorylase,
which is required for conversion of thymine to
D-thymidine,
was more abundant in monocytes that had been in culture for
a least 2 days (Fig.
3c). Since dTTP levels could be stimulated
to levels comparable to that in fully differentiated macrophages
(Fig.
3a), we examined whether this was sufficient to promote
reverse transcription in fresh monocytes. Infection of monocytes
in the presence or absence of exogenous
D-thymidine did not
have a significant impact on the extent of reverse transcription
whether infections were conducted with pseudotyped or with nonpseudotyped
viruses (Fig.
4b). Therefore, increasing dTTP levels to that
of differentiated macrophages was not sufficient to significantly
impact reverse transcription efficiency.
In this study we have attempted to characterize the point at
which monocyte infection by HIV-1 is restricted. Collectively,
our data suggest a reverse transcription defect in undifferentiated
monocytes that cannot be corrected by normalization of dNTP
levels. The restricted infection of fresh monocytes parallels
that which has been described for quiescent T lymphocytes (
13).
Nuclear factor of activated T cells (NFAT) is present at low
levels in quiescent lymphocytes, and it has been proposed that
this accounts for the inefficient reverse transcription in these
cells (
11). However, NFAT was not detectable in either fresh
monocytes or in differentiated macrophages, so differences in
NFAT expression could not account for the observations reported
in our study. It has been proposed that inefficient reverse
transcription due to low dNTP levels accounts for the restriction
to productive viral infection of quiescent lymphocytes. However,
although exogenous stimulation of dNTP levels enhanced reverse
transcription and generation of full-length transcripts, this
did not overcome the block to infection. These and other studies
(
22,
26) support the notion that a block subsequent to reverse
transcription prevents productive infection of quiescent lymphocytes.
Upon infection of monocytes, reverse transcription was highly
inefficient when analyzed up to 66 h postinfection and was not
improved by normalization of dNTP levels (Fig.
2). This suggests
a reverse transcription block in monocytes rather than a post-reverse
transcription block. Therefore, for monocytes, differentiation-dependent
cellular factors important for reverse transcription may be
rate limiting while, for quiescent lymphocytes, activation-dependent
cellular cofactors that regulate a post-reverse transcription
step in viral infection may be lacking.

ACKNOWLEDGMENTS
We thank B. Blais for assistance with flow cytometry analysis,
N. Landau for the Vpr-ß-lactamase expression plasmid,
members of the Stevenson laboratory for scientific discussion,
B. Mellor for preparation of figures, and N. Nelson for manuscript
preparation.
This work was supported in part by grants RR-11589 from the National Institute of Research Resources and AI-37475 from the National Institute of Allergy and Infectious Diseases to M.S.

FOOTNOTES
* Corresponding author. Mailing address: Program in Molecular Medicine, University of Massachusetts Medical School, 373 Plantation St., Suite 319, Worcester, MA 01605. Phone: (508) 856-4582. Fax: (508) 856-4075. E-mail:
mario.stevenson{at}umassmed.edu.


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Journal of Virology, May 2004, p. 5523-5527, Vol. 78, No. 10
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.10.5523-5527.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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