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Journal of Virology, March 2004, p. 3140-3144, Vol. 78, No. 6
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.6.3140-3144.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Repeated Low-Dose Mucosal Simian Immunodeficiency Virus SIVmac239 Challenge Results in the Same Viral and Immunological Kinetics as High-Dose Challenge: a Model for the Evaluation of Vaccine Efficacy in Nonhuman Primates
Adrian B. McDermott,1 Jacque Mitchen,1 Shari Piaskowski,1 Ivna De Souza,1 Levi J. Yant,1 Jason Stephany,1 Jessica Furlott,1 and David I. Watkins1,2*
Wisconsin National Primate Research Center,1
Department of Pathology and Laboratory Medicine, University of WisconsinMadison, Madison, Wisconsin2
Received 26 August 2003/
Accepted 4 November 2003

ABSTRACT
Simian immunodeficiency virus (SIV) challenge of rhesus macaques
provides a relevant model for the assessment of human immunodeficiency
virus (HIV) vaccine strategies. To ensure that all macaques
become infected, the vaccinees and controls are exposed to large
doses of pathogenic SIV. These nonphysiological high-dose challenges
may adversely affect vaccine evaluation by overwhelming potentially
efficacious vaccine responses. To determine whether a more physiologically
relevant low-dose challenge can initiate infection and cause
disease in Indian rhesus macaques, we used a repeated low-dose
challenge strategy designed to reduce the viral inoculum to
more physiologically relevant doses. In an attempt to more closely
mimic challenge with HIV, we administered repeated mucosal challenges
with 30, 300, and 3,000 50% tissue culture infective doses (TCID
50)
of pathogenic SIVmac239 to six animals in three groups. Infection
was assessed by sensitive quantitative reverse transcription-PCR
and was achieved following a mean of 8, 5.5, and 1 challenge(s)
in the 30, 300, and 3,000 TCID
50 groups, respectively. Mortality,
humoral immune responses, and peak plasma viral kinetics were
similar in five of six animals, regardless of challenge dose.
Interestingly, macaques challenged with lower doses of SIVmac239
developed broad T-cell immune responses as assessed by ELISPOT
assay. This low-dose repeated challenge may be a valuable tool
in the evaluation of potential vaccine regimes and offers a
more physiologically relevant regimen for pathogenic SIVmac239
challenge experiments.

INTRODUCTION
Worldwide, there are an estimated 42 million people who are
currently living with human immunodeficiency virus (HIV). Heterosexual
transmission is the predominant route of viral infection, particularly
in Asia and sub-Saharan Africa where more than 35 million people
are currently infected (
29). The risk of HIV infection is affected
by multiple factors that include transmission route, frequency
of sexual contact, genetic predisposition, and immunocompetence
of the individual (
6,
9,
20). The frequency of HIV infection,
particularly among women, has risen steadily, and there are
twice as many young women (aged 15 to 24 years) as men that
are currently infected with HIV in sub-Saharan Africa (
29).
According to the Joint United Nations Programme on HIV/AIDS,
approximately 58% of HIV-infected individuals in sub-Saharan
Africa are women and 9% are children (
29). Both sexual and perinatal
transmission of HIV are associated with a high plasma viral
load (
10,
14,
20,
23,
25,
27,
28).
Access to new and effective antiretroviral drugs is limited, and 5 million more people were infected during 2002 (29). Development of an effective vaccine strategy is therefore paramount. The majority of HIV vaccines in current clinical trials target cytotoxic T lymphocytes (CTL) because the generation of broadly neutralizing antibody response has been difficult to achieve (13, 22). Vaccines that specifically induce CTL have been tested in vaccinated macaques that were challenged with high doses of either simian-human immunodeficiency virus (SHIV) or simian immunodeficiency virus (SIV) (1, 4, 31). However, to evaluate such vaccines in the macaque model, a clinically relevant challenge is crucial to vaccine development. To date, even though amelioration of the disease course has been observed after challenge with the chimeric SHIV89.6P virus (3, 4, 8, 21, 24), few vaccination strategies have managed to significantly curtail the progression to simian AIDS (SAIDS) in animals challenged with highly pathogenic SIVs (239, 251, or E660) (5, 7). However, we and other groups have used SIVmac239 at doses of 103 to 105 50% tissue culture infective doses (TCID50) when challenging animals for the evaluation of potential vaccines (2, 18). These high-dose challenges ensure that all control animals become infected after a single exposure. However, SIV challenge following administration of a potential vaccine should ideally be at a dose that most accurately reflects challenge with HIV. The actual dose of HIV transmitted via sexual contact has been investigated but has proved to be dependent upon the type of model used (6, 10, 26). A study in sub-Saharan Africa showed a correlation between plasma viral loads in excess of 35,000 copies/ml and transmission to HIV-negative partners. Conversely, individuals with fewer than 1,500 copies/ml were less likely to transmit the virus (10, 20). Therefore, it is likely that the rate of transmission depends upon the concentration of the virus in the inoculum. Unfortunately, the recovery and detection of virus in semen has proved difficult, and concentrations ranging from <103 to >105 HIV RNA copies/ml of seminal plasma have been reported previously (6, 30). The routine mucosal challenge inoculum used in nonhuman primate SIV challenge studies far exceeds the amount of HIV in semen and can be in excess of 8 x 107 SIV RNA copies/ml. Here we investigate whether a more relevant low-dose viral challenge can infect and cause disease in Indian rhesus macaques.
To achieve a low-inoculum dose, we repeatedly challenged six animals intrarectally according to the strategy depicted in Fig. 1. Animals 1941 and 96107 received 30 TCID50, AJ10 and AJ11 received 300 TCID50, and 97009 and 98019 received 3,000 TCID50. Challenge was repeated after 2 weeks and then at weekly intervals thereafter until infection was detected. The plasma virus concentration was tested prior to the next weekly dose; if positive, the challenges for that animal were terminated. From the time of the initial challenge, the animals were screened regularly for humoral and cellular immune responses by enzyme-linked immunosorbent assay and whole-proteome ELISPOT assay, respectively.

Repeated low-dose challenge results in SIVmac239 infection.
Quantitative reverse transcription-PCR (RT-PCR) was used for
early virus detection and determination of plasma viral concentration
as described previously. Viral RNA was extracted from 800 µl
of plasma after the pelleted virus was digested with 1 mg of
proteinase per ml, and viral RNA was precipitated. Plasma viral
RNA concentrations were determined by quantitative RT-PCR using
the Roche LightCycler (Roche Diagnostics Corporation, Columbus,
Ind.). The forward primer was SIV-61F (5'-CCACCTACCATTAAGCCCGA-3'),
the reverse primer was SIV-143R (5'-CTGGCACTACTTCTGCTCCAAA-3'),
and the probe was SIV-84T (FAM reporter, TAMRA quencher) [5'-CATTAAATGCCTGGGTAAAATTGATAGAGGA(G/A)AAGAA-3'].
Cycling conditions were as follows: 61°C for 15 min, 95°C
for 30 s, 45 cycles at 95°C for 2 s, and 60°C for 12
s. Data were collected at the end of the extension phase only.
As expected, SIVmac239 was detected in the plasma from animals
97009 and 98019 following a single challenge with 3,000 TCID
50 of SIVmac239 (Fig.
2). However, AJ10 and AJ11 were challenged
eight and three times, respectively, (mean, 5.5 challenges)
with 300 TCID
50 before they became infected. The lowest dose
of 30 TCID
50 was administered 10 and 6 times (mean of eight
challenges) to animals 1941 and 96107 to establish SIVmac239
infection (Fig.
2). Longitudinal analysis of the plasma viral
concentration from all groups revealed similar kinetics regardless
of inoculum or number of infections the animals received (Fig.
3.). The plasma viral concentration peaks were in the expected
range of 10
7 to 10
8 copies/ml, which subsequently reduced to
approximately 10
6 copies/mla finding typical for this
virus (Fig.
3) (
19). The plasma viral concentration produced
by low-dose challenge showed no difference when compared to
that of 10 Mamu-B*17-negative animals exposed to a high-dose
challenge (Fig.
4A). However, one animal, AJ11, was challenged
three times with 300 TCID
50 of SIVmac239 and had a peak viral
load of only 10
5 copies/ml, a plasma viral concentration 10-fold
lower than that of the other animals that received low doses
of SIVmac239. Indeed, following this peak plasma virus concentration,
plasma virus in AJ11 became undetectable by our sensitive quantitative
RT-PCR technique. Interestingly, this animal (AJ11) is Mamu-B*17
positive, an allele associated with the control of SIVmac239
(
19). When compared to plasma viral concentrations in 13 other
Mamu-B*17-positive macaques, the concentration of plasma virus
was found not to differ in the acute phase, despite the high-dose
challenge of SIVmac239 administered to these animals (Fig.
4B).
Interestingly, comparison of the chronic-phase plasma virus
concentration of AJ11 and the plasma virus concentration of
the Mamu-A*01, B*17 double-positive long-term nonprogressors
(shown in red in Fig.
5B) showed no difference. Animals 97009,
98019, AJ10, and 1941 were sacrificed due to SAIDS-related diseases
at 26, 22, 26, and 10 weeks postinfection, respectively. We
therefore conclude that low doses of SIVmac239 were pathogenic
in these rhesus macaques regardless of dose or number of challenges
received, and these findings fall within our expected range
of life span with this virulent virus (
19). Two animals remain
asymptomatic to date (at 35 weeks postinfection), 96107 and
AJ11, with the former having a set point viral load of >10
6 copies/ml, and we are still unable to detect plasma virus in
the latter Mamu-B*17-positive animal.

Humoral and cellular immune responses.
To investigate whether low-dose repeated challenge may result
in antibody responses that differ from those seen in macaques
exposed to a high-dose viral challenge, we monitored SIV-specific
plasma antibody responses by using the commercially available
HIV type 2-specific enzyme-linked immunosorbent assay kit from
the Genetic Systems Corporation/Sanofi-Pasteur Diagnostics (Redmond,
Wash.). The detection of antibody from the low-dose, repeatedly
challenged animals produced the same kinetics as that seen in
high-dose-challenge animals.
It is possible that infection with a low-dose viral inoculum might allow for the development of broad and vigorous SIV-specific cellular responses. In order to monitor the development and breadth of cellular responses before and after each virus challenge, we screened the animals regularly according to our animal protocols. Therefore, to assess SIV-specific T-cell responses, we used a gamma interferon ELISPOT assay (U-Cytech BV, Utrecht, The Netherlands) at regular intervals (Fig. 5) during the repeated intrarectal challenges using freshly isolated Ficoll-separated peripheral blood mononuclear cells (105/well). Peptide pools made up of 10 15-mers overlapping by 11 amino acids (final concentration, 5 µg/ml), which spanned the entire SIVmac239 proteome, were used to detect T-cell immune responses as described previously (11, 15-17). The peripheral blood mononuclear cells and peptides were coincubated for 16 to 18 h, and the spots were visualized directly by using an AID reader system (Cell Technologies, Inc., Columbia, Md.). Responses were considered positive when the frequency of gamma interferon-secreting T cells exceeded the mean spot-forming cell count of the negative controls plus twice the standard deviation. In all of the study animals, we detected T-cell responses across the SIVmac239 proteome from the earliest time point tested after successful intrarectal challenge until the time of sacrifice. At more than 27 weeks postinfection, the two animals that are still alive, AJ11 and 97106, had broad T-cell responses to 27 and 24% of the SIVmac239 pools tested, respectively (Fig. 4). Analysis of the average number of pools recognized by animals in the different groups shows that, at time points before 11 weeks, 11.5 (14%), 19.5 (23%), and 46.5 (56%) SIVmac239 pools per animal were recognized in the 3,000, 300, and 30 TCID50 groups, respectively. This would suggest that more immune responses are recognized in the lower-dose-challenge inoculum groups than in the 3,000-TCID50 dose of SIVmac239 early in infection. However, given the small number of animals and the inherent genetic variation in outbred rhesus macaques, this trend may not be significant.
Our low-dose-challenge experiments clearly show that infection can be achieved by repeated exposure to low virus doses across mucosal surfaces. Infection with these low virus doses results in typical plasma virus concentrations and the normal development of humoral immune responses. Furthermore, broad, multiepitope-specific cellular immune responses develop in animals that are infected with repeated exposure to low doses of SIVmac239. Since these repeated low-dose exposures more closely resemble exposure to HIV, it will be interesting to determine whether vaccine-induced CTL in the mucosa can ameliorate the disease course after challenge with a low dose of this highly pathogenic SIVmac239 clone.

ACKNOWLEDGMENTS
We thank Bill Rehrauer and Tim Jacoby for major histocompatibility
complex typing. We also thank Eva Rakasz for assistance with
the antibody titers and for helpful discussions.
This work is supported by NIH grants AI46366, AI49120, RR15371, and RR00167. David Watkins is an Elizabeth Glaser Scientist.

FOOTNOTES
* Corresponding author. Mailing address: Department of Pathology and Laboratory Medicine, University of WisconsinMadison, 515 SMI, 1300 University Ave., Madison, WI 53706. Phone: (608) 265-3380. Fax: (608) 263-4031. E-mail:
watkins{at}primate.wisc.edu.


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Journal of Virology, March 2004, p. 3140-3144, Vol. 78, No. 6
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.6.3140-3144.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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