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Journal of Virology, August 2007, p. 8593-8600, Vol. 81, No. 16
0022-538X/07/$08.00+0 doi:10.1128/JVI.00769-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
N-Linked Glycosylation Attenuates H3N2 Influenza Viruses
David J. Vigerust,1
Kimberly B. Ulett,1
Kelli L. Boyd,2
Jens Madsen,3
Samuel Hawgood,3 and
Jonathan A. McCullers1*
Department of Infectious Diseases,1
Animal Resources Center, St. Jude Children's Research Hospital, Memphis, Tennessee 38105,2
Department of Pediatrics and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California 940433
Received 10 April 2007/
Accepted 25 May 2007

ABSTRACT
Over the last four decades, H3N2 subtype influenza A viruses
have gradually acquired additional potential sites for glycosylation
within the globular head of the hemagglutinin (HA) protein.
Here, we have examined the biological effect of additional glycosylation
on the virulence of H3N2 influenza viruses. We created otherwise
isogenic reassortant viruses by site-directed mutagenesis that
contain additional potential sites for glycosylation and examined
the effect on virulence in naïve BALB/c, C57BL/6, and surfactant
protein D (SP-D)-deficient mice. The introduction of additional
sites was consistent with the sequence of acquisition in the
globular head over the past 40 years, beginning with two sites
in 1968 to the seven sites found in contemporary influenza viruses
circulating in 2000. Decreased morbidity and mortality, as well
as lower viral lung titers, were seen in mice as the level of
potential glycosylation of the viruses increased. This correlated
with decreased evidence of virus-mediated lung damage and increased
in vitro inhibition of hemagglutination by SP-D. SP-D-deficient
animals displayed an inverse pattern of disease, such that more
highly glycosylated viruses elicited disease equivalent to or
exceeding that of the wild type. We conclude from these data
that increased glycosylation of influenza viruses results in
decreased virulence, which is at least partly mediated by SP-D-induced
clearance from the lung. The continued exploration of interactions
between highly glycosylated viruses and surfactant proteins
may lead to an improved understanding of the biology within
the lung and strategies for viral control.

INTRODUCTION
Influenza viruses express two envelope proteins that are involved
in virulence, neuraminidase (NA) and hemagglutinin (HA). During
the virus life cycle these proteins have distinct functions
in entry and release of the virus. HA plays a primary role in
the binding and uptake of the virus into target cells and is
the main target of neutralizing antibodies. Structurally, the
HA is a 200-kDa homotrimer with an ectodomain composed of a
globular head and a stalk region (
49). Both of these regions
undergo posttranslational modifications in the Golgi, where
glycoconjugates are added to certain sites of N-linked glycosylation.
Some of these glycosylation sites, primarily in the stalk region,
are indispensable to the proper folding and conformation of
the HA molecule (
9,
33). During the last 4 decades of circulation
in humans, N-linked glycosylation in and around the globular
head has gradually increased in H3N2 subtype viruses (
36,
48).
Carbohydrate attached to glycosylation sites has been previously
characterized in tissue culture to be cell type specific and
site specific and composed primarily of complex-type and oligomannose
oligosaccharide (
27,
35). The role of these glycoconjugates
in the life cycle of the virus and the evolutionary reasons
behind the increasing glycosylation seen since H3N2 viruses
began circulating in humans are poorly understood at present.
The presence of carbohydrate on the HA can have either positive or detrimental effects on the virus. For example, glycoconjugates that are positioned close to the cleavage site can interfere with proteolytic activation of the nascent HA0 (22). Alternatively, replication and release of virus may be facilitated by carbohydrate that is located near the receptor binding site through a mechanism of reduced receptor affinity (46, 47). Carbohydrate around the globular head can also potentially shield antigenic sites from immune recognition. This may contribute to antigenic drift of influenza viruses where successive glycosylation events prevent accessibility and recognition by antibodies in an immune population (1). Additional work from Klenk at al. illustrates that carbohydrate is especially important for the interaction of HA and NA, where a balance is needed between receptor binding activity and virus release (23). A virus containing HA with little carbohydrate modification can tightly bind the receptor, requiring greater NA activity to promote particle release. Conversely, an HA with more extensive glycosylation interacts weakly with receptors and requires a less active NA to facilitate release. Overall, the HA depends on a balance of glycosylation to mediate the proper folding of the HA, interaction of virus with receptor, and efficient particle release.
Collectins are a family of collagenous lectin molecules that are calcium-dependent carbohydrate binding proteins previously shown to bind enveloped viruses (6, 26, 32, 41). The function of these proteins is believed to be as a first line of defense against both bacterial and viral pathogens by binding to carbohydrate moieties on the pathogen surface. In support of this concept, children with a deficiency in mannose binding lectin are more prone to a variety of serious infections (21, 40). Multiple studies have shown that lung-resident surfactant proteins A and D (SP-A and SP-D, respectively) neutralize and aid in clearance of influenza A viruses (7, 8, 15, 18, 19). SP-A is more effective at neutralizing influenza viruses that contain low carbohydrate content and does so via sialic acid residues present on the carbohydrate recognition domain that compete virus away from cellular sialic acids (24). SP-D directly interacts with carbohydrate on the HA globular head. It preferentially binds to high-mannose oligosaccharides on the HA, most notably the oligosaccharide attached via amino acid 165, which is conserved in all H3N2 viruses isolated to date (8). Data from several labs suggest that the high avidity of SP-D binding to influenza viruses is a key contributor to the virus-neutralizing capacity of the bronchoalveolar fluid (8, 19, 43, 44).
We sought to investigate the potential cost of accumulating additional glycosylation on the globular head of the HA of influenza viruses. We constructed seven viruses expressing mutant HAs containing between 6 and 12 potential sites for N-linked glycosylation. We hypothesize that the level of glycosylation is inversely related to virulence in the naïve host; as glycosylation increases, the severity and sequelae of disease decrease due in part to improved recognition and neutralization by collectins.

MATERIALS AND METHODS
Generation of mutant viruses.
Plasmids expressing the internal genes from influenza virus
A Puerto Rico/8/34 (H1N1, referred to hereafter as PR8) and
the HA and/or NA from A/Hong Kong/1/68 (H3N2) (HK68), A/Leningrad/360/86
(H3N2) (Len86), A/Sydney/5/97 (H3N2) (Syd97), and A/Panama/2007/99
(H3N2) (Pan99) were obtained from Robert Webster (St. Jude Children's
Research Hospital [SJCRH]) or were cloned from viruses obtained
from Webster as described previously (
20). The plasmid expressing
the HA of HK68 was sequentially modified by site-directed mutagenesis
(QuickChange; Stratagene, La Jolla, CA) to encode additional
sites of glycosylation. Oligonucleotide primers were designed
using web-based Primer X (
www.Bioinformatics.org) from the consensus
sequence for HK68 to create the N-X-S/T sequon at positions
63, 126, 248, 135, and 144 using historic sequences found in
natural isolates from the past 38 years. Reassortant viruses
expressing an H3 HA, an N2 NA (from Syd97), and the internal
genes of PR8 were rescued into a coculture of MDCK and 293T
cells using the 8-plasmid reverse genetics system, as described
previously (
20). Viruses were propagated for an additional passage
in MDCK cells and then grown in eggs to produce stocks for use
in the experiments described here. Glycosylation mutants were
generated with the previous virus as a template to generate
viruses containing 1, 2, 3, 4, and 5 additional glycosylation
sites (Table
1). An additional mutant virus was created by disrupting
the glycosylation site at amino acid 165 of the HA. The nucleotide
sequences of all plasmids and of the HA and NA of all stock
viruses were confirmed by Big Dye Terminator Cycle sequencing
(Hartwell Center), and analysis was performed by alignment against
published sequences.
Immunoprecipitation and Western blotting.
Subconfluent MDCK cells were infected at a multiplicity of infection
of 0.1 with reassortant virus. At 48 h postinfection the monolayers
were disrupted in phosphate-buffered saline (PBS) containing
0.5% NP-40 and immunoprecipitated with EZview Red Anti-HA Affinity
Gel (Sigma Aldrich, St. Louis, MO) targeting amino acid residues
98 to 106 (YPYDVPDYA) of human influenza virus HA. Immunoprecipitates
were resolved on a 10 to 20% sodium dodecyl sulfate-polyacrylamide
gel electrophoresis gel (Bio-Rad, Hercules, CA). Western blotting
was performed with mouse monoclonal anti-HA antibody (Research
Diagnostics, Concord, MA) and TrueBlot horseradish peroxidase-conjugated
anti-mouse secondary antibody (eBioscience, San Diego, CA) and
visualized by enhanced chemiluminescence on radiographic film.
Mice.
Female BALB/cByJ and C57BL/6J mice were obtained from Jackson Laboratories and utilized at 6 to 8 weeks of age (Bar Harbor, ME). C57BL/6J mice deficient in SP-D were generated by author S. Hawgood at the University of California at San Francisco (4) and then bred at SJCRH. Mice were housed in groups of 4 to 6 in high-temperature, 31.2-cm by 23.5-cm by 15.2-cm polycarbonate cages with isolator lids. Rooms used for housing mice were maintained on a 12:12-h light:dark cycle at 22 ± 2°C with a humidity of 50% in the biosafety level 2 facility at SJCRH. Prior to inclusion in experiments, mice were allowed at least 7 days to acclimate to the animal facility. Laboratory Autoclavable Rodent Diet (PMI Nutrition International, St. Louis, MO) and autoclaved water were available ad libitum. All experiments were performed in accordance with the guidelines set forth by the Animal Care and Use Committee at SJCRH.
Infection model.
The dose infectious for 50% of embryonated chicken eggs (EID50) was determined by interpolation using the method of Reed and Muench and used as the basis to calculate the dose lethal for 50% of mice (MLD50) using serial dilutions of virus delivered to groups of 4 mice. For infection experiments, virus was diluted in sterile PBS and administered at a dose of 1 x 106 EID50 intranasally to mice lightly anesthetized with 2.5% inhaled isoflurane (Baxter, Deerfield, IL) in a total volume of 100 µl (50 µl per nostril). Mice were weighed at the onset of infection and each subsequent day for illness and mortality. Mice that were found to be moribund were euthanized and considered to have died that day.
Lung titers.
Mice were euthanized by CO2 asphyxiation. Lungs were aseptically harvested, washed three times in PBS, and placed in 750 µl of sterile PBS. Lungs were mechanically homogenized using an Ultra-Turrax T8 homogenizer (IKA-werke, Staufen, Germany). Lung homogenates were pelleted at 10,000 rpm for 5 min, and the supernatants were used to determine the viral titer for each set of lungs using serial dilutions on MDCK monolayers.
Pathology.
Lungs were removed immediately after euthanasia and were insufflated and fixed overnight with 2% neutral buffered paraformaldehyde. After 24 h, the lungs were transferred into 10% neutral buffered formalin for an additional 24 h; the lungs were then embedded in paraffin, sectioned, stained with hematoxylin and eosin, and examined microscopically for histopathology by an experienced veterinary pathologist (K. L. Boyd) blinded to the composition of the groups. The lung parenchyma and large airways were considered separately and assigned a grade of 0 to 3 based on the histologic character of the lesions. A score of 1 was given to mild findings including minimal infiltrates of lymphocytes and plasma cells around airways and vessels, minimal epithelial hyperplasia, minimal leukocyte infiltration of alveolar spaces, and <10% of the lung affected. A score of 2 was given for moderate findings including moderate infiltrates of lymphocytes and plasma cells around airways and vessels, moderate epithelial hyperplasia with focal necrosis, focally extensive infiltration of the alveolar spaces by leukocytes with some consolidation, focal pleuritis, and >10% but <30% of the lung affected. A score of 3 was given for more severe findings including extensive necrosis of airway epithelium and the interstitium, extensive leukocyte infiltration and consolidation, severe pleuritis, and lobar involvement.
Inhibition of hemagglutination by rhSP-D.
Recombinant human SP-D (rhSP-D) was expressed in Chinese hamster ovary cells and purified by maltose affinity chromatography as previously described (16). Inhibition of hemagglutination was done using standard methods. Briefly, virus suspensions titrated to 4 HA units were incubated with serial dilutions of rhSP-D for 30 min at room temperature. A 0.5% suspension of chicken red blood cells was added, and the minimum concentration needed to inhibit hemagglutination was determined in quadruplicate assays. In a second experiment, 1.25 µg of rhSP-D (the minimum amount which would inhibit hemagglutination from all viruses) was incubated with serial dilutions of virus prior to hemagglutination. In parallel, virus was incubated with PBS, and the HA titer of the diluted suspension was determined. The maximal number of HA units which could be prevented from hemagglutinating red blood cells is reported.
Statistical analysis.
Comparison of survival between groups of mice was done with a log rank chi-squared test on the Kaplan-Meier survival data. Comparison of viral lung titers, weight loss, and inhibition of hemagglutination between groups was done using analysis of variance. A P value of <0.05 was considered significant for these comparisons. SigmaStat for Windows (version 3.11; SysStat Software, Inc.,) was utilized for all statistical analyses. Due to the small number of SP-D-deficient animals available for use, studies involving those mice were underpowered for statistical analysis.

RESULTS
Viruses differing in glycosylation of the HA differ in virulence.
To assess the impact of different amounts of oligosaccharide
on virulence, reassortant viruses with different H3 HAs were
used to infect naïve mice. Viruses expressed the H3 HA
from HK68 (7 potential sites of glycosylation), Len86 (9 potential
sites of glycosylation), or Pan99 (12 potential sites of glycosylation)
and were paired with both the HK68 NA and the Syd97 NA to control
for the contribution of an HA-NA functional match. When matched
to the HK68 NA, viruses containing the HK68 (7 sites) or Len86
(9 sites) HAs required nearly 3 logs less virus to kill mice
(MLD
50 of 10
5.6 for both) than did a virus containing the Pan99
HA (12 sites; MLD
50 of >10
7.25). These viruses caused significantly
more weight loss and mortality when administered to groups of
mice at a dose of 1
x 10
6 EID
50 (Fig.
1A and B). Only the virus
expressing the HK68 HA retained lethality (MLD
50 of 10
5.8 for
that virus, while other viruses had an MLD
50 of >10
7.0) when
matched to the Syd97 NA (Fig.
1C and D), which has one additional
glycosylation site compared to the HK68 NA. These data are consistent
with our hypothesis that more heavily glycosylated viruses are
less virulent in a naïve host since the viruses with seven
potential glycosylation sites (HK68 HA) were clearly more virulent
than the viruses with 12 potential sites (Pan99). The difference
in the virulence of the virus expressing the Len86 HA when matched
to the Syd97 NA may be because of a poor functional match to
that NA or may be due to an extra glycosylation site on the
Syd97 NA relative to the HK68 NA. We sought to resolve these
possibilities by generating viruses differing in glycosylation
on an isogenic background.
Generation and characterization of mutant HAs with increasing oligosaccharides on the globular head.
To control for differences in HA-NA functional match and glycosylation
of the NA, viruses were created by reverse genetics to be isogenic
in all respects except the potential level of glycosylation.
Mutations in the globular head of HK68 were made to create sites
for potential glycosylation (Table
1; Fig.
2A). Western blotting
of lysates from MDCK cell culture demonstrates a gradual decrease
in electrophoretic mobility as potential glycosylation sites
are added stepwise in the HK68 H3 HA (Fig.
2B). The

144 (+5)
mutant (where

indicates a change in glycosylation at this residue
and the number in parentheses indicates the change in the number
of glycosylation sites) (12 sites total) migrates to the same
position as a virus with the Pan99 HA (12 sites). A virus generated
to lack the site at position

167 (–1) migrates faster
than the wild-type HK68 HA, suggesting that this site was occupied
by carbohydrate in the wild-type virus. The addition of carbohydrate
to some or all of these potential sites did not affect the replication
of the viruses. Single and multistep growth curves and peak
titers in both eggs and MDCK cells were similar for the seven
viruses (data not shown).
Glycosylation decreases the virulence of influenza viruses.
Preliminary data suggested that the level of glycosylation could
affect the outcome of infections in vivo (Fig.
1). To confirm
this finding, groups of six BALB/cByJ or C57BL/6J mice were
infected intranasally with each single-step glycosylation mutant
to determine the specific effect of glycosylation without influence
from any other factor. A hierarchy of weight loss was seen in
BALB/cByJ animals that was dependent on the number of sites
of potential glycosylation (Fig.
3A). Animals infected with
the least glycosylated viruses (6, 7, or 8 sites) lost significantly
more weight, and most mice infected with wild-type or

167 (–1)
virus succumbed to infection by day 7 (Fig.
3A and B). The relatively
increased morbidity of these two viruses in C57BL/6J mice was
similar to that of BALB/cByJ mice although no animals succumbed
to infection at this dose (data not shown). A possible mechanism
for this decreased virulence was clearance of virus, since the
mean viral lung load increased between days 3 and 7 for the
two lethal viruses but decreased for the other 5 (Fig.
3C).
Severity of lung injury decreases as glycosylation increases.
Lungs from infected BALB/cByJ mice were harvested to examine
the histological features of disease. Histopathologic changes
in the lungs of mice infected with the most virulent virus,
the wild-type HK68, included epithelial hyperplasia and hypertrophy
of the airways, moderate infiltration of inflammatory cells
in a peribronchial distribution with some extension into the
parenchyma, and scattered foci of necrosis with edema and fibrin
deposition (Fig.
4A, D, and G). In general, the level of pathology
in the lung decreased as the level of glycosylation increased.
Mild inflammation and hyperplasia were seen in all lungs examined,
although both the severity and the extent of the lesions were
diminished in lungs from mice infected with more highly glycosylated
viruses compared to wild type. With the exception of mild epithelial
hypertrophy, the airways of mice infected with viruses containing
two to five additional glycosylation sites were normal (Fig.
4E and F and Table
2). The character of the parenchymal disease
was much milder in mice infected with viruses containing four
or five additional glycosylation sites compared to the other
viruses (Fig.
4C and Table
2). Examination of lungs from C57BL/6J
mice infected with the same panel of viruses showed a similar
pattern of pathology (data not shown).
Inhibition of hemagglutination by SP-D is dependent on level of HA glycosylation.
After demonstrating that the virulence of the glycosylation
mutants was inversely related to their level of glycosylation
in naïve mice, we sought to explore whether clearance by
SP-D was responsible for these differences. Groups of 3 to 4
mice deficient in SP-D production were infected with single-step
glycosylation mutants to examine the effect on disease outcome.
An inverse pattern of weight loss and mortality was seen compared
to wild-type C57BL/6J mice. The viruses expressing a greater
level of glycosylation elicited more weight loss than the wild
type (Fig.
5A), and only viruses that contained the highest
levels of potential oligosaccharide were found to elicit death
in SP-D-deficient animals (Fig.
5B). Lung titers from animals
deficient in SP-D show an inverse pattern with the

135 (+4)
and

144 (+5) mutants maintaining a 1- to 2-log higher mean titer
in the lung compared to wild type and the

63 (+1) mutant (Fig.
5C).
In vitro experiments using recombinant human SP-D showed that
the purified protein inhibited the hemagglutination of all of
the viruses in a dose-dependent manner. In HA inhibition assays,
the minimal concentration of rhSP-D required to neutralize 4
HA units of

167 (–1), HK68 wild type,

63 (+1), and

126
(+2) strains was 1.25 µg. A lower amount of rhSP-D, 750
ng, was sufficient for inhibition of the

248 (+3),

135 (+4),
and

144 (+5) mutants. The maximum hemagglutination inhibition
capacity of 1.25 µg of rhSP-D was 8 HA units of the

167
(–1) mutant on the low end and 512 HA units of the

135
(+4) mutant on the high end, indicating greater inhibitory capacity
for viruses containing greater glycosylation (Fig.
6).

DISCUSSION
Over the past nearly 40 years of circulation, H3N2 viruses have
gradually acquired additional oligosaccharide content around
the globular head of the protein. These progressive, adaptive
changes likely occurred because they provided an evolutionary
advantage. However, since the changes have been gradual and
are not fixed features of the HA, we reasoned they likely also
came at some cost. We constructed a series of mutant viruses
differing only in sites of potential glycosylation on the globular
head of the HA to test the hypothesis that the level of oligosaccharide
content is inversely related to virulence and tested this hypothesis
in a mouse model of infection. We demonstrate that the functional
outcome of additional N-linked glycosylation on the globular
head of H3N2 influenza viruses is to attenuate the severity
of infection in naive mice, likely mediated by improved neutralization
by SP-D. A breakpoint for virulence in mice was evident at eight
total sites of glycosylation on the HA (3 sites on the globular
head); for maximal hemagglutination inhibition capacity of recombinant
SP-D the breakpoint was nine total sites (4 sites on the globular
head). Our conclusions were supported by studies in mice deficient
in SP-D, which evidenced an inverse pattern of disease, with
viruses possessing the highest potential for glycosylation eliciting
significant disease and mortality.
Glycosylation of surface proteins plays a role in the biology of many viruses. including Hendra (5), Hantaan (37), severe acute respiratory syndrome coronavirus (SARS-CoV) (30), West Nile (17), hepatitis C (13), and influenza viruses. The function of surface glycoconjugates in the life cycle of many of these viruses is to aid in entry into target cells. For example, the hepatitis virus E2 and West Nile virus PrM and E proteins rely upon glycosylation to interact with immune molecules such as DC-SIGN (dendritic cell-specific ICAM-3 grabbing nonintegrin) and the related liver lectin L-SIGN for attachment and entry (10, 11). The glycosylated SARS-CoV S protein and filovirus envelope glycoprotein can interact with the lectin LSECtin (liver and lymph node sinusoidal endothelial cell C-type lectin) to enhance viral uptake and infection (14). Human immunodeficiency virus type 1 and influenza virus have also been described as using glycosylated gp120 and HA molecules to interact with and mediate entry via DC-SIGN and mannose receptor molecules on dendritic cells and macrophages (29, 31, 45). In addition, glycosylation of the surface proteins of SARS-CoV, Nipah, Hendra and Hantaan viruses has been described to participate in infectivity, protein folding, tropism, and proteolytic processing (2, 3, 12, 25, 28, 30, 34).
It has become clear that the addition of glycosylation in many viruses is also a mechanism for viral evasion and persistence. Evidence for this view derives from studies where successively adding additional sites for linkage of oligosaccharide by site-directed mutagenesis provided influenza A viruses with the ability to evade the host response without negatively impacting survival and biological activity (1). The additional sugar on the globular head resulted in a decrease in receptor binding and did not affect fusion activity, but, importantly, the viruses were now more resistant to antibody recognition. Skehel et al. showed that the introduction of a site for glycosylation at amino acid position 63 in the X-31 (H3N2) virus resulted in a lack of recognition by monoclonal antibody directed against X-31 (38). Thus, acquisition of carbohydrates on the globular head of the HA of influenza viruses may be an evolutionary adaptation allowing further circulation in an immune population. The trend toward accumulation of sites for potential glycosylation can be seen in both the H3N2 and H1N1 lineages. From its introduction into the human population in 1918, the H1N1 viruses have progressed from 4 sites of potential glycosylation, all within the stalk region, to 8 sites for potential glycosylation, 4 of which are now in the globular head. In the H3N2 strains, the pandemic strain at its introduction contained 6 sites within the HA1 subunit, 2 of which were on the globular head. Currently circulating H3N2 viruses now have 13 potential sites for glycosylation, the original 4 sites in the stalk region and 9 sites on the globular head.
In this study we have engineered five additional sites of glycosylation into the globular head of HK68 to recapitulate the acquisition of glycosylation that has occurred in circulating H3N2 strains over the last 38 years. Additionally, we created a reverse mutant by removing the site for glycosylation in antigenic site B [
167 (–1)] which has been implicated as a potential site of recognition by the lung collectin SP-D (19). Our data demonstrate that there is generally an attenuation of disease severity in naïve mice as the level of glycosylation increases. However, in our model the
167 (–1) virus did not appear to be any more virulent than wild type. We found a breakpoint between 8 and 9 sites of glycosylation (3 to 4 additional sites on the globular head) for virulence and neutralization, suggesting that after this point the effects mediated by SP-D are maximized. From these experiments we cannot distinguish whether this breakpoint derives generally from reaching a plateau in carbohydrate content or is specific to the particular sites we engineered into the virus. Data from SP-D-deficient animals support our proposed mechanism since mice infected with viruses of higher potential glycosylation were not attenuated in these animals as they were in fully competent hosts. In fact, our data suggest that clearance via other mechanisms, such as SP-A, may be more important for the less glycosylated viruses, perhaps because the lack of carbohydrates on the surface improves access of SP-A to its site of binding. The differences between the breakpoint for virulence (8 sites) and inhibition of hemagglutination (9 sites) may be due to the contribution of SP-A. Further study using recombinant SP-A and animals deficient in SP-A or both SP-A and SP-D is warranted to dissect the relative contribution of each.
These findings have important implications for our understanding of influenza biology and host interaction. Pandemic strains from this century have contained few sites for glycosylation on the globular head where the carbohydrates attached there might be accessible to collectins. The HA of the H1N1 strain of 1918 has been shown to play a major role in the virulence of that virus (42) and had glycosylation sites only in the stalk. The H2N2 pandemic strain of 1957 contained only 1 site on the globular head, and the H3N2 strain of 1968 had just 2 sites. Highly pathogenic avian influenza viruses of the H5N1 subtype which have recently crossed over into humans have a total of only six potential sites for glycosylation, excluding 1 site in the cytoplasmic tail which is unlikely to be glycosylated (39). During human infections with H5N1 strains, the lack of neutralization by collectins could potentially contribute to the high virulence.
The presence of glycosylation may have important implications for vaccine design as well. A strong neutralizing antibody response may be dependent on access to the surface of the HA protein, which may be blocked by carbohydrates. Thus, standard vaccines made from recently circulating, highly glycosylated viruses may elicit poor responses; using genetic engineering to remove potential glycosylation sites may alleviate this problem and improve the vaccines (4). However, our data suggest that this approach may affect virulence if applied to live attenuated influenza vaccines. The balance between attenuation and immunogenicity would have to be carefully considered.
In summary, our study demonstrates that the level of potential glycosylation impacts the disease severity and outcome of infection in naïve animals. The likely mechanism explaining this observation is neutralization and clearance of the virus, mediated by the collectin SP-D. This may provide a balance for the benefits, such as evasion of the immune response, garnered as the virus accrues more surface carbohydrates. Further analysis of the impact of both SP-D and SP-A, particularly in more complex systems where preexisting immunity is present, would be of interest. An exploration of the role of collectins in a model such as ferret that better approximates the disease in humans would also be important to better understand the biology of influenza in the lung.

ACKNOWLEDGMENTS
D.J.V., K.B., and J.A.M. were supported by grants from the ALSAC
and the NIAID (grant AI066349). J.M. and S.H. were supported
by grants HL-24075 and HL-58047 from the National Heart, Lung,
and Blood Institute.

FOOTNOTES
* Corresponding author. Mailing address: St. Jude Children's Research Hospital, 332 N. Lauderdale St., Memphis, TN 38105-2794. Phone: (901) 495-5164. Fax: (901) 495-3099. E-mail:
jon.mccullers{at}stjude.org 
Published ahead of print on 6 June 2007. 

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Journal of Virology, August 2007, p. 8593-8600, Vol. 81, No. 16
0022-538X/07/$08.00+0 doi:10.1128/JVI.00769-07
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