CMV late phase-induced mTOR activation is essential for efficient virus replication in polarized human macrophages.

Human cytomegalovirus (CMV) remains one of the most important pathogens following solid-organ transplantation. Mounting evidence indicates that mammalian target of rapamycin (mTOR) inhibitors may decrease the incidence of CMV infection in solid-organ recipients. Here we aimed at elucidating the molecular mechanisms of this effect by employing a human CMV (HCMV) infection model in human macrophages, since myeloid cells are the principal in vivo targets of HCMV. We demonstrate a highly divergent host cell permissiveness for HCMV with optimal infection susceptibility in M2 but not M1 polarized macrophages. Employing an ultrahigh purified HCMV stock we observed rapamycin-independent viral entry and induction of IFN-ß transcripts, but no proinflammatory cytokines or mitogen-activated protein kinases and mTOR activation early after infection. However, in the late infection phase, sustained mTOR activation was observed in HCMV-infected cells and was required for efficient viral protein synthesis including the viral late phase proteins pUL-44 and pp65. Accordingly, rapamycin strongly suppressed CMV replication 3 and 5 days postinfection in macrophages. In conclusion, these data indicate that mTOR is essential for virus replication during late phases of the viral cycle in myeloid cells and might explain the potent anti-CMV effects of mTOR inhibitors after organ transplantation.

Immune responses and cytokine induction in the development of severe hepatitis during acute infections with murine cytomegalovirus.

Salivary gland-derived murine cytomegalovirus (SGV) infections of mice have been widely used as models of human cytomegalovirus infections and in the study of CMV biology. Still, many aspects of SGV pathogenesis are not clearly defined. Fatal and non-fatal SGV infections were investigated to characterize pathogenetic correlates of mortality and to assess the role of the immune response in disease progression. Suppression of immune responses was observed in both lethal and sublethal infections. Depletion of immune cell populations in spleen, however, correlated with severe CMV-induced hepatitis and mortality. In addition, T cell depletion studies indicated a requirement for this immune cell subset in control of liver damage and survival of infected mice. Examination of cytokine responses revealed a previously undescribed shock-like syndrome in lethally-infected mice characterized by high levels of tumor necrosis factor alpha and interferon gamma. Furthermore, the sites of tumor necrosis factor alpha gene induction did not strictly correlate with either viral load or the sites of tissue damage during infection. Taken together, these findings define the pathogenetic progression of disease as it relates to disease outcome and suggests that organ-specific differences in cytokine induction play a significant role in the late stages of acute lethal MCMV infections.

The immunoevasive function encoded by the mouse cytomegalovirus gene m152 protects the virus against T cell control in vivo.

Cytomegaloviruses encode numerous functions that inhibit antigen presentation in the major histocompatibility complex (MHC) class I pathway in vitro. One example is the mouse cytomegalovirus (MCMV) glycoprotein gp40, encoded by the m152 gene, which selectively retains murine but not human MHC class I complexes in the endoplasmic reticulum-Golgi intermediate compartment/cis-Golgi compartment (Ziegler, H., R. Thäle, P. Lucin, W. Muranyi, T. Flohr, H. Hengel, H. Farrell, W. Rawlinson, and U.H. Koszinowski. 1997. Immunity. 6:57-66). To investigate the in vivo significance of this gene function during MCMV infection of the natural host, we constructed recombinants of MCMV in which the m152 gene was deleted, as were the corresponding virus revertants. We report on the following findings: Deletion of the m152 gene has no effect on virus replication in cell culture, whereas after infection of mice, the m152-deficient virus replicates to significantly lower virus titers. This attenuating effect is lifted by reinsertion of the gene into the mutant. Mutants and revertants grow to the same titer in animals deprived of the function targeted by the viral gene function, namely in mice deficient in beta2-microglobulin, mice deficient in the CD8 molecule, and mice depleted of T cells. Upon adoptive transfer of naive lymphocytes into infected mice, the absence of the m152 gene function sensitizes the virus to primary lymphocyte control. These results prove that MHC-reactive functions protect CMVs against attack by CD8(+) T lymphocytes in vivo.

Evaluation of functional nerve recovery shows that allogeneic nerve graft treated with ICAM-1 and LFA-1 mAbs can be good alternative to syngeneic graft.

The objective of the study is to establish recovery results of tibial nerve defects reconstructed using allogeneic and xenogeneic graft, in host immunosuppressed with Intercellular Adhesion Molecule-1 (ICAM-1) and Lymphocyte Function Antigen-1 (LFA-1) monoclonal antibodies (mAbs). A pilot study was conducted in fifteen Fischer rats by forming a 1 cm right tibial nerve gap, then reconstructing it with 1.2 cm long grafts, namely, Wistar allogeneic, Black mouse xenogeneic, and syngeneic (n = 5/group). The main study included forty-eight rats allocated to the following groups (n = 12/group): 1) Allograft without treatment as control group. 2) Allograft with intraperitoneal ICAM-1 and LFA-1 mAbs treatment. 3) Allograft preserved in Belzers' solution including ICAM-1 mAbs plus standard intraperitoneal treatment. 4) Syngraft as benchmark. At 3, 6 and 9 weeks postengraftment walking track analysis was performed and expressed as Tibial Functional Index (TFI). Motor and compound nerve action potential across the graft conduction velocities were measured at week 10. Xenograft did not show any functional recovery and was therefore excluded from main study. However, pilot and main study results showed recovery results in both treated allogeneic groups and were comparable to benchmark syngraft. Therefore, allogeneic nerve graft could be an alternative in peripheral nerve reconstruction and spinal cord grafting.

Hierarchical and redundant lymphocyte subset control precludes cytomegalovirus replication during latent infection.

Reactivation from latent cytomegalovirus (CMV) infection is often associated with conditions of immunosuppression and can result in fatal disease. Whether the maintenance of systemic CMV latency is mainly governed by factors of the infected cell or by immune control functions is unknown. Likewise, the putative immune control mechanisms which could prevent the induction and spread of recurrent CMV infection are not clearly identified. We took advantage of latently infected B cell-deficient mice and a sensitive method for virus detection to study CMV reactivation after ablation of lymphocyte subsets. A crucial role of both T lymphocytes and natural killer (NK) cells was demonstrated. Within 5 d after depletion of lymphocytes, productive infection occurred in 50% of mice, and 14 d later 100% of mice exhibited recurrent infection. A hierarchy of immune control functions of CD8(+), NK, and CD4(+) cells was established. Reactivation was rare if only one of the lymphocyte subsets was depleted, but was evident after removal of a further subset, indicating a functional redundancy of control mechanisms. The salivary glands were identified as the site of most rapid virus shedding, followed by the detection of recurrent virus in the lungs, and eventually in the spleen. Our findings document a previously unknown propensity of latent CMV genomes to enter productive infection immediately and with a high frequency after immune cell depletion. The data indicate that only the sustained cellular immune control prevents CMV replication and restricts the viral genome to a systemic state of latency.

Virus attenuation after deletion of the cytomegalovirus Fc receptor gene is not due to antibody control.

The murine cytomegalovirus (MCMV) fcr-1 gene codes for a glycoprotein located at the surface of infected cells which strongly binds the Fc fragment of murine immunoglobulin G. To determine the biological significance of the fcr-1 gene during viral infection, we constructed MCMV fcr-1 deletion mutants and revertants. The fcr-1 gene was disrupted by insertion of the Escherichia coli lacZ gene. In another mutant, the marker gene was also deleted, by recombinase cre. As expected for its hypothetical role in immunoevasion, the infection of mice with fcr-1 deletion mutants resulted in significantly restricted replication in comparison with wild-type MCMV and revertant virus. In mutant mice lacking antibodies, however, the fcr-1 deletion mutants also replicated poorly. This demonstrated that the cell surface-expressed viral glycoprotein with FcR activity strongly modulates the virus-host interaction but that this biological function is not caused by the immunoglobulin binding property.

Cervicobrachial syndrome--work and disability.

The subjects in the study were 114 persons receiving a disability pension or referred for disability assessment. They were placed in two groups of 57 persons each, one with marked cervicobrachial syndrome and the other without. The latter group was chosen by the method of equivalent pairs with regard to sex and age. All subjects underwent a clinical examination and a standardized questionnaire was completed. The questionnaire pertained to the state of health, focussing on the amount and type of physical burdening at the workplace and on activities outside the workplace. Sixty-five percent of the subjects were aged from 51 to 60 years. A statistically significant difference was established between earlier occupation and cervicobrachial syndrome. Cervicobrachial syndrome was found in 31.6% of unskilled workers and 12.3% of the controls (P < 0.05). A forced body posture during work was recorded in 74% of the subjects with the syndrome and in 50% of the control subjects (P < 0.05). Repetitive movements at work were reported by a large number of subjects with cervicobrachial syndrome (71.9:49.1%; P < 0.05) who also claimed to strain the arms (84.2:61.4%; P < 0.05) and burden the cervical spine (68.5:40.4%; P < 0.05) during household activities to a significantly greater extent than the controls. A possible preventive approach to the occurrence and progression of cervicobrachial syndrome is discussed.