Restriction of herpes simplex virus by macrophages. An analysis of the cell-virus interaction.

Macrophages restrict herpes simplex virus replication and can prevent the development of herpetic disease in mice. In an attempt to define the nature of this restriction, an analysis of virus-specified macromolecular syntheses in infected macrophages was undertaken. The significant results were the following: All cells were killed, but the infection was considered to be abortive since the level of infectious virus in macrophage cultures dropped steadily to a level beyond detection by 25 hr after infection. This restriction appeared to be specific for macrophages; the virus replicated efficiently in other mouse cells. DNA with a density characteristic for herpes simplex virus DNA was extracted from infected cultures, and the proportion of macrophages synthesizing DNA increased from less than 1% to greater than 50% by 6 hr after infection. Studies employing polyacrylamide gel electrophoresis indicated that the major viral-specific proteins were induced in macrophage cultures. In addition, all cells showing cytopathic changes characteristic of herpes virus infection also contained viral antigens which could be detected by fluorescent antibody techniques and, by 15 hr after infection, most contained nascent capsids lacking central dense cores. It is suggested that an error in DNA metabolism may be the primary cause of restriction.

Molecular and biological characterization of a herpes simplex virus type 1 (HSV-1) neuroinvasiveness gene.

Pathogenetic studies of herpes simplex virus type 1 (HSV-1) strains ANG and its mouse brain-passaged descendant ANG path revealed no difference in neurovirulence but a significant difference in neuroinvasiveness. Thus, both viruses induced a fatal encephalitis in mice after direct injection into the brain, but only ANG path induced lethal neurologic disease after inoculation on rear footpads. The difference in neuroinvasiveness is not related to the capacity to replicate in mouse neural tissues or mouse cells in general, but is specifically related to virus entry into the peripheral nervous system in the footpad. Marker rescue experiments in which ANG path genes were used to confer neuroinvasiveness on ANG indicated that the gene that codes for glycoprotein D (gD) is responsible for the phenotypic difference. Analyses of the gD genes by dideoxy-sequencing techniques identified a base difference in the coding sequences and predicted that the ANG gD gene codes for alanine (GCC codon) at amino acid position 84 in the open reading frame and the ANG path gD gene codes for glycine (GGC codon) at this site. Using these data, an oligonucleotide probe predicted to be specific for the ANG path gD gene was prepared, and in Southern blot analyses, this probe revealed that neuroinvasiveness-rescued agents had incorporated the base change seen in the ANG path gD gene. We conclude that HSV-1 glycoprotein D functions to effect neuroinvasiveness and we discuss potential mechanisms that may be involved.

Latent herpes simplex virus in the central nervous system of rabbits and mice.

Herpes simplex virus (HSV) type 1 induces a long-standing latent infection in the central nervous system of mice and rabbits. The infection was extablished in the brain stems of rabbits after corneal inoculation of the virus, and in the spinal cords of mice after rear footpad infection. In these animals, infectious virus could not be recovered by direct isolation from tissues; it was detected only after the tissues were maintained as organ cultures in vitro.

Latent herpes simplex virus in spinal ganglia of mice.

Herpes simplex virus establishes a persistent, latent infection in spinal ganglia after mice have recovered from posterior paralysis. Infectious virus is replicated when these ganglia are explanted and maintained as organ cultures in vitro.

Two avirulent herpes simplex viruses generate lethal recombinants in vivo.

While it is widely appreciated that infection with a virulent virus can produce disease in an animal, the ability of a mixture of avirulent viruses to produce disease by means of complementation or recombination in vivo has not been established. In this study, two weakly neuroinvasive herpes simplex virus type 1 (HSV-1) strains were simultaneously inoculated onto the footpads of mice. Many (62%) of the animals that received a 1:1 mixture of the viruses died, whereas the animals that received a similar or 100-fold higher dose of each agent alone survived. Of fourteen viruses isolated from the brains of ten mice that died after receiving the mixture of the two weakly neuroinvasive viruses, eleven were recombinants; three of these recombinants were lethal when reapplied to the footpads of mice. These results show that two avirulent HSV-1 variants may interact in vivo to produce virulent recombinants and a lethal infection. They also suggest that different genetic lesions account for the weakly neuroinvasive character of the HSV-1 strains ANG and KOS after footpad inoculation.

RNA complementary to a herpesvirus alpha gene mRNA is prominent in latently infected neurons.

In initial attempts to define the molecular events responsible for the latent state of herpes simplex virus, in situ hybridization was utilized to search for virally encoded RNA transcripts in latently infected sensory neurons. The use of cloned probes representing the entire viral genome indicated that transcripts encoded within terminal repeats were present. When the alpha genes encoding ICP-0, ICP-4, and ICP-27 and the gamma 1 gene encoding VP-5 were employed, only RNA transcripts hybridizing to the ICP-0 probe were detected. In latently infected cells, the ICP-0--related transcripts were localized principally in the nucleus; this was not the case in acutely (productively) infected neurons or in neurons probed for RNA transcripts coding for actin. In Northern blotting experiments, an RNA of 2.6 kilobases was detected with the ICP-0 probe. When single-stranded DNAs from the ICP-0 region were used as probes, RNA from the strand complementary to that encoding ICP-0 messenger RNA (mRNA) was the major species detected. This RNA species may play a significant role in maintaining the latent infection.

A latent, nonpathogenic HSV-1-derived vector stably expresses beta-galactosidase in mouse neurons.

A genetically engineered herpes simplex virus variant was constructed for use as a stable gene vector for neurons. To inhibit replication, the agent possessed a deletion in the immediate early gene ICP4, and to minimize reactivation from the latent state, the gene encoding the latency-associated transcript was deleted. The E. coli beta-galactosidase gene under the control of the Maloney murine leukemia virus long terminal repeat promoter was inserted into the ICP4 region. When introduced into the peripheral nervous system, this virus established latent infections and stably expressed beta-galactosidase in primary sensory neurons. Expression of beta-galactosidase over a more limited time period was observed when the latent infection was established in motor neurons of the hypoglossal nucleus. Agents of this general design have considerable potential for use as gene vectors for studies of neuronal function and correction of genetic defects affecting neurons.

Long-term expression of a foreign gene from a unique position in the latent herpes simplex virus genome.

As a result of its capacity to establish and maintain a life-long latent infection in the nervous system, herpes simplex virus (HSV) has been promoted as an ideal vector for introducing DNA into mature, differentiated, post-mitotic neurons. Although delivery of foreign genes into neurons using HSV vectors has been well established, the potential of these vectors for scientific inquiry or therapeutic use has been hampered by the lack of efficient long-term expression of these foreign genes. In the few instances where expression from the latent genome has been reported, expression appears to be minimal and levels of mRNA present have not been established. Here we describe HSV viral vectors that express a foreign gene during latency in dorsal root ganglia (DRG). More particularly, we have constructed a vector that, by histochemical assays for the protein, expresses the beta-galactosidase (beta-Gal) gene for at least 18 months post infection. We have further characterized the expression of beta-Gal transcripts by quantitative reverse transcription polymerase chain reaction (RT-PCR) and determined that there are 32,000 copies of beta-Gal transcripts per 0.5 microgram of total RNA at 18 months post infection. The vector makes use of the mouse Moloney leukemia virus (MMLV) long terminal repeat (LTR) promoter located directly upstream from the latency-associated transcripts (LAT) promoter region and expresses mRNA from the DNA strand opposite to that expressing the LAT. Finally, the vector was constructed using a system that allows other promoter/gene constructs to be easily inserted into the viral genome. It may have utility in studying the effects of cellular or viral gene expression on establishment, maintenance or reactivation from latency or for the delivery and expression of therapeutic proteins employed in gene therapy of the nervous system.

Passage of herpes simplex virus type 1 on chick embryo fibroblasts confers virulence for chick embryos.

The pathogenesis of chorioallantoic membrane (CAM) infection with herpes simplex virus 1 and 2 (HSV-1 and HSV-2) as well as chick embryo fibroblast (CEF) passaged HSV-1 was studied. It was found that HSV-2 is at least a million-fold more virulent than HSV-1 as measured by pfu/LD50 ratios for the embryo. Serial passage of HSV-1 in vitro on CEF cells selected for a virus (CEFP10) which, unlike its parental HSV-1 strain, is able to kill the embryo. The restriction endonuclease maps of CEFP10 and its parental strain are indistinguishable and the mechanism of the increased virulence of CEFP10 was demonstrated to be its enhanced replication in chick embryo cells both in vivo and in vitro. In contrast, despite its inferior replicative ability, HSV-2 was found to have a biologically important specific invasiveness function that is not simply related to overall viral replication. Finally, the ability to isolate HSV-1 (CEFP10) virulent for the chick embryo after passage in vitro illustrates that tissue culture passage of HSV in appropriate cells may actually increase virulence for the animal host.

Long-term expression of a reporter gene from latent herpes simplex virus in the rat hippocampus.

A problem in utilizing herpes simplex virus (HSV) as a vector for expression of foreign genes in CNS neurons has been the inability to facilitate long-term expression of the engineered genes. Previously, we showed that the murine moloney leukemia virus LTR would drive beta-galactosidase (beta-gal) transcription for extended periods from the latent viral genome in sensory, but not motor neurons. In this communication we further evaluate the utility of the LTR promoter for use in long-term expression vectors. Following stereotactic injection of 8117/43 (an ICP4 minus, non-replicating virus with the LTR driving the beta-gal gene, or KD6 (an ICP4 minus non-replicating virus not expressing beta-gal) into the hippocampus of rats, polymerase chain reaction (PCR) analysis of viral DNA after 2 months indicated that latent infections were established. Assaying by both x-gal staining and reverse transcriptase PCR we demonstrate that (1) beta-gal can be detected for at least 6 months in hippocampal neurons, and (2) although the number of beta-gal transcripts in these cells drops considerably by 2 weeks, they can be detected during the period studied. These studies indicate that the LTR promoter is active and affords long-term expression in the CNS, albeit at comparatively low levels compared to those observed at acute times.

Latent infections by herpes simplex virus in experimental animals.

Studies in experimental animals, initially the rabbit and more recently the mouse, have been a great importance in establishing present day concepts concerning the phenomenon of herpesvirus latency. These early observations coupled with more recent knowledge of virological consequences following surgical manipulation of the trigeminal tract have led to a general hypothesis for the natural history of herpetic infections: The infection follows a circuit from skin, mucous membrane, or eye (the primary infection) to the corresponding sensory ganglia via associated nerves. Virus becomes latent in the ganglia and later, as a result of one of the many provocations known to be associated with recurrence of herpetic lesions, is reactivated and travels via the nerve to the surface and again produces lesions. Current research investigating this hypothesis is reviewed.

Intraaxonal transport of Herpes simplex virus in the rat central nervous system.

Light and electron microscopic observation 3--4 days after microinjection of Herpes simplex virus (HSV) into the left neostriatum of rat demonstrated the following results. (1) Virus labeled nerve cells were found in the ipsilateral substantia nigra; a large number of infected neurons were in the zona compacta and some were in the zona reticulata. No virus infection was evident in the contralateral side. (2) Virus labeled neurons were found in the cortex, a greater number ipsilaterally than contralaterally, and in the dorsal raphé nuclei. Cortical microinjection of HSV led to infection of some cortical cells but no neostriatal cells. We conclude, therefore, that spread of the virus to the cortex, the substantia nigra and the dorsal raphé following neostriatal injection was by retrograde axonal transport. (3) The left neostriatum, where HSV was injected, showed a surprisingly small number of virus infected neurons. The infected neurons were mostly the large neurons; the majority of medium sized neurons were well preserved. There was massive degeneration of nerve terminals throughout the neuropil. Most of these degenerating nerve terminals are considered to be afferent fibers.

Defining herpes simplex genes involved in neurovirulence and neuroinvasiveness.

In this discussion, strategies for physically mapping HSV gene functions associated with significant biologic effects are presented and discussed. They represent an application of molecular biological technologies to complex biologic systems, and are a beginning step in understanding the fundamental basis of herpetic disease. Future studies will involve precise identification of relevant genes, and studies of the important properties of products encoded by these genes.

Implementation of measurement instruments in physical therapist practice: development of a tailored strategy.

BACKGROUND AND PURPOSE: The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is infrequent. The aims of this case report were to develop and evaluate a plan for the systematic implementation of 2 measurement instruments frequently recommended in Dutch physical therapy clinical guidelines: the Patient-Specific Complaints instrument and the Six-Minute Walk Test. CASE DESCRIPTION: A systematic implementation plan was used, starting with a problem analysis of aspects of physical therapist practice. A literary search, structured interviews, and sounding board meetings were used to identify barriers and facilitators. Based on these factors, various strategies were developed through the use of a planning model for the process of change. OUTCOMES: Barriers and facilitators were revealed in various domains: physical therapists' competence and attitude (knowledge and resistance to change), organization (policy), patients (different expectations), and measurement instruments (feasibility). The strategies developed were adjustment of the measurement instruments, a self-analysis list, and an education module. Pilot testing and evaluation of the implementation plan were undertaken. The strategies developed were applicable to physical therapist practice. Self-analysis, education, and attention to the practice organization made the physical therapists aware of their actual behavior, increased their knowledge, and improved their attitudes toward and their use of measurement instruments. DISCUSSION: The use of a planning model made it possible to tailor multifaceted strategies toward various domains and phases of behavioral change. The strategies will be further developed in programs of the Royal Dutch Society for Physical Therapy. Future studies should examine the use of measurement instruments as an integrated part of the process of clinical reasoning. The focus of future studies should be directed not only toward physical therapists but also toward the practice organization and professional associations.