Immune effector cell (IEC)-mediated protection from HSV-1 retinitis occurs in the brain.

Following uniocular anterior chamber inoculation of the KOS strain of HSV-1 into euthymic BALB/c mice, virus spreads from the injected eye to the brain and from the brain to the optic nerve and retina of the uninjected eye resulting in retinitis. Adoptive transfer of HSV-1-specific immune effector cells (IEC) within 24 h of anterior chamber inoculation of virus prevents retinitis. To determine where protection occurs, mice were injected with HSV-1 via the anterior chamber route, and fluorescently-labeled HSV-1-specific-IEC or ovalbumin-specific-lymph node cells were adoptively transferred intravenously. The eyes and brains of these mice were sectioned and examined for virus-infected cells and for fluorescently-labeled adoptively transferred cells. None of the mice in the group receiving an adoptive transfer of virus-specific IEC had evidence of virus infection of the ipsilateral suprachiasmatic nucleus (SCN), whereas the ipsilateral SCN of all of the mice in the control groups were virus-positive by day 5 P.I. Since virus spreads from the ipsilateral SCN to the contralateral optic nerve and retina to cause retinitis in the uninoculated eye, the results of these studies suggest IEC-mediated protection from HSV-1 retinitis occurs proximal to the ipsilateral SCN. Furthermore, since only HSV-1-specific IEC conferred protection and only these cells were observed in the brain, protection and trafficking of cells after adoptive transfer was virus-specific.

Spread of HSV-1 to the suprachiasmatic nuclei and retina in T cell depleted BALB/c mice.

Following uniocular anterior chamber inoculation of the KOS strain of HSV-1 in euthymic BALB/c mice, virus spreads from the injected eye to the brain, and from the brain to the optic nerve and retina of the uninjected eye by day 7 post inoculation (p.i.), but the optic nerve and retina of the injected eye are not infected with virus. Infection of the optic nerve and retina of the injected eye is observed only in athymic mice or in mice depleted of both CD4+ and CD8+ T cells. To determine the role of T cells in virus spread, adult female BALB/c mice were thymectomized and T cell depleted. Mice were co-injected with the KOS strain of HSV-1 and RH116, a thymidine kinase-negative mutant of KOS containing the Escherichia coli lac Z gene. Animals were sacrificed on days 3-7 p.i., and the eyes and brains were examined for blue-stained, virus-infected cells. A difference in the timing of virus infection was observed in the area of the suprachiasmatic nuclei only in mice depleted of both CD4+ and CD8+ T cells, and in this group, the contralateral suprachiasmatic nucleus was infected two days earlier. Since one route by which virus could infect the retina of the injected eye is via connections of the contralateral suprachiasmatic nucleus to the ipsilateral optic nerve, these findings suggest that (a) retinitis observed in the injected eyes of mice depleted of both CD4+ and CD8+ T cells results from virus infection of the contralateral suprachiasmatic nucleus followed by spread of virus to the ipsilateral optic nerve and retina and (b) early HSV-1 infection of the contralateral suprachiasmatic nucleus is prevented by a T cell dependent mechanism.

T lymphocyte infiltration in the brain following anterior chamber inoculation of HSV-1.

Following inoculation of the KOS strain of herpes simplex virus type 1 (HSV-1) into one anterior chamber of euthymic BALB/c mice, virus spreads from the injected eye to the central nervous system and from the central nervous system to the optic nerve and retina of only the uninoculated eye. In contrast, in athymic BALB/c mice or mice depleted of both CD4+ and CD8+ T cells, virus spreads to the optic nerve and retina of both the injected eye and the uninjected eye. To determine the location in the central nervous system where spread of virus to the optic nerve and retina of the injected eye is prevented, euthymic BALB/c mice were injected with a mixture of KOS and RH116, a mutant of KOS that contains the Escherichia coli beta-galactosidase (beta-gal) gene. Several animals were sacrificed each day; serial frozen sections of the brain were prepared and sequential sections were stained for beta-gal or for T cells. At all sites except the suprachiasmatic nuclei, virus and T cells arrived at approximately the same time. However, at day 5 post inoculation (PI), T cells were present in both the ipsilateral and the contralateral suprachiasmatic nuclei, but only the ipsilateral suprachiasmatic nucleus was virus-positive. Since virus spreads from the ipsilateral suprachiasmatic nucleus to the contralateral optic nerve, these results suggest that T cells infiltrating the area of the contralateral suprachiasmatic nucleus prior to the arrival of virus at this site prevent virus spread into the optic nerve of the inoculated eye.

Neural spread of herpes simplex virus after anterior chamber inoculation.

A genetically engineered herpes simplex virus type 1 (HSV-1, strain RH116) that expresses beta-galactosidase (beta-gal) was used as a marker to trace the route of interocular spread of HSV-1 after anterior chamber (AC) inoculation into BALB/c mice. Because RH116 is thymidine kinase deficient (TK-), the wild-type TK+ KOS strain of HSV-1 was used as a helper virus to complement RH116 during in vivo infection. After coinfection of BALB/c mice with RH116 and KOS in the AC of one eye, beta-gal expression by RH116 was detected in both the eyes and in the central nervous system (CNS). Our results suggest that after AC inoculation into BALB/c mice: (1) virus spreads from the injected eye to the CNS through parasympathetic fibers of the oculomotor nerve that supply the iris and ciliary body; (2) virus spread in the CNS is limited primarily to nuclei of the visual system and the suprachiasmatic area of the hypothalamus; and (3) virus is transmitted from the CNS to the retina of the contralateral eye by retrograde axonal transport through the optic nerve along the endocrine-optic pathway between the retina and the suprachiasmatic nucleus of the hypothalamus.

Sparing of the ipsilateral retina after anterior chamber inoculation of HSV-1: requirement for either CD4+ or CD8+ T cells.

PURPOSE: To determine whether CD4+ T cells, CD8+ T cells, or both CD4+ and CD8+ T cells are required for preservation of the ipsilateral retina after uniocular anterior chamber inoculation of herpes simplex virus type 1 (HSV-1). METHODS: Adult-thymectomized BALB/c mice were T cell depleted by administration of anti-CD4 monoclonal antibody (mAb), anti-CD8 mAb, or anti-CD4 mAb and anti-CD8 mAb together. Control mice were thymectomized but were not T cell depleted. HSV-1 (KOS) was inoculated in one anterior chamber. At intervals after inoculation, the injected eyes were examined histopathologically or homogenized to determine the kinetics of infectious virus recovery. Additional groups of in vivo depleted mice were injected with wild type KOS and RH116 (a mutant of KOS containing the Escherichia coli beta-galactosidase gene) to determine whether viral genes were expressed in the retina in any of the mice. RESULTS: In the inoculated eyes of mice depleted of both CD4+ and CD8+ T cells, there was a significantly higher incidence of acute destructive retinitis at days 9 and 14 postinoculation (PI), and the titer of virus recovered at day 14 PI was significantly higher. Viral gene expression in the retina and the optic nerve was observed after day 7 PI only in the group of mice depleted of both CD4+ and CD8+ cells. In contrast, acute destructive retinitis was not observed in nondepleted mice or in mice depleted of either CD4+ or CD8+ T cells alone, and virus recovery was not significantly different among these three groups of mice. No virus-infected cells were observed in the optic nerve or the sensory retina of nondepleted mice, of mice depleted of only CD4+ cells, or of mice depleted of only CD8+ cells. CONCLUSION: The results of these studies suggest that either CD4+ or CD8+ T cells can spare the retina of the injected eye after uniocular anterior chamber inoculation of HSV-1. Because virus appeared after day 7 PI in the ipsilateral optic nerve and retina only in mice depleted of both CD4+ and CD8+ T cells, these results suggest that spread of virus to the ipsilateral retina occurs via the optic nerve and that either CD4+ or CD8+ T cells can prevent spread of virus to the inoculated eye resulting in sparing of the ipsilateral retina.

Two waves of virus following anterior chamber inoculation of HSV-1.

Following inoculation of herpes simplex virus type 1 (HSV-1) into the anterior chamber of one eye of a Balb/c mouse, a pattern of ocular retinal disease occurs which is characterized by retinal necrosis, disruption of the retinal architecture of the uninoculated contralateral eye, and sparing of the retina of the virus-inoculated eye. Our direct virus culture studies have revealed that, after uniocular anterior chamber inoculation, virus reaches the uninoculated eye in two temporally separate waves. The first wave of virus is detected in the uninoculated eye as early as one day postinoculation (pi), long before virus is found in either of the optic nerves or the brain. The second wave of virus arrives in this eye between 7 and 10 days pi. Sequentially, the path of the second wave of virus appears to move from the injected eye to (1) the ipsilateral optic nerve, (2) the brain, (3) the contralateral optic nerve, and (4) the posterior segment of the uninoculated contralateral eye, suggesting that interocular spread of the second wave of virus after anterior chamber inoculation occurs via neural pathways. Results of histopathologic examinations and virus culture studies suggest that the early wave of virus contributes to the inflammation observed at the angle structures of the contralateral eye 7-8 days pi and that the second wave of virus accounts for the peak virus titer observed on day 10 pi, a peak which coincides with the destruction of the retina of this eye. It is proposed that the first wave is causally related to the development of retinitis, which occurs as the second wave reaches the retina.

T cells in the uninjected eye after anterior chamber inoculation of herpes simplex virus type 1.

PURPOSE: To investigate T cell infiltration in the posterior segment of the uninjected eye after uniocular anterior chamber inoculation of HSV-1. METHODS: The anterior chamber of one eye of euthymic BALB/c mice was injected with 1 x 10(4) plaque-forming units (PFU) to 2 x 10(4) PFU of herpes simplex virus type 1 (HSV-1; KOS strain). All mice were examined for retinitis on day 8 postinoculation (p.i.). Only mice with retinitis were retained and used in these experiments. Animals were killed on days 9, 11, 14, 21, 35, and 63 p.i. The uninjected eyes were removed. Some of the uninjected eyes were sectioned and stained for CD4+ and CD8+ cells using the avidin-biotinylated enzyme complex method. Infiltrating cells were collected from the remaining uninoculated eyes and stained using rat anti-mouse monoclonal antibodies specific for CD4+ or CD8+ T cells, and the percentage of CD4+ and CD8+ T cells was determined by flow cytometry. RESULTS: At day 9 p.i. (acute retinitis), T cells were observed in the uvea but not in the retina of the contralateral eye. CD4+ and CD8+ cells were observed in the sensory retina coincident with the onset of retinal necrosis (day 11 p.i.), and CD4+ and CD8+ T cells continued to be detected in the remnants of the retina up to and including day 63 p.i. The maximum percentage of both CD4+ and CD8+ T cells was observed at day 21 p.i. CONCLUSIONS: These results demonstrate that T cells enter the retina of the uninoculated eye during HSV-1 infection. The observation that T cells arrive in the sensory retina at the onset of retinal necrosis and not during acute retinitis and the peak of virus replication provides further evidence that T cells play a role in development of retinal necrosis. The result that T cells are observed in the uninjected eye as late as day 63 p.i. suggests that T cells might also have a role in the resolution phase of the disease.

HSV-1 retinitis and delayed hypersensitivity in DBA/2 and C57BL/6 mice.

Following uniocular anterior chamber (a.c.) inoculation of HSV-1 into BALB/c mice, the architecture of the uninoculated eye is destroyed by a pan-retinal inflammatory process within 10 days. BALB/c inoculated with HSV-1 via the a.c. route also develop anterior chamber associated immune deviation (ACAID), one characteristic of which is impairment of virus-specific delayed hypersensitivity (DH) responsiveness. To determine whether other strains of mice develop ACAID and contralateral retinitis, DBA/2 and C57BL/6 mice were inoculated with HSV-1 (KOS strain) via the a.c. route. At intervals after inoculation, animals were examined clinically for evidence of retinitis in the uninoculated eye and were either (1) sacrificed for virus recovery studies or (2) ear-challenged for DH assays. Seven of 15 DBA/2 mice had clinical evidence of retinitis in the uninoculated eye by day 10 post-inoculation (p.i.). At this time, the average titer of virus in the uninoculated eyes was 3.37 log10 PFU/ml. Animals of this strain also had significantly impaired HSV-1 virus-specific DH responses consistent with ACAID. No (0/12) C57BL/6 developed contralateral retinitis; at day 10 p.i., the average virus titer in the uninoculated eyes of C57BL/6 mice was 1.10 log10 PFU/ml. Following a.c. inoculation of HSV-1, C57BL/6 mice developed vigorous DH responses comparable to those of subcutaneously immunized, DH-positive animals. The results of these experiments suggest that different strains of mice vary in their susceptibility to HSV-1 retinitis and that the development of retinitis is linked to the amount of virus in the uninoculated eye.(ABSTRACT TRUNCATED AT 250 WORDS)

Herpes simplex retinitis in the mouse. Clinicopathologic correlations.

BALB/c mice inoculated with herpes simplex virus type 1 in one anterior chamber develop retinitis with subsequent retinal necrosis in the contralateral eye. The clinical features of this disease were characterized with indirect ophthalmoscopy and fundus photography. Three phases of the disease were delineated: (1) acute retinitis; (2) retinal necrosis; and (3) resolution; the clinical findings in each phase were correlated with the microscopic features. In addition, we compared the virus titers from individual animals with and without clinical evidence of retinitis to demonstrate that retinal inflammation correlated with the titer of virus in the uninoculated eye. This animal model is useful for the analysis of the clinical, virologic and immunologic manifestations of herpetic retinitis.

Optic nerve involvement in viral spread in herpes simplex virus type 1 retinitis.

Colchicine was used to block fast axonal transport of the optic nerve of the uninjected eye after uniocular anterior chamber inoculation of herpes simplex virus type 1 (HSV-1). The results of these experiments suggest that second-wave virus is transported to the retina of the uninjected contralateral eye through the optic nerve of the uninjected eye, since intravitreal treatment with colchicine reduced both the viral titer and prevalence of animals with histopathologic evidence of retinitis. The chemical block to viral entry provided by colchicine was both dose- and time-dependent, with administration of colchicine that was timed to interfere with the second viral wave being the most effective. Colchicine did not appear to be directly inhibitory to viral replication or toxic to the virus, and colchicine did not cause clinical or microscopic evidence of retinal inflammation. Intravitreal injection of colchicine did not alter the timing or recovery of the first wave of virus.

Physiologic and morphologic retinal changes induced by murine cytomegalovirus in BALB/c and severe combined immune deficient mice.

Anterior chamber inoculation of murine cytomegalovirus (MCMV, 10(4) and 10(5) plaque-forming units) induced both physiologic and morphologic changes in the retinas of immunocompetent BALB/c and B- and T-cell-deficient severe combined immune deficient (SCID) mice. In BALB/c mice, the depression of the b-wave began on days 3-4 postinoculation (PI) and a further depression was recorded on day 7 PI. The electroretinograms (ERGs) remained depressed 1-2 weeks PI after which there was a recovery of the amplitude of the ERG 2-6 weeks later. The recovery was not complete; the maximum amplitude at 6 weeks was significantly lower than the preinoculation value. There was a greater loss in the amplitude than in the sensitivity of the ERG. Histologic examination of retinas with depressed ERGs showed swelling of the retinal pigment epithelium and distortion and shortening of the outer segment of the photoreceptors. With recovery of the ERG, there was normalization of the retinal histology. In SCID mice, the ERGs were extinguished, and there was no recovery. Histologically, there was a complete loss of the photoreceptors in the SCIDs, and electron microscopic examination showed viral particles in the retinal pigment epithelium and inner nuclear cells. These results demonstrate that MCMV can induce retinal pathology as reported in patients and show the importance of B- and T-lymphocytes in controlling the progression of this disease process.

Dissemination and replication of MCMV after supraciliary inoculation in immunosuppressed BALB/c mice.

PURPOSE: To study replication and dissemination of murine cytomegalovirus (MCMV) in immunosuppressed (IS) and non-IS BALB/c mice after ocular inoculation via the supraciliary route. METHODS: BALB/c mice were immunosuppressed by injections of methylprednisolone, and MCMV was injected via the supraciliary route. Ocular and nonocular tissues from both IS and non-IS mice were studied by plaque assay of tissue homogenates. The frequency of virus-positive leukocytes was determined by PCR. RESULTS: In the inoculated eye, virus replication was significantly higher in both the anterior segment and the posterior segment of IS mice. Virus spread to extraocular sites in both IS and non-IS mice; however, significantly higher titers of virus were recovered from the salivary glands and lungs of IS mice than from non-IS mice, and clearance of virus from these sites was delayed in IS mice. Virus spread from the injected eye via leukocytes, and PCR amplification revealed that the frequency of virus-infected leukocytes was approximately 200-fold higher in IS mice. CONCLUSIONS: The results of these studies suggest that immunosuppression significantly enhances virus replication in the inoculated eye, salivary glands, and lungs, leads to a higher frequency of virus-positive leukocytes, and delays clearance of virus from ocular and nonocular tissues. These results also suggest that retinitis in the injected eye of IS mice correlates with significantly higher titers of virus in the posterior segment.

HSV-2 alters retinal physiology and morphology bilaterally in mice.

Anterior chamber inoculation of 10(4) PFU of the MS strain of HSV-2 resulted in physiologic and morphologic changes in the retina of the inoculated and the uninoculated eyes. In the inoculated eyes, electroretinogram (ERG) depression was first detected on day 3 and abolished ERGs on day 8 postinoculation (PI). The decrease in the ERGs was rapid and the time course was similar for all of the eyes. In spite of a 90% decrease in the amplitude of the b-wave, the retinal sensitivity did not change. Of 23 eyes tested on or after day 10 PI, none had normal, 4.3% had reduced, and 95.6% had abolished ERGs. In the uninoculated eyes, ERG depression was first detected on day 8 and abolished ERGs on day 12 PI. The course of the ERG depression was more variable, and some of the eyes showed a decrease in retinal sensitivity. Of the 22 eyes tested on or after day 17 PI, 18% had normal, 32% had reduced, and 50% had abolished ERGs. The majority (17/33) of the retinas of the inoculated eyes showed panretinal necrosis, although 7 of 33 retinas had pathology confined to the outer layers of the retina. In the uninoculated eyes, only 5 of 30 retinas were necrotic and 14 of 30 retinas had pathology limited to the outer layers of the retina. These observations suggested that the physiologic and morphologic changes progress through two stages: an early stage with reduced ERGs and pathology limited to the outer retinal layers, and a second stage in which the ERG is abolished and the pathologic changes extend into the inner retina. Not all retinas progress to the second stage.

Modulation of murine herpes simplex virus type 1 retinitis in the uninoculated eye by CD4+ T lymphocytes.

PURPOSE: To investigate the contribution of CD4+ and CD8+ T lymphocytes to retinitis in the contralateral eye after anterior chamber inoculation of herpes simplex virus type 1 (KOS strain). METHODS: T-cell-depleted BALB/c mice were prepared by adult thymectomy and treatment with anti-L3T4 (anti-CD4) monoclonal antibody and/or anti-Lyt2.2 (anti-CD8) monoclonal antibody. On days 9 and 14 after inoculation of herpes simplex virus type 1 (KOS strain) via the anterior chamber, the titer of virus in the uninoculated eye was determined by plaque assay. The eyes were examined microscopically, and the severity of retinitis was evaluated using a histopathologic scoring system. RESULTS: At day 14 postinoculation, significantly less severe destruction of the parenchyma and less inflammatory cell infiltration were observed in the retina of the uninoculated eye of CD4+ T-cell-depleted mice and of mice depleted of both T-cell subsets. The titer of virus in the uninjected eye of CD4+ T-cell-depleted mice and of mice depleted of both CD4+ and CD8+ T cells was also significantly higher at day 14 postinoculation. CONCLUSIONS: The results of the studies suggest three ways CD4+ T cells might contribute to the pathogenesis of herpes simplex virus type 1 retinitis in the uninoculated contralateral eye: (1) accumulation of massive inflammatory cell infiltrates in the retina, (2) induction of retinal destruction, and (3) clearance of herpes simplex virus type 1 from the contralateral eye. In infection of the contralateral retina of nondepleted mice after uniocular anterior chamber inoculation of KOS, CD4+ T cells are required to induce fulminant retinitis and to mediate clearance of virus from the uninoculated eye by day 14 postinoculation. The exact mechanism by which CD4+ T cells contribute to contralateral retinitis remains to be identified.

Retinitis and deviant immune responses following intravitreal inoculation of HSV-1.

Following anterior chamber inoculation of herpes simplex virus type 1 (HSV-1) into one eye of adult, immunocompetent BALB/c mice, an interesting pattern of ocular pathology and systemic immune responses emerges, characterized by destruction of the contralateral retina with sparing of the ipsilateral retina; and impairment of delayed hypersensitivity (DH) accompanied by intact humoral immunity to the virus. Experiments using animals inoculated via the intravitreal route revealed a different pattern of retinitis in the inoculated and in the uninoculated fellow eye following intravitreal inoculation of HSV-1. The retinitis in the inoculated eye results in localized, focal necrosis with concomitant preservation of the retinal architecture in areas juxtaposed to those in which retinal destruction occurs. The retinitis in the uninoculated contralateral eye is characterized by pan-retinal inflammation and subsequent loss of the architecture of the entire retina. Intravitreally inoculated animals exhibited virus-specific impairment of DH responses to HSV-1 but were capable of producing anti-HSV-1 neutralizing antibody. Impairment of DH response after inoculation of live HSV-1 suggests that intraocular processing of viral antigens occurs such that processed antigens are released systemically in a soluble form.

Bilateral alterations of the ERG and retinal histology following unilateral HSV-1 inoculation.

The physiological condition of the retinas of BALB/c mice inoculated unilaterally in the anterior chamber with the KOS strain of herpes simplex virus type 1 (HSV-1) was monitored by ERG recordings. After the ERG recordings, the retinas were examined for histopathological changes. In the inoculated eye, depressed ERGs were recorded on day 2 PI and abolished ERGs on day 4 PI. The changes in the ERGs were complete by day 5-6 PI. Of the 53 inoculated eyes followed for longer than day 6 PI, four (7.5%) remained normal, 30 (56.6%) had reduced ERGs and 19 (35.8%) had abolished ERGs. In the contralateral eyes, the first changes were noted on day 8 PI, and abolished ERGs were recorded on day 9 PI. Of the 55 contralateral eyes followed for longer than 10 days, 15 (27.3%) remained normal, four (7.2%) had reduced ERGs and 36 (65.4%) had abolished ERGs. The percentage of eyes with depressed ERGs was significantly higher in the inoculated than in the uninoculated eyes, and the percentage of eyes with abolished ERGs was significantly higher in the uninoculated eyes than in the inoculated eyes. The histopathological alterations were different for the two eyes. In the inoculated eyes, the changes were mainly in the outer retina, with characteristic folds in the photoreceptor and outer nuclear layer interspersed with normal appearing retina. The pigment epithelium was also abnormal. In the uninoculated eyes, the changes began in the inner retina but rapidly spread to all layers of the retina. This panretinal necrosis accounted for the higher percentage of abolished ERGs in the uninoculated eyes. The differences in the alterations of the ERG and the histopathological changes may be related to the underlying mechanism of action of the HSV-1 during the evolution of the experimental retinopathy.

Adoptive transfer of murine cytomegalovirus-immune lymph node cells prevents retinitis in T-cell-depleted mice.

PURPOSE: The purpose of this study was to determine whether adoptive transfer of murine cytomegalovirus (MCMV)-immune lymph node cells prevents retinitis in immunosuppressed mice. METHODS: Adult BALB/c mice were thymectomized and T-cell depleted using rat monoclonal antibodies specific for mouse CD4+ and CD8+ T-cells. The level of rat immunoglobulin G in the treated mice was monitored by enzyme-linked immunosorbent assay. Immune cells were labeled with PKH26-GH immediately before adoptive transfer, and flow cytometry was used to determine the percentage of adoptively transferred T-cells (PKH+, fluorescein isothiocyanate [FITC+]) in the spleens of the recipient mice 3 days after transfer. The ability of adoptively transferred cells to protect from retinitis was studied in T-cell-depleted mice injected with MCMV through the supraciliary route. Mice received 4 x 10(7) in vitro-restimulated MCMV-immune cells, 4 x 10(7) freshly isolated MCMV-immune cells, 4 x 10(7) freshly isolated ovalbumin-immune cells, or no cells (control group). RESULTS: The best time to balance depletion of endogenous T-cells with persistence of transferred cells was 3 weeks after T-cell depletion. Both restimulated and freshly isolated MCMV-immune cells conferred protection from retinitis. Freshly isolated ovalbumin-immune lymph node cells did not prevent retinitis, indicating that protection was virus-specific and merely was not because of transfer of antigen-activated lymph node cells. CONCLUSIONS: Adoptive immunotherapy has been used to prevent cytomegalovirus (CMV) infection in patients who have undergone transplantation, and, by extrapolation, the results of these studies suggest that adoptive immunotherapy with human CMV-specific immune cells might be used to prevent or ameliorate CMV retinitis in immunocompromised patients.

Murine cytomegalovirus infection causes apoptosis of uninfected retinal cells.

PURPOSE: To determine the role of apoptosis in prevention and/or exacerbation of retinal disease in a mouse model of cytomegalovirus retinitis. METHODS: Immunocompetent or T-cell- depleted BALB/c mice were injected with murine cytomegalovirus (MCMV) by supraciliary injection. On sequential days after infection, mice were killed, and eyes were harvested for cryosectioning or for DNA extraction. Ocular sections were stained with monoclonal antibodies specific for MCMV or for T cells or used in the TdT-dUTP terminal nick-end labeling (TUNEL) assay to detect apoptotic cells. RESULTS: In immunocompetent BALB/c mice, TUNEL assays revealed that a large area of the retina was apoptotic in relation to the relatively small number of MCMV-infected cells that were observed in the subjacent choroid and/or retinal pigment epithelium. In infected eyes from T-cell- depleted mice, there were more TUNEL-positive cells, and the areas of apoptosis were more extensive than in immunocompetent mice. These observations correlated with the increased extent of MCMV infection that is observed in the eyes of T-cell- depleted mice. However, irrespective of immune status, TUNEL-positive apoptotic cells were present mainly in areas of the retina overlying areas of MCMV-infected choroid and/or retinal pigment epithelium. More intense DNA laddering, indicative of increased apoptosis, was observed in the posterior segments of the eyes of T-cell- depleted mice after supraciliary inoculation with murine cytomegalovirus compared with less intense DNA laddering in the posterior segments of eyes of immunocompetent MCMV-infected mice. CONCLUSIONS: The ability of the mouse's immune system to control MCMV infections in some tissues depends on induction of apoptosis in virus-infected cells. However, in the retina, cells undergoing apoptosis were not virus-infected, a finding that suggests that apoptosis of uninfected retinal cells may play a role in the pathogenesis of MCMV retinitis.

Natural killer cells prevent direct anterior-to-posterior spread of herpes simplex virus type 1 in the eye.

PURPOSE: Anterior chamber (AC) inoculation of the KOS strain of herpes simplex virus type 1 (HSV-1) results in morphologic sparing of the ipsilateral retina, whereas the retina of the uninoculated contralateral eye becomes infected and undergoes acute retinal necrosis. Natural killer (NK) cells are an important component of the primary immune response to most virus infections. The purpose of this study was to determine whether NK cells are involved in preventing early direct anterior-to-posterior spread of HSV-1 after AC inoculation. METHODS: Normal BALB/c mice were inoculated with 4 X 10(4) plaque-forming units (PFU) of the KOS strain of HSV-1 using the AC route. NK activity was measured in the spleen, the superficial cervical and submandibular lymph nodes, and the inoculated eye by lysis of chromium-labeled, NK-sensitive YAC-1 target cells. Histopathologic scoring and immunohistochemical staining for HSV-1 were performed in NK-depleted (injected intravenously with anti-asialo GM1) or mock-depleted (injected intravenously with normal rabbit serum) mice. RESULTS: In mock-depleted mice, NK activity in the spleens, superficial cervical and submandibular lymph nodes, and inoculated eyes peaked at postinoculation (pi) day 5 and declined by pi day 7. Treatment with anti-asialo GM1 eliminated NK activity in the eye and at nonocular sites. The histopathologic scores at pi day 5 indicated more damage to the retinas of NK-depleted mice than to those of mock-depleted mice, and immunohistochemical staining for HSV-1 showed spread of the virus to the sensory retina only in NK-depleted mice. CONCLUSIONS: NK cells were activated within 5 days after AC inoculation of the KOS strain of HSV-1. Activation of NK cells appears to play a role in preventing direct anterior-to-posterior spread of the virus in the inoculated eye which, in turn, protects the retina of this eye and helps to explain why the architecture of the retina of this eye is spared.

Spread of murine cytomegalovirus to inner ocular structures following disruption of the blood-retina barrier in immunosuppressed BALB/c mice.

PURPOSE: The aims of this study were to determine whether disruption of the blood-retina barrier (BRB) increases spread of murine cytomegalovirus (MCMV) to the eye after intraperitoneal inoculation and whether systemic immunosuppression influences the location of MCMV in the ocular compartment. METHODS: The BRB of the left eye of normal and immunosuppressed mice was disrupted by supraciliary inoculation of tissue culture medium followed 2 hours later by intraperitoneal injection of MCMV. Plaque assay of homogenized ocular tissue was used to determine the frequency of virus-positive eyes and the titer of virus in the eyes. Beta-galactosidase staining of frozen sections was used to locate virus in the eyes. RESULTS: In nonimmunosuppressed mice, the frequency of virus isolation, as well as the titer of virus, were significantly higher in eyes in which the BRB had been disrupted. Although the frequency of virus isolation was the same in both eyes of immunosuppressed mice, the titer of virus was significantly higher in the eye in which the BRB had been disrupted. The most striking result was that the location of virus was different in the nondisrupted eyes of immunosuppressed mice than it was in the disrupted eyes of immunosuppressed mice. In the former, virus was seen only in the outer ocular structures (conjunctiva, sclera, lacrimal gland), whereas in the latter, virus was observed in the retina and anterior segment (iris, ciliary body) as well as the outer ocular structures. CONCLUSIONS: The results of these studies suggest that ocular damage followed by increased spread of virus to and within the eye during systemic infection with CMV may be one mechanism by which development of CMV retinitis is facilitated in patients with acquired immune deficiency syndrome.