A quantitative luminescence assay for measuring cell uptake of aqueous-based microcapsules in vitro.

We recently developed a system of microencapsulation consisting of aqueous-based polymers (e.g. alginate) and aqueous amines (e.g. spermine). We found that microencapsulation enhanced virus-specific protective immune responses. In addition, we found that microencapsulation may enhance virus-specific immune responses by selecting for antigen-presenting cells (APC) that are more efficient at processing and presenting viral antigens than those involved after natural infection. To determine the intracellular trafficking patterns and fate of microcapsules within APC, we developed a luminescence assay that permits the determination of specific quantities of proteins introduced into cells by microcapsules. We found that the time-dependent uptake of horseradish peroxidase (HRP)-labeled microcapsules was accurately detected in lysates of peritoneal exudate cells using luminol. The amplitude of HRP-catalyzed chemiluminescence in cell lysates correlated with the capture efficiency and retention kinetics of HRP in three different microcapsule preparations. HRP was most efficiently captured and retained by linking biotinylated HRP to microcapsulses chemically modified at the amine moiety with egg avidin. This preparation yielded more accurate and sensitive quantitation of HRP contained within cells than preparations capturing HRP or HRP-conjugated goat antibody into the microcapsular matrix by ionic interactions.

Correlates of protection against rotavirus infection and disease.

Repeated infections with the 'mucosal' pathogen rotavirus are common in children. Subsequent rotavirus infections usually cause milder symptoms than first-time infections. Therefore, although natural rotavirus infection attenuates the severity of subsequent infections, it does not prevent reinfection or mild disease. On the other hand, natural infection with 'systemic' viruses such as measles, mumps, rubella, or varicella often confers life-long protection against mild disease associated with reinfection. The degree to which differences in the pathogenesis of systemic and mucosal pathogens determines differences in the capacity of natural infection to induce life-long protective immunity will be discussed. This paradigm will be used to explore the immunological effector functions associated with protection against rotavirus challenge.

The rotavirus vaccine.

BACKGROUND: Rotavirus gastroenteritis is an important cause of morbidity and mortality worldwide. OBJECTIVES: To review the biology, immunology, and virology of rotavirus infections and describe the efforts towards the construction of vaccines using human and animal rotaviruses. STUDY DESIGN: A review of the literature and provision of the author's understanding and speculation of vaccination of infants against rotavirus disease. RESULTS: In August 1998 the Food and Drug Administration in the United States approved the licensure of a rotavirus vaccine. Both the Advisory Committee of Immunization Practices and the American Academy of Pediatrics are likely to recommend that the vaccine be given to all children by mouth as a series of three doses at 2, 4, and 6 months of age. The vaccine is made by combining a simian rotavirus strain (RRV) with several human strains representing different rotavirus serotypes. An understanding of the biology, immunology, and virology of rotavirus will help to explain the strengths and limitations of the rotavirus vaccine. CONCLUSION: If used as recommended, the rotavirus vaccine should cause a significant decrease in the number of deaths, hospitalizations, and office visits of children infected with rotavirus.

WC3 reassortant vaccines in children.

Bovine rotavirus strain WC3 (P7[5], G6) administered at the 12th passage level was well tolerated clinically in infants and efficiently induced serum virus neutralizing antibody (VNA) with bovine rotavirus G6 specificity. The protective efficacy of WC3 vaccine against all rotavirus disease was inconsistent, varying in four separate trials from 76% to 0%; some selective protection against severe disease was seen in all trials. WC3 reassortants containing the gene for an individual human rotavirus VP7 (G) or VP4 (P) surface antigen were also well tolerated, but preferentially induced VNA to the WC3 parent. Efficacy trials of human G1 VP7 reassortant WI79-9 (P7[5], G1) consistently led to > 60% protection against all rotavirus disease. A quadrivalent WC3 reassortant vaccine was developed to contain four separate monovalent reassortants expressing human rotaviruses surface proteins G1, G2, G3, and P1A [8] respectively. In a multicenter trial including 439 infants, this vaccine induced 67.1% protection against all rotavirus disease (defined as positive for rotavirus antigen by ELISA only [p = < 0.001]) and 72.6% protection when the standard for rotavirus diagnosis was a positive test of stool for both rotavirus antigen by ELISA and rotavirus RNA by electropherotype analysis (p = < 0.001). In this trial, episodes of the most severe rotavirus disease (clinical severity score > 16.0 eight cases) occurred only in placebo recipients.

The cultivation of human rotavirus, strain 'Wa', to high titer in cell culture and characterization of the viral structural polypeptides.

The structural proteins of the 'Wa' (serotype 2) strain of human rotavirus have not been described previously. Single-cycle virus growth in MA-104 cells using 5 micrograms/ml of trypsin in the growth medium was rapid with maximal viral yields (approximately 10(6) PFU/ml) obtained 10-12 h post-infection. There was a continuous progression of cytopathic effect (CPE) from 6- to 5-h post-infection. Under conditions of multiple-cycle growth, a greater concentration of trypsin (40 micrograms/ml) in the growth medium was required to obtain rapid progression of CPE and production of a high titer (approximately 10(7) PFU/ml) of infectious (double-shelled) virus. Single- and double-shelled virions were separated by isopycnic centrifugation in CsCl and analyzed by SDS-PAGE. Five proteins with molecular weights of 116,000, 92,000, 88,000, 84,000 and 41,000 were identified as components of the inner shell and four proteins with molecular weights of 60,000, 38,000, 32,000 and 27,000 were located in the outer shell.

Immunologic methods and correlates of protection.

Studies of natural rotavirus (RV) infection in children have shown that protection against subsequent RV disease occurs (1). Assessment of humoral immune responses has included study of the importance of circulating vs intestinal antibodies (Abs), serotype-specific vs group-specific Abs, and RV-specific immunoglobulins IgA, IgM, and IgG (1). Following natural RV infection, RV-specific IgM, followed by IgA and IgG, appear in serum and duodenal fluid or stool of young children (2). Protection against subsequent RV infection is predicted by the quantity of virus-specific IgA in the feces and serum (3, 4). In addition, virus-specific antibody-secreting cells (ASC) of the IgA, IgM, and IgG isotypes have been detected in the blood of infants following RV infection (5), although correlation between the presence of ASCs and protection against subsequent disease has not been studied. Serum neutralizing antibodies (nAbs) occur after natural RV infection in children, and are serotype-specific (4,6). Overall, protection against subsequent RV infection is correlated with higher titers of nAb (4). Protection against infection has been correlated with homotypic nAb to the G1 serotype (4); however, other studies suggest that protection is not dependent on serotype-specific nAb (7).

Viral diseases: infections of the gastrointestinal tract.

In the 1970s investigations generated a remarkable amount of information on the viruses responsible for acute gastroenteritis. The two viruses responsible for most cases occur in epidemiologically distinct clinical forms. Although occasionally epidemic, rotavirus infections are usually sporadic and primarily affect infants and young children. This illness is characterized by severe diarrhea commonly lasting five to eight days and frequently associated with upper respiratory tract symptoms, fever, and vomiting. The Norwalk agent and Norwalk-like viruses are characteristically epidemic and responsible for community-wide outbreaks of gastroenteritis among all ages. The disease this agent produces usually lasts 24 to 48 hours and is characterized by various combinations of vomiting, diarrhea, nausea, headache, and low-grade fever.

Rotaviruses: immunological determinants of protection against infection and disease.

Although studies of rotavirus immunity in experimental animals and humans have often yielded conflicting data, a preponderance of evidence supports the following answers to the questions initially posed. 1. What is the importance of virus serotype in formulating an optimal vaccine? Both vp4 and vp7 induce virus-neutralizing antibodies after either natural infection or immunization; the capacity of vp4 to induce rotavirus-specific neutralizing antibodies is probably greater than that of vp7. However, protection against disease after immunization of infants and young children is induced by strains heterotypic to the challenge virus (e.g., immunization with WC3 induces protection against disease induced by serotypically distinct human G1 strains). In addition, oral inoculation of infants with primate or bovine reassortant rotaviruses containing genes that encode human vp7 has not consistently induced a higher level of protection against challenge than that induced by parent animal rotaviruses (see Table I). Therefore, although vp4 or vp7 or both are probably important in inducing protection against challenge, it has not been clearly demonstrated that inclusion of the epidemiologically important human (as distinct from animal) P or G type is important in protection against human disease. 2. Which immunological effector arm most likely protects against rotavirus disease? No immunological effector arm clearly explains protection against heterotypic challenge. Protection against disease is not predicted by rotavirus-specific neutralizing antibodies in serum. Rotavirus-specific, binding sIgA in feces [detected by enzyme-linked immunosorbent assay (ELISA)] induced after natural infection does correlate with protection against disease induced by subsequent infection. However, protection after immunization with WC3 may occur in the absence of a detectable fecal sIgA response. The relationship between rotavirus-binding sIgA and sIgA-mediated neutralizing activity directed against the challenge virus remains to be determined. Binding rotavirus-specific sIgA in feces detected by ELISA may only be a correlate of other events occurring at the intestinal mucosal surface. The presence of broadly cross-reactive, rotavirus-specific CTLs at the intestinal mucosal surface of mice acutely after infection is intriguing. It would be of interest to determine the degree to which the presence of cross-reactive, rotavirus-specific CTLs in the circulation is predictive of the presence of virus-specific CTLs among intestinal lymphocytes and protection against challenge. Unfortunately, studies of virus-specific CTLs are difficult to perform in children. 3. By what means is virus antigen best presented to the host to elicit a protective immune response? Oral inoculation may not be necessary to induce a protective, virus-specific immune response at the intestinal mucosal surface.(ABSTRACT TRUNCATED AT 400 WORDS)

Host factors associated with protection against rotavirus disease: the skies are clearing.

Over the past several years, a number of studies have clarified aspects of rotavirus immunology and vaccinology previously considered controversial. In this review, studies that address the following questions will be summarized: Which host factors are responsible for recovery from acute rotavirus infection? Are the host factors responsible for recovery from acute infection the same as those necessary for prevention of infection? What is the relative importance of the nature of the inoculum (e.g., homologous or heterologous host virus and live or inactivated virus), route of inoculation, or virus serotype in vaccine development? What is the immunologic basis by which infection with 1 viral serotype protects against challenge with another serotype (heterotypic protection)?

Identification of the two rotavirus genes determining neutralization specificities.

Bovine rotavirus NCDV and simian rotavirus SA-11 represent two distinct rotavirus serotypes. A genetic approach was used to determine which viral gene segments segregated with serotype-specific viral neutralization. There were 16 reassortant rotaviruses derived by coinfection of MA-104 cells in vitro with the SA-11 and NCDV strains. The parental origin of reassortant rotavirus double-stranded RNA segments was determined by gene segment mobility in polyacrylamide gels and by hybridization with radioactively labeled parental viral transcripts. We found that two rotavirus gene segments found previously to code for outer capsid proteins vp3 and vp7 cosegregated with virus neutralization specificities.

Maternal antibody-mediated protection against gastroenteritis due to rotavirus in newborn mice is dependent on both serotype and titer of antibody.

In order to evaluate the role of passively acquired, rotavirus-specific antibodies in protection against diarrhea, we inoculated mouse dams with rotaviruses of various serotypes, and their newborns were orally challenged with a primate rotavirus (simian SA-11). Dams were immunized by using a regimen that included repeated inoculations administered either orally or intraperitoneally with adjuvant. The serum antibody response detected in dams by radioimmunoassay and plaque-reduction neutralization after parenteral immunization was approximately 15-fold and 80-fold greater, respectively, than that found after oral "hyperimmunization." Parenteral immunization with rotavirus serotypes either homotypic or heterotypic to the challenge virus protected suckling mice against diarrhea; protection was closely correlated with the in vitro neutralizing activity of maternal serum against the challenge virus. Oral immunization with only rotavirus strains homotypic to the challenge virus afforded protection; the lower immune response after oral immunization with rotaviruses heterotypic to the challenge virus resulted in a titer of neutralizing antibody to the challenge virus below the protective threshold. From our current studies it appears that antibody-mediated passive protection against rotavirus challenge is dependent on both serotype and titer of antibody.

The rotavirus vaccine.

A rotavirus vaccine was recently licensed by the Food and Drug Administration and is likely to be recommended for use in all infants by both the Advisory Committee on Immunization Practices and the American Academy of Pediatrics. If used as recommended, the vaccine is likely to prevent much of the 500,000 physician visits, 50,000 hospitalizations, and 20 to 40 deaths caused by rotavirus infections every year in the United States. An understanding of the biology, immunology, and pathogenesis of rotavirus infection will help to explain the strengths and limitations of the rotavirus vaccine.

Induction of mucosal B-cell memory by intramuscular inoculation of mice with rotavirus.

We investigated the capacity of intramuscular (i.m.) immunization with heterologous-host rotavirus (simian strain RRV) to induce mucosal virus-specific memory B cells in mice. We found that prior i.m. immunization enhanced the magnitude of mucosal virus-specific immunoglobulin A (IgA) production but did not alter the site and timing of induction of virus-specific IgA responses after challenge.

Rotavirus-specific proteins are detected in murine macrophages in both intestinal and extraintestinal lymphoid tissues.

Rotaviruses replicate in mature, villous epithelial cells of the mammalian small intestine. Although rotavirus has not been detected in plasma of infants with rotavirus-induced gastroenteritis, rotavirus particles and rotavirus genomic RNA have been detected in extraintestinal sites (e.g. cerebrospinal fluid). Using a murine rotavirus strain well adapted to growth in the small intestines of suckling mice, we found that macrophages (and to a lesser extent B cells) in gut-associated lymphoid tissue contained rotavirus-specific proteins, and that these antigen-containing cells travelled to sites distant to the intestine.

Protection against rotavirus-induced gastroenteritis in a murine model by passively acquired gastrointestinal but not circulating antibodies.

Newborn mice suckled on dams immunized either orally or parenterally with primate rotavirus SA-11 were protected against diarrhea induced by SA-11 virus challenge. Experimental oral administration of milk from orally immunized dams protected suckling mice against challenge; protective activity was detected both in the anti-rotavirus immunoglobulin A (IgA) and IgG fractions, but IgA was more potent in vivo than IgG. Oral administration of milk from parentally immunized dams also protected suckling mice against challenge; in this case, protective activity was detected in the anti-rotavirus IgG fraction. In newborn mice foster-nursed by seronegative dams, circulating rotavirus-specific antibodies in high titer did not protect mice against oral SA-11 virus challenge. It appears that the most effective rotavirus vaccine will be that which induces an efficient production of antibodies active at the intestinal cell surface.