key: cord- -hkc vbmj authors: schughart, klaus title: sysgenet: a meeting report from a new european network for systems genetics date: - - journal: mamm genome doi: . /s - - - sha: doc_id: cord_uid: hkc vbmj the first scientific meeting of the newly established european sysgenet network took place at the helmholtz centre for infection research (hzi) in braunschweig, april - , . about researchers working in the field of systems genetics using mouse genetic reference populations (grp) participated in the meeting and exchanged their results, phenotyping approaches, and data analysis tools for studying systems genetics. in addition, the future of grp resources and phenotyping in europe was discussed. sysgenet is funded through the cost framework (http://www.cost.eu/about_cost). cost is an intergovernmental framework for european cooperation in science and technology that promotes and coordinates nationally funded research in europe, through funding of research networks. sysgenet is coordinated by klaus schughart (helmholtz center for infection research, braunschweig, germany) . more detailed information about sysgenet can be obtained from the website http://www.helmholtzhzi.de/sysgenet/. infectious diseases continue to represent a threat to human health. due to global warming and travel, newly emerging diseases are spreading at an unprecedented rate around the world. examples are the dissemination of antibioticsresistant mycobacteria, the new swine influenza virus variant, sars, and west nile virus (wnv). several research groups are using mouse grps to identify complex genetic influences on the host susceptibility to infections. grps have been and will continue to be an important basis for understanding infectious diseases in humans. a very good example for translational research was presented by pascal rihet, who identified genomic susceptibility regions to malaria in human populations in africa (delahaye et al. ) and then continued to compare these results with studies in mouse grps. in this way, a region on human chromosome and its homologous regions on mouse chromosomes and were identified. subsequent expression studies in mice will now help to determine the molecular networks and genes involved. paul denny described the mapping of genetic susceptibility to streptococcus pneumonia infections in mouse inbred strains to chromosomes (denny et al. ) and (unpublished) . infection susceptibility to influenza was described by klaus schughart, who also pointed out that high susceptibility includes a hyperreactive immune response in the host (srivastava et al. ). xavier montagutelli generated a unique resource of mus spretus c bl/ j interspecific recombinant congenic strains that carry different genomic fragments of mus spretus on a c bl/ j background (burgio et al. ). this grp was used to identify resistance and susceptibility regions to various pathogens, including rift valley fever, west nile virus, yersinia pestis, and influenza. the first lines of the collaborative cross strains have been screened by fuad iraqi for a number of susceptibility loci to various pathogens (unpublished). it was remarkable to see that several quantitative trait loci (qtl) showed high significance and that the genomic intervals for several loci were very narrow, which should make it possible to identify quickly the underlying quantitative trait genes. metabolic diseases in humans are dramatically on the rise; obesity and related diseases in particular represent a serious challenge to future health systems. several groups addressed the complex genetics of metabolic functions and disorders using different mouse grps. gudrun brockmann reported on the mapping of qtls for obesity in a specific mouse strain isolated in berlin and the bxd congenic strain set (neuschl et al. ) . the future goal is to relate these qtls to genetic polymorphisms that influence the immune system. joan campbell-tofte presented the use of herbal extracts for the treatment of type diabetes in humans. she nicely illustrated the use of mouse models: from human to mouse to humans and back to the mouse. pénélope andreux reported on the setting up of a mouse clinic in lausanne for a systematic analysis of mouse grps for a large number of metabolic phenotypes, including mitochondrial functions (koutnikova et al. ). juan m. falcon-perez described the genomic, proteomic, and metabolic phenotyping capabilities of their technological platform and introduced extracellular microvesicles and metabolomic profiles as two new biological sources for identifying biomarkers for the detection and monitoring of hepatic diseases (hackenberg et al. ). abnormalities and diseases of the liver are also the subject of studies presented by karl kashofer (kashofer et al. ). several loci for (nonalcoholic) steatohepatitis have been mapped in chromosome substitution strains, and a more detailed mapping in subcongenic strains is ongoing. although rats in general were the species of choice for use by experimental psychologists to study behavior, mice have been the preferred animal for behavior geneticists since at least the s. in addition, the adaptation of behavioral assays and the development of new methods have confirmed the mouse as one of the most preferred experimental systems to learn more about the genetic underpinnings of behavior and associated phenotypes. martien kas described the currently underlying scientific rationale. precise measurement of a well-described behavioral trait across a grp will lead to the identification of associated genes and genomic regions. in the next step these genes can be used to find homologous genes and pathways that contribute to the development of neuropsychiatric disorders in humans. the translational value of this interspecies genetic approach was nicely exemplified in a study in which a qtl for avoidance behavior in mice was related to bipolar disorders in humans (de mooij-van malsen et al. ). in a similar approach, iris hovatta used a cross-species neurogenomics comparison to correlate brain region-specific gene expression patterns and anxiety-like behavior in mouse grps to polymorphisms in the finnish population for anxiety disorders (hovatta et al. ) . the mouse genes allowed identification of potential candidate genes in humans who predispose to anxiety disorders. paul franken presented studies on the identification of genetic traits that influence homeostatic and circadian aspects of sleep, and the electroencephalogram in the bxd grp and in inter-and backcross panels of mice (shaw and franken ) . several genes that play a decisive role were identified, and further phenotyping of the extended bxd grp is planned. eero vasar and sulev kõks described the role of the wfs gene in knockout mice for anxiety behavior, an altered response to morphine and the release of striatal dopamine (koks et al. ; luuk et al. ). ewelina knapska reported the use of a highly sophisticated cage system, intellicage, to automatically record a number of different complex behavioral traits in mice (jaholkowski et al. ). mice can be housed in social groups but nevertheless tested individually. ryszard przewlocki reported on a systematic study on various inbred mouse strains to identify genetic determinants of alcohol and drug addiction (piechota et al. ) . combining these studies with comprehensive gene expression analyses revealed that glucocorticoid receptor-activated gene expression pathways play an important role. wim crusio studied behavioral traits in learning and related them to brain anatomy (crusio and schwegler ) . thereby, the extent of neuron projections in the hippocampus could be correlated to more efficient learning capabilities and these two phenotypes are very strongly correlated genetically. guus smit gave an overview on a collaborative effort in the netherlands in which several research groups have determined various behavioral phenotypic traits and qtls in a commonly used bxd population (loos et al. ). also, they established a mouse facility in which they are using automated screening cages with sophisticated video recording and analysis. cancer is still one of the most frequent causes of death in western countries, and understanding its molecular causes as well as establishing appropriate animal model systems for the development of new treatment strategies is very important. fragiskos kolisis reported on the setting up of an infrastructure for a systems biology approach to carcinogenesis and aging (chatziioannou et al. ). understanding proteasome function and dysfunction as well as studying the alterations of the genome and proteome that account for different cancer phenotypes in a mouse skin carcinogenesis model are among the research goals. javier santos used grps to identify genetic traits for the susceptibility to radiation-induced thymic lymphomas in interspecific recombinant congenic and consomic mouse strains (santos et al. ). frank lammert developed assay systems to determine genetic causes of liver fibrosis and inflammatory liver carcinogens in the bxd mouse recombinant congenic grp (weber et al. ) . leonard schalkwyk studied allele-specific methylation in humans (schalkwyk et al. ) . he estimated that potentially more than , sites in the genome exhibit allele-specific modifications, and of these % are not in cis, a number that largely exceeds the number of known imprinted loci. these findings suggest that individual genetic heterogeneity may be much larger than estimated thus far and may contribute to individual phenotypic differences. jiri forejt used inter-subspecific consomic strains (gregorova et al. ) to investigate male sterility and its consequences for interspecies hybrid sterility (mihola et al. ). furthermore, in the livers of inter-subspecific hybrid strains he discovered new patterns of gene expression that were absent from both parental strains. the capture, storage, handling, and analysis of large data sets will present a specific challenge for future systems genetics projects. ritsert jansen and pjotr prins presented their approaches to integrate data from various phenotypic studies, encompassing gene expression, metabolome, and classical traits, and to develop new tools for advanced and improved mapping of qtls (jansen et al. ; li et al. ; swertz and jansen ) . these tools will be provided to the scientific community. andreas beyer gave a report on how to integrate data obtained at the post-transcriptional level with rna expression data. several loci that influence the post-transcriptional regulation of gene products could be identified in yeast. steffen möller presented his suite for the analysis of expression qtl (http://eqtl.berlios.de), which is being applied to the analysis of experimental autoimmune encephalomyelitis in mouse and rat. anastasios bezerianos presented a platform and developments for the identification of gene regulatory networks integrating protein-protein interactions and microarray data (bezerianos and maraziotis ). they started with yeast data and will soon expand to mouse, concentrating on time-varying gene regulatory networks. morris swertz presented xgap, a software platform developed for data management and integration of large data sets from phenotyping and genotyping studies (swertz et al. ) . grant morahan described the development of an extended tool for webqtl that allows a genome-centric analysis of qtl interactions (unpublished). the collaborative cross (cc) is currently being generated as a community resource for more sensitive and refined mapping of qtls. the goal is to breed a large population of recombinant inbred strains starting from eight founder strains. the eight founder strains were selected to capture a large portion of the genetic variation in the mouse genome. in fact, the genetic variation represented in the cc will be twice the genetic variation present in the human population (reviewed in valdar et al. ) . the three sites where the resource is being generated reported the present status of their breeding colonies; the final goal is to generate a total of lines (chesler et al. ; iraqi et al. ; morahan et al. a) . grant morahan gave an update on the ''southern cross'' being established in perth, australia. an inbreeding depression was observed at generations - . at present, about strains have been bred beyond generation . the first strains are expected to be inbred by the end of the year. david threadgill reported the status of the breeding colony at the university of north carolina, chapel hill, nc, usa. about lines are currently breeding at unc. the first recombinant inbred lines will be available by the end of this year and lines by the end of . to speed up the inbreeding process, markerassisted breeding will be used to create homozygous lines beyond generation . genome analysis demonstrated that all parental genomes are well represented in the advanced generations. the first phenotyping analysis showed a large variation in body weight, exercise propensity, and susceptibility to pathogens. richard mott described the genome structure of a smaller cc colony, funded by the wellcome trust, which was developed by fuad iraqi and is presently housed in tel aviv, israel. a first phenotyping analysis for the qtls that affect recombination frequencies was performed. a full-genome sequencing project to complete the parental strains with high coverage is underway at the sanger institute. the two-day meeting in braunschweig has clearly demonstrated the great value of mouse grps in identifying genetic determinants of complex genetic traits for various phenotypic traits related to diseases in humans. the partners of the network collectively have great expertise in disease phenotyping and analysis of genetic reference populations. several examples that illustrated the translation of the knowledge gained in the mouse experimental systems to humans were presented. links to clinical researchers already exist at several places but will have to be further expanded in the future. furthermore, mouse grps can be ideally combined with mouse mutant lines carrying a gene-knockout mutation to determine the effect of a strong genetic defect in combination with modifier genes. it also became clear that a strong and sustained financial investment in mouse breeding and phenotyping facilities as well as in bioinformatic infrastructure is urgently needed to further advance a systems genetics approach in europe. open access this article is distributed under the terms of the creative commons attribution noncommercial license which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. greece; sulev kõks, university of tartu, estonia; frank wfs -deficient mice display impaired behavioural adaptation in stressful environment detection and interpretation of expression quantitative trait loci (eqtl) a mouse speciation gene encodes a meiotic histone h methyltransferase establishment of ''the gene mine'': a resource for rapid identification of complex trait genes systems genetics can provide new insights into immune regulation and autoimmunity a unique genetic defect on chromosome is responsible for juvenile obesity in the berlin fat mouse a new set of bxd recombinant inbred lines from advanced intercross populations in mice the mouse as a model for human biology: a resource guide for complex trait analysis the dissection of transcriptional modules regulated by various drugs of abuse in the mouse striatum the polymorphism architecture of mouse genetic resources elucidated using genome-wide resequencing data: implications for qtl discovery and systems genetics a role for stroma-derived annexin a as mediator in the control of genetic susceptibility to t-cell lymphoblastic malignancies through prostaglandin e secretion allelic skewing of dna methylation is widespread across the genome perchance to dream: solving the mystery of sleep through genetic analysis host genetic background strongly influences the response to influenza a virus infections beyond standardization: dynamic software infrastructures for systems biology xgap: a uniform and extensible data model and software platform for genotype and phenotype experiments simulating the collaborative cross: power of quantitative trait loci detection and mapping resolution in large sets of recombinant inbred strains of mice genetic determinants in hepatic fibrosis: from experimental models to fibrogenic gene signatures in humans bao l, wei l, peirce jl, homayouni r, li h et al ( ) combining gene expression qtl mapping and phenotypic spectrum analysis to uncover gene regulatory relationships. key: cord- -ip y j authors: becker, pablo d.; legrand, nicolas; van geelen, caroline m. m.; noerder, miriam; huntington, nicholas d.; lim, annick; yasuda, etsuko; diehl, sean a.; scheeren, ferenc a.; ott, michael; weijer, kees; wedemeyer, heiner; di santo, james p.; beaumont, tim; guzman, carlos a.; spits, hergen title: generation of human antigen-specific monoclonal igm antibodies using vaccinated “human immune system” mice date: - - journal: plos one doi: . /journal.pone. sha: doc_id: cord_uid: ip y j background: passive transfer of antibodies not only provides immediate short-term protection against disease, but also can be exploited as a therapeutic tool. however, the ‘humanization’ of murine monoclonal antibodies (mabs) is a time-consuming and expensive process that has the inherent drawback of potentially altering antigenic specificity and/or affinity. the immortalization of human b cells represents an alternative for obtaining human mabs, but relies on the availability of biological samples from vaccinated individuals or convalescent patients. in this work we describe a novel approach to generate fully human mabs by combining a humanized mouse model with a new b cell immortalization technique. methodology/principal findings: after transplantation with cd (+)cd (−) human hematopoietic progenitor cells, balb/c rag (−/−)il- rγc(−/−) mice acquire a human immune system and harbor b cells with a diverse igm repertoire. “human immune system” mice were then immunized with two commercial vaccine antigens, tetanus toxoid and hepatitis b surface antigen. sorted human cd (+)cd (+) b cells were retrovirally transduced with the human b cell lymphoma (bcl)- and bcl-xl genes, and subsequently cultured in the presence of cd -ligand and il- . this procedure allows generating stable b cell receptor-positive b cells that secrete immunoglobulins. we recovered stable b cell clones that produced igm specific for tetanus toxoid and the hepatitis b surface antigen, respectively. conclusion/significance: this work provides the proof-of-concept for the usefulness of this novel method based on the immunization of humanized mice for the rapid generation of human mabs against a wide range of antigens. hyper-immune sera containing polyclonal immunoglobulins (igs) have been widely used in both therapeutic and prophylactic clinical settings [ ] . however, the use of polyclonal sera was associated with several problems, such as the stimulation of allergic reactions, low reproducibility between clinical batches and high off-label use, which finally caused a decline in their use [ ] . the advent of technologies to make monoclonal antibodies (mabs) derived from animals, especially mice, has overcome many of the problems associated with the use of polyclonal sera. the technology to make monoclonal cell lines of antibody-producing cells by fusing antibody producing plasma cells with myeloma cells was described for the first time in by milstein and kohler [ ] . the therapeutic potential of mabs was immediately recognized and in the first mab, okt , was approved for therapeutic applications. this antibody inactivates t cells, thereby preventing rejections of organ transplants [ ] . however, because of the animal origin of the first generation of mabs that were used in clinical trials, human subjects treated with these antibodies developed vigorous immune reactions against the animal proteins, which were thereby eliminated preventing their therapeutic actions [ ] . to overcome these problems technologies were developed to diminish the immunogenicity of mouse antibodies by replacing part or the complete mouse antibody backbone by its human equivalent, first generating chimeric, and subsequently fully humanized antibodies [ ] . in a parallel approach transgenic mice bearing the human ig region were created to obtain fully human antibodies following immunization. the use of these mice obviates the elaborate molecular engineering of antibodies that is needed to humanize antibodies generated in wild-type mice, however, the maturation process of the mouse b cells expressing human igs is different from that of fully human b cells [ ] . immortalization of b cells from immune humans seems to be the logical strategy to avoid these problems. however, the methods to achieve this goal have showed low efficiencies, although some progress has recently been reported [ , ] . nevertheless, the major disadvantage of human b cells immortalization is the need for cells from either vaccinated individuals or patients who had recovered from an infection. thus, to fully exploit the ig repertoire of human b cells in an in vivo setting, we explored the possibility to raise mabs following de novo induction of human b cell responses in mice carrying elements of the human immune system (his). his mice are generated by engrafting immunodeficient mice with human hematopoietic stem cells (hsc) with or without human lymphoid tissues from fetal origin [ , , ] . in particular, mice deficient for the recombinase activating gene- (rag ) and the common gamma chain of the il- receptor (il rg) on a balb/c or a non-obese diabetic (nod) background are permissive for human hsc xenografts. inoculation of newborn mice from these strains with human hsc of fetal or umbilical cord blood origin gives rise to robust engraftment of a number of immune cells, including t, b, nk and dendritic cells. in this work, we describe a convenient approach to generate fully human mabs based on the immunization of balb/c rag / il- rcc / engrafted with human cd + cd hsc [ , ] . to this end, his mice were immunized with commercial vaccines against hepatitis b virus (hbv) and tetanus. following immunization, human cd + b cells were sorted based on surface cd expression, as a marker of memory phenotype, and the isotype of surface igs. the sorted b cell populations were immortalized in vitro by retroviral transduction with human b cell lymphoma (bcl)- and bcl-xl genes and antigen-specific b cell clones were established and characterized. the obtained results provided the proof-of-concept for the usefulness of this generic approach based on his mice combined with immortalization of human b cells for the rapid and inexpensive development of human mabs against a wide range of antigens. the use of fetal liver tissue obtained from elective abortions with gestational age ranging from to weeks was approved by the medical ethical committee of the amc-uva and was contingent on informed written consent. balb/c rag / il- rcc / mice were bred and maintained in individual ventilated cages, and fed with autoclaved food and water. his mice were generated as previously described [ , , , ] , with the approval of the animal ethical committee of the amc-uva (permit number dhl- ). in brief, human fetal livers were obtained from elective abortions with gestational age ranging from to weeks. magnetic enrichment of cd + cells (. % pure) was performed by using the cd progenitor cell isolation kit (miltenyi biotech), after preparation of single cell suspensions and isolation of mononuclear cells by density gradient centrifugation over lymphoprep (axis shield). finally, newborn (, days old) sub-lethally irradiated ( . gy) balb/c rag / il- rcc / mice were injected via intra-hepatic route with - sorted cd + cd human fetal liver hematopoietic stem cells in ml. all manipulations of his mice were performed under laminar flow. cell suspensions were prepared in rpmi medium supplemented with % fetal calf serum (fcs). twelve to sixteen weeks after cd + cd hsc engraftment, his mice were killed and single cell suspensions of splenocytes were prepared. red cells lysis was performed in ml of red cell lysis buffer (sigma) for min. splenocytes were washed, resuspended in ml of rlt lysis buffer (qiagen) and homogenized by passing through a -gauge needle several times using rnase free syringes. rna was prepared using rneasy mini kits (qiagen) according to manufactures instructions. bcr v h immunoscope was performed as previously described [ ] . briefly, cdna was prepared and real-time pcr performed by combining primers for the different v h chains (v h - ) and specific fluorochrome-labeled probes against the different constant regions (c h m, c h a and c h c). an additional four pcr cycles 'run-off reactions' were then performed on the pcr products using fluorescent primers specific for the constant regions (fcm, fca and fcc). products were gel separated to determine cdr lengths. analysis of six individual his-mice containing greater than % human chimerism in the spleen was performed. the number of human cd + b cells in chimeric spleens ranged from - . eight weeks after hsc transplantation, blood was taken from his mice to verify the level of engraftment by flow cytometry, as described elsewhere [ ] . his mice with a good level of human reconstitution (. % hcd + cells) were immunized by intramuscular route (biceps femoris) using a g needle, three times on weeks , and with either ml of the hbv vaccine (engerix-b, glaxosmithkline) or ml of tetanus toxoid (tt) containing vaccine (tetanus vaccine, the netherlands vaccine institute). these amounts correspond to / of the normal human dose. negative controls received the same volume of pbs buffer. two weeks after the last immunization, his mice were exsanguinated under isofluran/oxygen narcosis. spleens and mln were removed aseptically and cellular suspensions were prepared. the bm cells were isolated from the femur and tibia. from beckman coulter; cd (sk ), cd (sk ), cd (sk ), cd (hib ), cd (hit ), cd ( d and hi ), cd ra (hi ), cd (mi ), igm (g - ), igd (ia - ), igg (g - ) and ccr ( d ) from bd biosciences; cd (lt ) from abd-serotec; cd (lg. f ) from ebioscience. tt-specific b cells were also occasionally stained with pe-coupled tt, kindly provided by dr. andreas radbruch (german rheumatism research center, berlin, germany). dead cells were excluded based on dapi incorporation. all washings and reagent dilutions were done with pbs containing % fcs and . % nan . stained cells were analyzed with an lsr-ii interfaced to a facs-diva software system (bd biosciences). cell sorting of b cell subsets were performed on his mouse bm and spleens using a facs-aria cell sorter interfaced to a facs-diva software system (bd biosciences). for these experiments, all washings and reagent dilutions were done with % fcs supplemented pbs without nan . the human bcl [ , ] and bcl-xl [ ] encoding cdnas were further cloned in a lzrs retroviral expression vector, around a t a cleavage-promoting peptide sequence and upstream a cassette containing an internal ribosome entry site (ires) and the gene encoding gfp. we therefore obtained a lzrs vector in the following configuration: bcl -t a-bclxl-ires-gfp [ ] . transfection of phoenix-galv packaging cells and virus production were performed as previously described [ ] . before retroviral transduction, memory b cells were activated on c-irradiated ( gy) mouse l cell fibroblasts stably expressing cd l (cd l-l cells) in the presence of - ng/ml recombinant mouse interleukin- (rmil- , r&d systems) for h [ ] . the b cells were washed, mixed with retroviral supernatants in retronectin-coated plates (takara), centrifuged at room temperature for min at g, and subsequently incubated with the retroviruses at uc, % co for - h. transduced b cells were maintained in co-cultures using cd l-l cells ( cells/ml) and in standard imdm (gibco) culture medium supplemented with % fetal bovine serum (fbs; hyclone), penicillin/streptomycin (roche) and ng/ml rmil- . the analysis of human ig-v h sequences was performed as follows. total rna was isolated from approximately monoclonal b cells with trizol (invitrogen). the cdna was generated and subjected to pcr with primers specific to the different v h family members. pcr products were sequenced to determine the cdr region of the different clones. sequence analysis was performed using bigdye terminator chemistry (applied biosystems inc.) and codoncode aligner software. the plasma harvested from his mice ( days after the first and second immunization; days after the third immunization) and b cell clone culture supernatants were screened by elisa for the presence of total human igm, total human igg and antigenspecific antibodies. measurement of total igm and igg was performed by coating -well plates either with affinipure f(ab') fragment goat anti-human igm (fc m-specific, jackson immu-noresearch) or affinipure goat anti-human igg (fcc fragmentspecific; jackson immunoresearch). control human serum protein calibrator (dako) with known igm ( . mg/ml) and igg ( . mg/ml) concentrations was used as a standard to be compared to the samples. for the detection of antigen-specific antibodies, -well plates were coated either with tetanus vaccine (nederlands vaccin instituut) or engerix b (glaxosmithkline) ( diluted in pbs) for h at uc or overnight at uc. alternatively, ridascreen tetanus igg elisa plates (biopharm) were also used to screen for tt-specific antibodies. after coating, the plates were washed in elisa wash buffer (pbs, . % tween- ). a pbs solution containing % of milk was used as a blocking agent, before adding serial dilution of his mouse plasma (starting at a dilution of : ) or cell culture supernatants (starting at a dilution of : ). enzyme-conjugated detection antibodies were added at a dilution of : for hrp-conjugated anti-igg and a dilution of : for hrp-conjugated anti-igm (both from jackson immunoresearch). then, tmb substrate/stop solution (biosource) was used for the development of the elisa assay. statistical analyses were performed using graphpad prism version . for windows (graphpad software). data were subjected to two-tailed unpaired student t test analysis. the obtained p values were considered significant when p, . . we have generated his mice by transplanting human hsc into alymphoid balb/c rag / il- rcc / newborn mice ( figure a ). as reported previously, multilineage human hematopoietic reconstitution is observed in his mice, which demonstrate human thymopoiesis, b cell differentiation, nk cell and plasmacytoid dendritic cell development, and myelopoiesis [ , , , , ] . human immune cells accumulate in lymphoid tissues, and several b cell subsets are observed in his mice ( figure b) . we analyzed the human b cell repertoire present in naive his mice by using b cell receptor (bcr) immunoscope analysis based on quantitative pcr of ig variable (v h ) and constant (c h ) region gene segments [ ] . due to the lack of human spleen samples, the cells isolated from his mouse spleens, which contained sufficient numbers of human b cells to perform the immunoscope analysis, were compared to control human peripheral blood mononuclear cells (pbmc) samples, which were considered acceptable for the purpose of the performed comparison. we observed that igm-expressing b cells as well as ig isotype-switched b cells are found in naive his mice ( figure c) . the vast majority of b cells of his mice expressed an igm ( . . %), whereas igg ( . . %) and iga ( . . %) expressing b cells represented minor populations. only the frequency of iga-expressing b cells was found significantly higher in control human pbmc samples (p, . ). at - weeks post-transplantation (i.e. in steady state conditions), the human ig concentrations in the blood were mg/ml (igm) and mg/ml (igg) ( figure d ), as previously reported [ , ] . in comparison, the normal range for ig concentration in healthy humans is - mg igm/ml and - mg igg/ml. in brief, despite a low frequency of igg-expressing cells, both human igm and igg accumulated in the plasma of , month-old his mice to levels representing around % and % of adult human igm and igg concentrations, respectively. we further examined the antigen receptor repertoire diversity in his mice, by determining the length of cdr hypervariable regions for each ig-v h gene family. the analysis of cdr length distribution of individual his mouse splenocytes showed that igm repertoires are undistinguishable from normal human pbmc igm repertoires, as measured by the bcr immunoscope analysis ( figure e ). this observation suggests that his mice contain a broad variety of naive igm + b cell clones. the v h -family usage was large and similar to control human pbmc ( table ) . the bcr immunoscope analysis was also performed for igg and iga repertoires and we observed more restricted repertoires, as expected from b cells undergoing clonal selection and ig class switch recombination ( figure s ). immunization of his mice with hbv and tetanus vaccines results in the generation of antigen-specific antibody responses since his mice contained broad naïve b cell repertoires, we analyzed the induction of human antigen-specific b cell responses after immunization with commercially available human vaccines. we designed a vaccination protocol based on repeated intramuscular immunizations ( injections with -week intervals) of - -week old his mice with vaccines containing hepatitis b surface antigen (hbsag) or tt. seven days after the last immunization mice were sacrificed, the blood and the lymphoid organs were harvested, and the phenotype and function of human cells was analyzed. all his mice showed human reconstitution (. % hcd + cells) in the blood before starting the immunization protocol, which correlated with human engraftment in lymphoid organs. overall, % of hbsag-vaccinated ( out of vaccinated animals) and % of tt-vaccinated ( out of ) his mice showed significant production of antigen-specific igm antibodies, as detected by elisa (figure a) . we performed a kinetic monitoring of antigen-specific plasma ig levels in individual hbsag-vaccinated responder his mice and we observed that after the first immunization antigen-specific igs were rarely detected. in contrast, after the second immunization antigen-specific igm was detected, which steadily increased after the third immunization with approximately - % of responder mice also showing an antigen-specific igg response (figure a) . this suggests that repeated vaccination leads to enhanced antigen-specific antibody production. the responder mice exhibited higher total igm ( mg/ml) and total igg ( mg/ml) concentrations in their plasma, as compared to pbs-injected (igm: mg/ml; igg: mg/ml) and non-responder vaccinated (igm: mg/ml; igg: mg/ml) animals ( figure b) . at the end of the immunization protocol, vaccinated animals showed significantly higher numbers of hcd + cells in all organs (i.e. spleen, bone marrow (bm) and mesenteric lymph nodes (mln)) in comparison to mock-injected control mice. responder his mice exhibited higher numbers of human t and b cells in the spleen, as well as t cells in the bm ( table ; table s ), suggesting that the vaccination protocol had a positive impact on the accumulation of human b and t cells. moreover, the mln isolated from vaccinated his mice contained to -fold more hcd + cells than those of control animals ( figure c ), suggesting that the mln structure might play a role in eliciting an immune response in the his mice. in humans, the cd + memory b cell population contains the majority of antigen-experienced b cells [ , ] , and we reasoned that the same should be true in vaccinated his mice. we therefore cell sorted several different cd + cd + b cell subsets from individual his mice. we used two strategies to isolate the following human b cell (cd + cd + ) subsets from bm and spleens of vaccinated his mice: (i) cd hi cd hi , (ii) cd + cd lo/int igd + , and (iii) cd + cd lo/int igd on the one hand ( figure - , although the number of cells was increased for each of these subpopulations in the vaccinated animals, as expected from the enhanced number of total b cells ( table ) . we only observed a significant increase in the frequency of igg + b cells within the cd hi cd hi plasmablast population of vaccinated responder his mice, as compared to pbs-injected animals ( . . % and . . % of cd hi cd hi b cells, respectively; p = . ). in order to identify, isolate and immortalize the antigen-specific antibody-producing b cells, the aforementioned b cell subsets were transduced immediately after cell sorting with a retroviral vector encoding both human bcl and bcl-xl [ , ] . by ectopically expressing bcl and bcl-xl in splenic or peripheral blood memory b cells and culturing them with factors produced by follicular helper t cells (cd l and il- ), we generated highly proliferative, bcr positive b cell lines that secrete igs. since these cells express bcl , the differentiation of memory b cells to terminal plasma cells is blocked [ , , ] . therefore, the resulting b cells can expand extensively in vitro for long periods of time in presence of cd l and il- , and provide a tool to generate antigen-specific human bcr-positive, antibody-secreting b cell lines. the number of isolated cells from spleen and antigen-specific b cell clones that were generated with the bcl /bcl-xl transduction approach is provided in the table s . since the frequency of antigen-specific b cell clones was unknown, we started with microcell cultures ranging from . to cells per well. the wells containing antigen-specific b cells -as determined by hbsagspecific or tt-specific elisa -were subsequently cultured by limiting dilution to obtain monoclonal b cell lines. overall, we generated anti-hbsag igm + b cell clones from his mice vaccinated with hbsag, and anti-tt igm + b cell clones from his mice vaccinated with tt ( table s ). the estimated frequency of hbsag-specific b cells (clones) in the his mice after vaccination was / . the igm secretion level of the b cell clones were in the range of mg per cells over days in culture, which was in a similar range of secretion ( . - mg/ cells/ days) to what was previously reported for b cell clones generated from human blood [ ] . the igm v h regions of the bcr of the antigen-specific igm + b cell clones were sequenced. overall, the bcr of hbsag-specific and tt-specific b cell clones exhibited a v h sequence close to the germ-line sequence, although limited frequencies of somatic hyper-mutations were observed (table s and table s ). somatic hyper-mutations were occasionally detected in all framework regions (fr) and complementary determining regions (cdr), and most of the bcr diversity was the result of nadditions in the cdr region. based on the bcr sequence, we observed that out the anti-hbsag igm + b cell clones were unique, as well as out the anti-tt igm + b cell clones ( table s , table s and table s ). the supernatants of tt-specific b cell clones were further tested for their capacity to recognize different antigens by elisa. we observed that igm mabs did not cross-react with unrelated antigens (i.e., hbsag and respiratory syncytial virus (rsv) antigens) ( figure a) . the tt-specific b cell clones were also screened by flow cytometry for direct binding of the tt antigen labeled with a fluorochrome ( figure b) . interestingly, three types of clones that produced antibodies that gave a similar signal in elisa were detected, with high, intermediate and low binding of the fluorescent tt antigen. in the present work we established a new approach to generate fully human mabs. we immortalized b cells from vaccinated his mice by transduction with bcl and bcl-xl followed by expansion in presence of il- and cd l. antigen-specific b cell clones were obtained that expressed the bcr on their cell surface and secreted antigen-specific antibodies. similarly to methods based on the immortalization of human memory b cells from individuals that were either vaccinated or exposed to pathogens, our strategy exploits the antibody repertoire of human b cells which is likely to be different from that of b cells of mice expressing human ig gene segments. naïve his mice display an extensive human igm-expressing b cell repertoire. based on the analysis of the length of the cdr regions, this igm b cell repertoire is similar to the repertoire of healthy individuals. thus, his mice have no obvious limitations for the generation of human igm mabs against any possible antigen. upon intramuscular vaccinations with either tt or hbsag, approximately % of the his mice were able to mount an antigen-specific antibody response. human igm-producing b cell lines against both antigens were obtained after isolation of memory b cells followed by ex vivo differentiation into plasmablastlike cells. it is important to highlight that the selection of the antigen-specific human b cell clones relied on relevant bioassays (e.g., elisa or neutralization test). in contrast to ebv-based approaches, human b cell immortalization using transduction with bcl- and bcl-xl preserves the expression of the bcr at the surface and antigen-specific b cell clones can also be selected by binding of labeled antigen to the bcr of immortalized memory b cells (e.g. by using a labeled antigen). even when igg was used as a selection criterion, we were unable to establish antigen-specific igg + human b cell clones. the reason for this might be that t cell help in this system is suboptimal as indicated by the absence of antigen-specific t cell responses after vaccination (not shown). we also observed that the bcr of the b cell clones had a close to germ-line sequence, suggesting that also the induction of somatic hyper-mutation is sub-optimal in his mice. in our hands the great majority of the vaccinated his mice showed a defective formation of germinal centers [ , ] , which further explains the absence of antigenspecific ig-class switched b cells. so far, humanized mouse models based on the transplantation of human hsc only -i.e. without additional human tissues -share these limitations, and immunization strategies result in the limited generation of class-switched antigen-specific b cell responses [ , , ] . similar patterns are observed in human hsc-transplanted immunodeficient mice infected with lymphotropic pathogens, such as hiv [ ] or ebv [ ] , although dengue virus infection in his mice was reported to induce an igg response in a majority of the responder animals [ ] . it is not clear why igg antigen-specific responses are limited while serum igg can accumulate efficiently, considering the low frequency of igg + b cells in his mice. it remains to be determined whether this apparent discrepancy might be explained by the conjunction of particularly effective igg production on a cell basis by igg + b cells (which might occur in a t cell independent manner, such as in the case of the igg subclass), long-term stability of human igg in the his mouse serum as compared to human igm, and/or defective survival of igg + b cells under specific conditions (e.g. after antigen-specific triggering of the bcr). although igm mabs might already be useful for some specific applications or could be modified by ig class swapping to obtain igg mabs [ ] , optimized humanized mouse models with improved b cell function are highly desirable. one reason for the suboptimal interaction of t and b cells may be the poor survival resulting in a high turnover of human t cells (discussed in [ , ] ), making it very likely that procedures leading to improved accumulation of human t cells may promote b cell responses and isotype switching. it was already shown that human b cells undergoing isotype switching can be obtained in humanized mice, provided that a human environment supporting this process is present, e.g. in scid mice transplanted with human fetal bones, thymus and lymph nodes [ ] . consistent with this notion, enhanced human peripheral t cell accumulation was observed in nod/scid mice transplanted with human bone marrow hsc, fetal liver and fetal thymus tissues (referred to as blt mice), as compared to conventional humanized mouse systems [ ] . interestingly, blt mice consistently generated an antigen-specific igg response after hiv-infection [ ] . although it is yet unknown whether the isotype switch observed in blt mice is truly t cell dependent, those data might support the idea that improved t cell homeostasis has a positive impact on b cell responses. to obtain humanized mouse models with improved b and t cell homeostasis, alternative strategies not relying on the transplantation of human fetal tissues -which are not necessarily easy to access to, for ethical, legal or practical reasons -will likely be favored in the future. the replacement of mouse genes involved in the hematopoietic system by their human equivalent is a valuable strategy to improve development, maintenance and/or function of several hematopoietic cell subsets in humanized mouse models, as shown with cytokines, such as il- and il- [ , , , ] , or mhc molecules (n.d.h and j.p.d., manuscript submitted) [ , ] . the fact that the human cd was shown to be unable to properly interact with the mouse sirpa indicates that reintroducing a functional phagocyte inhibition mechanism via the cd /sirpa signaling axis is another strategy of potential interest [ ] . in conclusion, our results show using two standard vaccine antigens the general applicability of an innovative b cell immortalization method in combination with the his mouse model to generate human mabs. similarly to methods based on the immortalization of human memory b cells from vaccinated or convalescent individuals [ ] , our approach exploits the broad antibody repertoire of human b cells, overcoming the potential limitations of conventional humanized murine mabs such as laboriousness or impaired biological properties, synthetic antibody libraries that require a known target antigen, and transgenic mice bearing the human ig locus that have limited b cell repertoires. in addition, our method enables to exploit experimental infection models and immunization regimes that would be unethical or untenable in humans. considering the upcoming advances in his mice models [ ] , this new approach will provide a powerful tool to generate human mabs for either diagnostic or therapeutic purposes. figure s igg/iga b cell repertoire in naïve his mice. similarly to figure e , the naive igg (a) and iga (b) b cell repertoires of his (balb-rag/c) mice were evaluated on splenocytes by performing a bcr immunoscope for each v h family. the profiles obtained with control human pbmc are also shown. found at: doi: . /journal.pone. .s ( . mb tif) figure . limited dilutions of b cells transduced with bcl- and bcl-xl were performed with . and . cells/well. after sub-cloning of the positive wells, we generated igm + anti-hbsag mabs, of which are unique (as determined by ig-v h sequence, see table s ), and igm + anti-tt mabs, of which are unique (see table s ). in the case of hbsag vaccination, the number of screened b cells was (( * . )+( * . ))* = , which eventually suggests that the frequency of hbsag-specific b cells is at least / b cells. found at: doi: . /journal.pone. .s ( . mb doc) igm v h amino-acid sequence of generated hbsagspecific b cell clones. the germ-line sequence is given for each v h family, with indication of framework regions (fr) and complementary determining regions (cdr). highlighted amino-acids correspond to n-additions (in the cdr region) and somatic hyper-mutation events, whether it results in a silent mutation (green) or not (red). clones with identical bcr sequences are grouped together. found at: doi: . /journal.pone. .s ( . mb pdf) the mechanism of diphtheria immunity and tetanus immunity in animals immunogenicity of therapeutic monoclonal antibodies continuous cultures of fused cells secreting antibody of predefined specificity upping the ante on antibodies mice with a human touch molecular engineering and design of therapeutic antibodies from xenomouse technology to panitumumab, the first fully human antibody product from transgenic mice an efficient method to make human monoclonal antibodies from memory b cells: potent neutralization of sars coronavirus generation of stable monoclonal antibody-producing b cell receptorpositive human memory b cells by genetic programming experimental models to study development and function of the human immune system in vivo human-hemato-lymphoid-system mice: opportunities and challenges humanized mice in translational biomedical research monitoring the effect of gene silencing by rna interference in human cd + cells injected into newborn rag -/-gammac-/-mice: functional inactivation of p in developing t cells development of a human adaptive immune system in cord blood celltransplanted mice il- trans-presentation promotes human nk cell development and differentiation in vivo t cellindependent development and induction of somatic hypermutation in human igm+ igd+ cd + b cells many human peripheral vh -expressing igm+ b cells display a unique heavy-chain rearrangement experimental model for the study of the human immune system: production and monitoring of ''human immune system'' rag -/-gamma c-/-mice stat -mediated up-regulation of blimp is coordinated with bcl down-regulation to control human plasma cell differentiation a senescence rescue screen identifies bcl as an inhibitor of anti-proliferative p (arf)-p signaling il- enhances thymic human t cell development in ''human immune system'' rag / il- rgammac / mice without affecting peripheral t cell homeostasis stat regulates the self-renewal capacity and differentiation of human memory b cells and controls bcl- expression cd : a memory bcell marker human b cell subsets rapid cloning of high-affinity human monoclonal antibodies against influenza virus human immunoglobulin m memory b cells controlling streptococcus pneumoniae infections are generated in the spleen human blood igm ''memory'' b cells are circulating splenic marginal zone b cells harboring a prediversified immunoglobulin repertoire control of inflammation, cytokine expression, and germinal center formation by bcl- bcl- represses genes that function in lymphocyte differentiation, inflammation, and cell cycle control the bcl- protooncogene controls germinal-centre formation and th -type inflammation antigen-specific antibody production of human b cells in nog mice reconstituted with the human immune system antigen-specific human t-cell responses and t cell-dependent production of human antibodies in a humanized mouse model disseminated and sustained hiv infection in cd + cord blood cell-transplanted rag -/-gamma c-/-mice a new humanized mouse model of epstein-barr virus infection that reproduces persistent infection, lymphoproliferative disorder, and cell-mediated and humoral immune responses dengue virus infection and immune response in humanized rag ( / )gamma(c)( / ) (rag-hu) mice potent antibody therapeutics by design humanized mice for modeling human infectious disease: challenges, progress, and outlook generation of primary antigen-specific human t-and b-cell responses in immunocompetent scid-hu mice humanized mice mount specific adaptive and innate immune responses to ebv and tsst- intrarectal transmission, systemic infection, and cd + t cell depletion in humanized mice infected with hiv- lentiviral vector delivery of human interleukin- (hil- ) to human immune system (his) mice expands t lymphocyte populations human lymphoid and myeloid cell development in nod/ltsz-scid il r gamma null mice engrafted with mobilized human hemopoietic stem cells generation of functional human t-cell subsets with hla-restricted immune responses in hla class i expressing nod/scid/il r gamma(null) humanized mice priming of protective t cell responses against virus-induced tumors in mice with human immune system components polymorphism in sirpa modulates engraftment of human hematopoietic stem cells we thank berend hooibrink for expert cell sorting and maintenance of the amc-uva flow cytometry facility. we acknowledge the bloemenhove clinic (heemstede, the netherlands) for providing fetal tissues and the staff of the animal research institute amsterdam for animal care. access to technologies available at the centre d'immunologie humaine of the institut pasteur was greatly appreciated. key: cord- -uh q we authors: zhang, yi; sun, honglei; fan, lihong; ma, yuan; sun, yipeng; pu, juan; yang, jun; qiao, jian; ma, guangpeng; liu, jinhua title: acute respiratory distress syndrome induced by a swine h n variant in mice date: - - journal: plos one doi: . /journal.pone. sha: doc_id: cord_uid: uh q we background: acute respiratory distress syndrome (ards) induced by pandemic h n influenza virus has been widely reported and was considered the main cause of death in critically ill patients with h n infection. however, no animal model has been developed for ards caused by infection with h n virus. here, we present a mouse model of ards induced by h n virus. methodology principal findings: mice were inoculated with a/swine/shandong/ / (sd/ ), which was a h n influenza variant with a g d mutation in the hemagglutinin. clinical symptoms were recorded every day. lung injury was assessed by lung water content and histopathological observation. arterial blood gas, leukocyte count in the bronchial alveolar lavage fluid and blood, virus titers, and cytokine levels in the lung were measured at various times post-inoculation. mice infected with sd/ virus showed typical ards symptoms characterized by % lethality on days – post-inoculation, highly edematous lungs, inflammatory cellular infiltration, alveolar and interstitial edema, lung hemorrhage, progressive and severe hypoxemia, and elevated levels of proinflammatory cytokines and chemokines. conclusions/significance: these results suggested that we successfully established an ards mouse model induced by a virulent h n variant without previous adaptation, which may be of benefit for evaluating the pathogenesis or therapy of human ards caused by h n virus. a novel influenza a (h n ) virus of swine origin emerged among humans in mexico during the spring of and rapidly spread worldwide [ ] . the pandemic prompted the world health organization (who) to raise the alert level to the highest rating of six, the pandemic phase, within months [ ] . in august , who officially declared that the disease was in the post-pandemic period [ ] ; however, it is still circulating among humans, together with seasonal viruses. although most influenza cases caused by h n virus infection typically display mild upper respiratory tract syndrome, some cases progress to severe pneumonia and acute respiratory distress syndrome (ards) [ , ] . many studies have shown that ards caused by h n virus results in . - % mortality [ , , , ] , which was regarded as the major cause of death by h n virus infection [ ] . ards is the result of acute injury to lung tissue, commonly resulting from sepsis, trauma, and severe pulmonary infections [ ] . infectious factors, most of which are viruses, have become one of the most important causes of ards in humans [ , , ] . clinical cases and established animal models have revealed that the pathogenesis and pathological features of ards induced by different viral pathogens are distinct [ , ] . however, knowledge of the pathogenesis of h n virus, especially ards induced by h n virus, is still limited and hinders therapeutic strategies. therefore, it is necessary to evaluate the pathogenesis of ards caused by h n virus infection in an appropriate animal model to assess potential therapies. mice are a good model for evaluating the pathogenesis and antiviral therapy of influenza pneumonia, due to the general fidelity of the illness in mice to the human disease [ ] . moreover, a mouse model of ards caused by highly pathogenic h n avian influenza virus infection has been well established [ ] . the typical h n virus, such as a/california/ / (ca/ ), can efficiently replicate in mouse lungs without prior host adaptation. however, it only causes moderate lung lesions and no mortality, even when inoculated at a high dose of pfu [ , ] . thus, such typical h n viruses may not be able to induce ards in a mouse model. in the present study, we used a virulent variant h n virus, which was isolated from a pig and possessed a virulenceassociated ha-d g mutation, to establish an ards mouse model. the model established here provides a useful tool to explore the mechanism of ards, as well as screening and therapeutic options. six-week-old female mice were infected intranasally (i.n.) with . pfu sd/ virus. some of the infected mice showed signs of illness, such as altered gait, inactivity, ruffled fur, and anorexia on day post-infection (p.i.). from day p.i., the body weight of most mice significantly decreased ( figure s ). by day p.i., most mice presented with more severe clinical signs of respiratory disease, including labored respiration and respiratory distress, and most mice lost almost % of their initial body weight. on day p.i., most mice were nearly unable to respond to exterior stimuli, and acute respiratory rates and labored respiration were observed (video s , and video s for control). approximately % of mice died between days and p.i. gross observation of infected mice showed that the lungs were highly edematous, with profuse areas of hemorrhage and consolidation. no obvious gross lesions were observed in the kidneys, liver, spleen or brain of infected mice. mice were infected i.n. with . pfu sd/ virus, and three mice were euthanized on days , , , , and p.i., and the virus titers in viscera were determined. as shown in figure a , the virus titer in the lung gradually increased between days and p.i., and reached a peak on day p.i. the virus titers in the lung gradually decreased from day p.i., and only one of three mice possessed detectable virus in the lungs on day p.i. no viruses were detected in other organs, including heart, spleen, liver, kidneys, blood and brain, at the indicated time. these results indicate that sd/ virus could replicate efficiently in mouse lung but did not cause systemic infection. as shown in figure b , the effect of sd/ viral infection on lung wet:dry weight ratio did not change significantly within days p.i. however, a dramatic increase was observed from day p.i., and reached a peak on day p.i., which was nearly twice that observed in control group lungs (p, . ). the change in lung wet weight:body weight ratio was similar to the change in lung wet:dry weight ratio ( figure c ). the results indicated that the sd/ virus could induce acute lung edema in mice. kinetic observation of lung lesions of sd/ -virus-infected mice is shown in figure . on day p.i., lung lesions were characterized by dropout of mucous epithelium and inflammatory cells adhering to the bronchiolar surface ( figure c , d). on day p.i., severe edema could be seen around blood vessels ( figure e ); interstitial pneumonia was also observed that showed interstitial edema and thickening of the alveolar walls; and the alveolar lumen was flooded with detached alveolar cells, erythrocytes, and inflammatory cells ( figure e , f). on day p.i., the virus caused more severe interstitial pneumonia and peribronchiolitis, characterized by edema and extensive of lymphocytes, neutrophils and plasma cells around the area of bronchiolitis ( figure g , h). lesions in the lungs of infected mice were still severe on day p.i., with extensive alveolar collapse, and remaining alveoli were filled with fibrin, desquamated alveolar cells, and inflammatory cells. lymphocytes and alveolar macrophages were the predominant inflammatory cells observed at high magnification ( figure j ). masson's stain revealed that alveolar walls and spaces were filled with collagen fibers ( figure a , b), indicating that proliferative fibroblastic lesions may develop. in comparison, lungs from mockinfected control mice had no apparent histological changes ( mice were inoculated i.n. with . pfu sd/ viruses; tissues were collected at indicated times p.i. and viruses were titrated in mdck cells. body weight, lung wet and dry weight were determined and recorded. the lung wet weight:body weight ratio and lung wet:dry weight ratio were calculated and used as an indicator of lung edema. *p, . , **p, . , ***p, . , comparison between ratios obtained from the virusinfected and control groups. bars represent means sd of data from three mice. doi: . /journal.pone. .g immunohistochemistry revealed viral antigens in the epithelial cells of the bronchioles ( figure d ), terminal bronchioles, and alveolar epithelial cells ( figure e ). these data indicated that sd/ virus could infect the epithelia of the lower airway and cause viral pneumonia in mice. as shown in table , virus-infected mice showed a slightly decreased partial pressure of arterial oxygen (pa o ), saturation of arterial oxygen (sa o ), and slightly increased partial pressure of arterial carbon dioxide (pa co ) from days to p.i. most infected mice presented with severe clinical signs of respiratory distress on day p.i., and blood gas analysis also showed that pa o and sa o dramatically decreased compared with the controls (p, . ). these results suggested acute respiratory dysfunction and severe hypoxemia in virus-infected mice. the number of leukocytes in balf from sd/ -infected mice showed an increase from day p.i. ( table ). the balf of virusinfected mice on day p.i contained . cells/ml and was significantly different from the . cells/ml observed for pbsinoculated mice (p, . ). these data indicate a dramatic increase in inflammatory cells in the lungs of sd/ -infected mice. to quantify the immune cell subpopulations responding to viral infection, we next determined cell differential counts in the infected lungs by wright staining. compared with pbs-inoculated animals, mice infected with sd/ virus exhibited an increase of neutrophils from days p.i., and the peak was -fold greater than that of the control group on day p.i. leukopenia was detected on day p.i., and was statistically significant on day p.i. (p, . ); the lowest value appeared on day p.i. (p, . ). furthermore, differential blood counts revealed that the number of lymphocytes sharply decreased in infected mice. the lowest number of lymphocytes observed occurred on day p.i. (figure b ), which dropped to , % of the control group number (p, . ). to determine the cytokine responses that occur after sd/ virus infection, we measured the levels of five cytokines and chemokines in lungs of infected mice on days , , , and p.i. as shown in figure , all five were significantly different between virus-infected and control mice. interleukin (il)- and il- in the virus-infected mice reached peak levels as early as day p.i. and were significantly higher than those of the control group (p, . ). interferon (ifn)-c, monocyte chemotactic protein (mcp)- , and tumor necrosis factor (tnf) dramatically increased in mouse lungs on days - p.i. (p, . ), consistent with the appearance of pulmonary lesions. these results showed that infection with sd/ viruses resulted in elevated amounts of proinflammatory chemokines and cytokines in the lungs of mice. in the spring of , a novel influenza a(h n ) virus rapidly spread worldwide, resulting in the first influenza pandemic of the st century [ ] . critically ill cases caused by h n virus retrospectively showed that most had progressed or died due to ards [ , ] . however, the pathogenesis and therapeutic intervention of ards caused by h n infection have still not been elucidated. animal models of disease are important for characterizing pathogenesis and developing the preclinical evidence for revised approaches to ventilating patients with ards [ ] . here, we present a mouse model for the study of ards induced by sd/ virus, a virulent h n variant. previous studies have indicated that typical h n viruses such as ca/ bind only to a- , -linked sialic acid (sa) receptor [ ] , but only the a- , -linked sa receptor is found in the mouse respiratory tract [ ] . therefore, such a typical h n virus may not be able to induce ards in mice. in fact, we used ca/ virus to induce ards in mice; however, animals inoculated with a high dose of ca/ virus ( . pfu) only showed moderate respiratory symptoms, and no lethality was observed (unpublished data). it has been shown that h n virus possessing a d g mutation in hemagglutinin (ha) could increase the pathogenicity in mice [ , ] and binding to the a- , sa receptor [ ] . moreover, clinical data indicate that such variants are only associated with severe h n human infection [ ] . therefore, we suggest that the variant possessing the d g mutation in ha can induce ards in a mouse model. the virus used in the present study was isolated from swine in , and sequence analysis revealed that all the eight genes of the isolate had a close relationship with the h n influenza virus circulating in humans. notably, the swine isolate, sd/ , had a d g mutation in ha. compared with ca/ virus (ld . pfu), sd/ showed significantly increased virulence in mice, with an ld of . pfu, which was nearly identical to that of the mouse-adapted strain a/hong kong/ md/ (ld = . pfu) [ , ] . mice infected i.n. with . pfu sd/ virus showed obvious respiratory symptoms, including visually prominent signs of respiratory distress and abdominal respiration, with approximately % mortality between days and p.i. the lungs of virus-infected mice were highly edematous, which was also demonstrated by dramatically increased lung wet:dry weight ratio. pathological changes presented a progressive pattern, typically diffuse alveolar damage, interstitial and alveolar edema, neutrophil and macrophage-dominant inflammatory cellular infiltration, and areas of hemorrhage and necrotizing bronchiolitis. arterial blood gas saturation is a key parameter of ards in humans [ ] . in the present mouse model, pao and sao of infected mice were significantly lower than in the control group from day p.i., especially on day p.i., where these parameters sharply decreased, and most virus-infected mice began to die. these changes in arterial blood gas demonstrated that most infected mice developed severe hypoxemia consistent with of the appearance of clinical signs and lung lesions of ards. previous studies showed that mice infected with typical h n virus only exhibited mild interstitial inflammatory infiltration and limited alveolitis [ , ] , whereas severe lung damage was found in the sd/ -infected mice, including severe edema around the blood vessels and bronchiolitis, and extensive inflammatory accumulation from to days p.i. at days p.i., the surviving mice developed an irreversible fibrosis involving collagen deposition in alveolar walls and spaces, which was similar to that observed in human ards patients with h n infection [ ] . our histopathological results were consistent with ards induced by other influenza viruses. mice infected with mouse-adapted virus of the a/puerto rico/ / (h n ), or high pathogenic h n virus also showed a progressive series of pathological changes from interstitial pneumonia to diffuse alveolar damage [ , ] . however, in contrast to highly pathogenic h n virus, mice infected with sd/ virus did not show viral spread to extrapulmonary organs. immunohistochemical examination revealed the presence of viral antigens in the bronchioles, terminal bronchiolar epithelium, and alveolar epithelial cells. perhaps sd/ virus infection of the alveoli, particularly type ii pneumocytes, rather than bronchioles, is a key to the development of ards. type ii pneumocytes are responsible for the production and secretion of surfactant to lower the surface tension of water and allow membrane separation, and insufficient pulmonary surfactant in the alveoli may result in alveolar collapse [ , ] . the pandemic h n and high pathogenic h n viruses preferentially infect type ii pneumocytes and alveolar macrophage in mice [ , ] . alveolar macrophages may play a critical role in disease pathogenesis, not through production of infectious virus but rather through the upregulation of proinflammatory cytokines that may further damage alveolar pneumocytes [ ] . these phenomena suggest that viral cell tropism may determine the processes of ards. pulmonary aberrant immune response is considered a significant feature of ards induced by h n virus [ , ] . in the present mouse model, the number of leukocytes observed in the balf of virus-infected mice significantly increased compared with the control mice on day p.i. different counts in balf showed that the proportion of neutrophils dramatically increased. these innate immune cells were capable of reducing the virus load in the lung [ ] ; however, they could cause lung injury through direct or indirect mechanisms. neutrophil oxidants and proteases can cause direct injury of cells in the alveolar-capillary membrane [ ] . neutrophils and macrophages can secrete copious amounts of chemokines and cytokines that can recruit more immune cells into lung tissues, and produce a ''cytokine storm'', one of the most important factors in the production of ards [ ] . a retrospective cohort study of h n patients found that higher levels of proinflammatory cytokines and chemokines in plasma were observed in the ards-death group compared with the survived-without-ards or the mild-disease groups [ ] . another study in critically ill patients with ards caused by h n virus infection has shown that the hallmarks of disease severity were elevated levels of il- , il- , il- and tnf-a [ ] . we examined the levels of five cytokines and chemokines in infected mouse lungs and found significant differences between the virus-infected and mock groups. it has proved that high levels of il- were able to mediate acute lung injury [ ] , and had a negative correlation with the pa o :fi o ratio in severely affected patients with h n virus infection [ ] . our data showed sd/ viral infection induced high levels of il- in mouse lung, which may also play an important role in the course of ards. hagau etc. found the levels of tnf-a increased significantly in the h n -related ards patients [ ] . in present study, tnf levels also dramatically increased in the lungs of virus-infected mice, and were consistent with the clinical symptoms and reached peak levels when mice began to die. in addition, high levels of il- , ifn-c and mcp- were also present in the virus-infected mouse lungs, similar to observations found in severely affected humans with h n infection [ ] . in summary, we successfully established an ards mouse model induced by a virulent h n variant, which demonstrated key human ards clinical and pathological features, such as respiratory distress, low pa o , exudative, proliferative and fibrotic lung, and high levels of inflammatory cells and cytokines. the mouse model may contribute to the study of the pathogenesis and therapy of ards induced by h n virus. to determine ld of sd/ virus, eight -week-old female balb/c mice per group were inoculated i.n. with - pfu ( ml) viruses and monitored for days. the value of mld was calculated using the spearman-karber method and expressed by pfu per mld [ ] . we evaluated the pathogenicity of the virus in mice and found that it could efficiently replicate in the lungs of mice with high lethality ( . pfu per mld ). to determine the optimal dose of inoculation, mice in each group were infected i.n. with . , . or . pfu viruses, and the signs, body weight, and mortality were monitored daily for each group for days. pilot experiments indicated that a dose of . pfu was optimal, because the course of the disease was prolonged and the mice presented with obvious signs of respiratory illness. balb/c mice were lightly anesthetized and inoculated i.n. with ml . pfu sd/ virus in pbs. mock-infected animals were inoculated i.n. with ml pbs. at the indicated time, infected mice were sacrificed, and the parameters that present the course of the disease were determined. twenty mice ( infected with sd/ virus and inoculated with pbs) were used to investigate clinical signs and mortality for days. three mice were euthanized on days , , , , and p.i. and their organs were collected. the collected tissues were weighed, and % homogenates were prepared in cold pbs. the homogenates were centrifuged at rpm for min to remove cell debris, and then the supernatants were -fold serially diluted for viral titer determination by plaque assay in mdck cells. virus titers were expressed as mean log pfu/g standard deviation (sd). three mice were euthanized on days , , , , and p.i., and the lungs were removed and weighed and then desiccated in an oven at uc for h. the lung wet weight:body weight ratio and lung wet:dry weight ratio were calculated and used as an indicator of lung edema, as previously described [ ] . three mice were euthanized on days , , and p.i. the lungs were fixed in % buffered formalin, embedded in paraffin, sectioned, and stained with hematoxylin and eosin. lungs on day p.i. were also stained with masson's trichrome. lung tissue sections taken on day p.i. were stained for influenza a virus antigens. an anti-influenza nucleoprotein monoclonal antibody (aa h; abcam, hong kong) was used to identify influenza a virus nucleoprotein in sections. secondary antibody (millipore, billerica, ma, usa) against the primary antibody was labeled with horseradish peroxidase, and the color reaction was developed with a horseradish peroxidase reaction kit (diaminobenzidine-tetrahydrochloride; sigma, st. louis, mo, usa). blood gas analysis was performed as previously described [ , ] . three mice were anesthetized with zoletil (tiletamine-zolazepam; virbac; mg/g) on days , , , and p.i. arterial blood samples were withdrawn into a heparinized syringe by percutaneous left ventricular sampling of lightly anesthetized mice that were spontaneously breathing room air. blood gas analysis was immediately performed using a vetstat electrolyte and blood gas analyzer (idexx laboratories, westbrook, ma, usa). leukocyte counts in balf were performed as previously described [ , ] . briefly, three mice were euthanized on days , , and p.i., and the lungs were lavaged twice in situ with the chest cavity opened by midline incision with a total volume of . ml saline ( uc) inserted through an endotracheal tube. the rate of recovery of balf was not less than % for all animals tested. after the amount of fluid recovered was recorded, an aliquot of balf was diluted : with . % crystal violet and . % acetic acid for leukocyte staining and erythrocyte hemolysis. the number of leukocytes in the balf was counted with a hemacytometer under a microscope. for differential counts, the balf samples from each mouse were stained with wright stain, and the numbers of monocytes, neutrophil and lymphocytes were determined, on the basis of morphologic criteria, under a light microscope, with evaluation of at least cells per slide. all slides were counted twice by different observers blinded to the status of the animal. heparinized blood samples were collected on days , , and p.i. the total numbers of leukocytes and differential blood counts for three individual mice were analyzed using an automated hematology analyzer. il- , il- , tnf, ifn-c and mcp- levels were determined in lung homogenates using a cytometric bead array technique (bd cytometric bead array mouse inflammation kit; bd bioscience, san diego, ca, usa) according to the manufacturer's instructions. briefly, ml mouse inflammation capture bead suspension and ml pe detection reagent were added to an equal amount of sample standard dilution and incubated for h at room temperature in the dark. subsequently, samples were washed by adding ml wash buffer and centrifugation at g at room temperature for min. supernatants were discarded and ml wash buffer was added. samples were analyzed on a bd facsarray bioanalyzer (bd bioscience) according to the manufacturer's instructions. standard curves were prepared similar to the method above. data were analyzed using bd cba software (bd bioscience). finally, the chemokine or cytokine levels were recorded as pg/ml homogenate. data were analyzed by two-way analysis of variance using graphpad prism version . (graphpad software, san diego, ca, usa). when a significant effect was observed, pairwise comparisons were performed using the bonferroni post-hoc test. all data are reported as mean sd. influenza ( ) clinical aspects of pandemic influenza a (h n ) virus infection world now at the start of influenza pandemic world health organization. h n now in the post-pandemic period pandemic influenza a (h n ) in argentina: a study of patients on mechanical ventilation delayed clearance of viral load and marked cytokine activation in severe cases of pandemic h n influenza virus infection critical care services and h n influenza in australia and new zealand critically ill patients with influenza a (h n ) infection in canada extracorporeal membrane oxygenation for severe influenza a (h n ) acute respiratory distress syndrome: a prospective observational comparative study update: swine influenza a (h n ) infections-california and texas acute respiratory distress syndrome clinical issues and research 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proinflammatory cytokines in human macrophages by influenza a (h n ) viruses: a mechanism for the unusual severity of human disease? lung pathology in fatal novel human influenza a (h n ) infection pathogenicity of influenza viruses with genes from the pandemic virus: functional roles of alveolar macrophages and neutrophils in limiting virus replication and mortality in mice pathogenesis of the adult respiratory distress syndrome. evidence of oxidant activity in bronchoalveolar lavage fluid preparing for the next pandemic clinical aspects and cytokine response in severe h n influenza a virus infection identification of oxidative stress and toll-like receptor signaling as a key pathway of acute lung injury th and th hypercytokinemia as early host response signature in severe pandemic influenza trimmed spearman-karber method for estimating median lethal concentrations in toxicity bioassays hypercapnia via reduced rate and tidal volume contributes to lipopolysaccharideinduced lung injury the pulmonary circulation of homozygous or heterozygous enos-null mice is hyperresponsive to mild hypoxia respiratory reovirus /l induction of intraluminal fibrosis, a model of bronchiolitis obliterans organizing pneumonia, is dependent on t lymphocytes role of p mitogen-activated protein kinase in a murine model of pulmonary inflammation the authors thank dr. yanxin hu and dr. deping han for technical assistance in histopathologic observation. key: cord- -jd cyg authors: dos santos, gimena; rogel, micah r.; baker, margaret a.; troken, james r.; urich, daniela; morales-nebreda, luisa; sennello, joseph a.; kutuzov, mikhail a.; sitikov, albert; davis, jennifer m.; lam, anna p.; cheresh, paul; kamp, david; shumaker, dale k.; budinger, g. r. scott; ridge, karen m. title: vimentin regulates activation of the nlrp inflammasome date: - - journal: nat commun doi: . /ncomms sha: doc_id: cord_uid: jd cyg activation of the nlrp inflammasome and subsequent maturation of il- β have been implicated in acute lung injury (ali), resulting in inflammation and fibrosis. we investigated the role of vimentin, a type iii intermediate filament, in this process using three well-characterized murine models of ali known to require nlrp inflammasome activation. we demonstrate that central pathophysiologic events in ali (inflammation, il- β levels, endothelial and alveolar epithelial barrier permeability, remodelling and fibrosis) are attenuated in the lungs of vim(−/−) mice challenged with lps, bleomycin and asbestos. bone marrow chimeric mice lacking vimentin have reduced il- β levels and attenuated lung injury and fibrosis following bleomycin exposure. furthermore, decreased active caspase- and il- β levels are observed in vitro in vim(−/−) and vimentin-knockdown macrophages. importantly, we show direct protein–protein interaction between nlrp and vimentin. this study provides insights into lung inflammation and fibrosis and suggests that vimentin may be a key regulator of the nlrp inflammasome. supplementary information: the online version of this article (doi: . /ncomms ) contains supplementary material, which is available to authorized users. t he cytoskeleton comprises microfilaments, microtubules and intermediate filaments (ifs) . vimentin is the most abundant if protein and has a critical role in stabilizing intracellular architecture . until recently, the importance of vimentin remained elusive because vimentin knockout (vim À / À ) mice displayed a relatively normal phenotype . however, a thorough characterization of vim À / À mice under stress conditions revealed prominent abnormalities [ ] [ ] [ ] , complementing the metabolic, signalling and regulatory abnormalities displayed by patients with if-related diseases and mice expressing functional mutations in ifs , [ ] [ ] [ ] [ ] . recently, evidence to support a role for ifs as scaffolds for macromolecular complexes involved in critical cell signalling functions was reported , . in this study, we demonstrate that vimentin is required for the activation of the nlrp (nacht, lrr and pyd domains-containing protein ) inflammasome, a macromolecular complex that orchestrates early inflammatory responses of the innate immune system. the nlrp inflammasome is activated in response to a broad spectrum of infectious agents known to cause acute lung injury (ali), including the bacterial pathogens staphylococcus aureus, pseudomonas aeruginosa and mycobacterim tuberculosis [ ] [ ] [ ] and viral pathogens such as influenza a virus . the wide range of pathogens known to activate the nlrp inflammasome suggests that nlrp indirectly senses microbes by probing for hostderived danger-associated molecular patterns that are produced or released after cellular or tissue injury , . for example, uric acid released from cells exposed to bleomycin triggers the nlrp inflammasome, leading to maturation of interleukin b (il- b) and inflammation . in both human patients and animals treated with bleomycin, il- b released from injured cells results in production of the pro-fibrotic cytokine transforming growth factor b (tgf-b), which contributes to the development of pulmonary fibrosis . in addition, exposure to crystalline particles such as asbestos and silica also cause pulmonary fibrosis that is regulated by the nlrp inflammasome , . the nlrp inflammasome must be tightly regulated to avoid deleterious effects from the wide array of pathogens, pathogenassociated molecular patterns, danger-associated molecular patterns and environmental irritants, which are known to trigger its activation. unlike other inflammasome-associated nod-like receptor (nlr) proteins, nlrp is expressed at very low levels in naive macrophages. activation of the nlrp inflammasome requires two distinct pro-inflammatory stimuli. in the first step, toll-like receptor (tlr) signalling activates nf-kb and upregulates nlrp and pro-il- b . the second step involves the assembly of the multiprotein complex, which induces selfcleavage of caspase- , which in turn mediates the cleavage of pro-il- b into its biologically active form . the mechanism by which the inflammasome is ultimately activated is still a subject of intensive research. we postulate that vimentin is required for nlrp inflammasome assembly and activation. the experiments described below use three well-established rodent models of nlrp inflammasome activation and result in increased levels of biologically active il- b that contribute to lung injury. our data suggest that the if protein vimentin may act as an additional checkpoint to control the nlrp inflammasome. vimentin deficiency suppresses inflammation and injury. lipopolysaccharide (lps) is a potent inducer of inflammation and a known nlrp inflammasome activator [ ] [ ] [ ] . to determine whether vimentin is important in the inflammatory response, wild-type (wt) and vimentin knockout (vim À / À ) mice were subjected to a lethal dose of lps, which induces both proinflammatory cytokine expression and a systemic inflammatory response that is associated with significant mortality. wild-type mice displayed about a threefold increase in mortality compared with vim À / À mice. vim À / À mice had a median survival of h, whereas wt animals had a median survival of b h (fig. a) . surviving vim À / À mice exhibited mild lethargy, coat ruffling, febrile shaking and eye watering but recovered by day . to study whether vimentin affects lps-induced inflammation and ali, we used a sublethal dose of lps, as previously described , . histopathological examination showed that lungs of lps-treated wt mice had more severe alveolar damage characterized by interstitial oedema and more fluid and debris in the airspace than in lps-treated vim À / À mice (fig. b) . wild-type mice exposed to lps exhibited an increase in wet-todry lung weight ratio and total protein concentration in the bronchoalveolar lavage fluid (balf), whereas vim À / À mice failed to exhibit such an increase (fig. c,d) . exposure to lps is followed by large increases in immune cells in the airspace , . therefore, to further characterize the nature of immune cell recruitment into the lungs, we performed a systematic flow cytometric analysis of whole-lung lysates . no differences were observed in the myeloid cell population between wt and vim À / À mice treated with saline ( supplementary fig. a ). as expected, both wt and vim À / À mice challenged with lps had significant increases in neutrophils and moderate increases in macrophages compared with saline-treated animals ( supplementary fig. a ); no differences were observed between wt and vim À / À mice challenged with lps ( supplementary fig. a) . these data suggest that the protection from the lpsinduced increase in alveolar capillary barrier permeability observed in vim À / À mice was not associated with impaired recruitment of inflammatory cells to the lung. lps induces rapid production and release of pro-inflammatory cytokines and chemokines, which are sufficient to induce lung inflammation and ali in mice and humans . when we exposed wt and vim À / À mice to lps for h, significantly more caspase- and mature il- b were found in balf from wt mice than in vim À / À mice (fig. e,f) . furthermore, whole-lung homogenates prepared from wt and vim À / À mice exposed to lps had increased levels of il- b messenger rna (mrna, supplementary fig. b) . these data suggest that vimentin is not involved in the tlr-mediated nf-kb activation and upregulation of pro-il- b and nlrp (refs - ) . rather, vimentin must be required for the second step in lps-induced caspase- activation and il- b maturation via the nlrp inflammasome. vimentin required for asbestos-induced injury and fibrosis. the nlrp inflammasome has been implicated in the pathological increase of il- b production in a variety of pulmonary inflammatory diseases that lead to fibrosis, including asbestosis [ ] [ ] [ ] . in a model of asbestosis, we sought to determine whether vim À / À mice showed diminished cytokine production and whether these animals were protected from lung injury and pulmonary fibrosis. wild-type and vim À / À mice were exposed to crocidolite asbestos or an inert particle, titanium dioxide (tio ); markers of injury, inflammation, cytokine production and fibrosis were assessed. confirming previous reports , , asbestosexposed mice had increased total cell numbers in balf compared with tio -exposed animals. however, significantly fewer cells were recruited to the lungs of vim À / À mice after asbestos exposure (fig. a) . additional analysis of immune cell recruitment into the lungs of wt and vim À / À mice was performed by fluorescence-activated cell sorting analysis of whole-lung lysates ( supplementary fig. a) . wild-type mice had profound inflammatory cell infiltrates following exposure to asbestos as observed by haematoxylin and eosin (h&e) staining; in contrast vim À / À mice showed reduced inflammation ( supplementary fig. b ). wild-type mice exhibited an increase in total protein concentration in balf, whereas vim À / À mice failed to exhibit such an increase (fig. b) . the reduction in inflammation in vim À / À mice exposed to asbestos was associated with reduced levels of caspase- and il- b in balf compared with wt mice (fig. c,d) . these data suggest that vimentin is required for asbestos-mediated activation of the nlrp inflammasome (step ), but not for nf-kb activation and upregulation of pro-il- b and nlrp (step ). furthermore, we observed that wt mice exposed to asbestos develop pulmonary fibrosis, as assessed by masson trichrome and picrosirius red stain (a dye that binds specifically to collagen fibrils, fig. e ) and sircol assay (fig. f) . vimentin deficiency prevented pulmonary fibrosis, as no significant increase in collagen deposition was observed in vim À / À mice (fig. e,f) . collectively, these results demonstrate that loss of vimentin prevents asbestos-induced collagen deposition and fibrosis. vimentin required for bleomycin-induced injury and fibrosis. bleomycin is one of the best characterized rodent models of pulmonary fibrosis ; intratracheal delivery of the drug causes severe ali, which is followed by clearance of alveolar inflammatory cells, fibroblast proliferation and increased collagen deposition . moreover, bleomycin-induced fibrosis has been shown to be dependent on the nlrp inflammasome . wt and vim À / À mice were exposed to bleomycin for days. wt mice displayed intense lung inflammation as assessed by h&e staining (fig. a) , increased wet-to-dry lung weight ratio (fig. b) , and increased protein concentration in balf (fig. c) . all of these end points were significantly attenuated in vim À / À mice (fig. a-c) . exposure to bleomycin resulted in a large increase in immune cells in the airspace of both wt and vim À / À mice as assessed by flow cytometric analysis of whole-lung lysates ( supplementary fig. a ). vim À / À mice failed to exhibit an increase in caspase- (fig. d ) and il- b (fig. e) in balf following the exposure to bleomycin; in contrast, wt mice showed a robust activation of caspase- and production of mature il- b (fig. d,e) . as a proinflammatory cytokine, macrophage-produced il- b is known to induce production of interleukin (il- ). we observed that wt mice, but not vim À / À mice, had increased levels of il- following the exposure to bleomycin (fig. f ). tgf-b is a critical mediator of remodelling and fibrotic responses in the lung. total tgf-b was detected after activation in balf from wt mice days following the exposure to bleomycin, but remained at the baseline level in balf from vim À / À mice (fig. g ). no significant difference was observed between wt and vim À / À mice in nlrp inflammasome-independent cytokines tnf-a and mcp- (fig. h,i) . interestingly, il- b mrna levels were increased in the lungs of both wt and vim À / À mice following the exposure to bleomycin ( supplementary fig. b ). bleomycin exposure results in chronic inflammation and progressive pulmonary fibrosis , . the role of vimentin in pulmonary fibrosis was examined days following the administration of bleomycin. the lung architecture was similar for saline-treated wt and vim À / À mice, but in wt mice bleomycin induced extensive fibrotic areas with abundant collagen production, as assessed by masson trichrome stain ( fig. a and supplementary fig. a ). cellular infiltrates, alveolar wall destruction and collagen deposition were significantly reduced in vim À / À mice. similarly, we observed increases in collagen deposition in bleomycin-treated wt mice by staining with picrosirius red (fig. b) . in contrast, there was virtually no collagen deposition in the lungs of vim À / À mice (fig. b) . lung collagen concentrations, as assessed by sircol assay, were (a) survival of wt and vim À / À mice subjected to a lethal dose of lps ( mg kg À , intraperitoneally) was measured and compared. the survival curves were analysed using the log rank test, which calculates the chi-square (w ) for each event time for each group and sums the results. the summed results for each group were added to derive the ultimate chi-square to compare the full curves of each group. the log rank test for the entire data set was p ¼ . . (b-f) wt and vim À / À mice were challenged with a sublethal dose of lps and markers of ali were measured after h, as assessed by h&e staining (scale bar, mm) (b); by wet-to-dry lung weight ratio (c); and by protein content in the balf (d). inflammasome activation was measured by elisa for caspase- (e) or il- b (f) in balf from vim À / À and wt mice. data in b-e are from three independent experiments of n ¼ - animals per group and presented as mean±s.d. **po . , ***po . relative to wt versus vim À / À , by one-way analysis of variance with a correction provided by the bonferroni multiple comparisons test. nature communications | doi: . /ncomms article . ± . and . ± . mg per lung in bleomycin-treated wt and vim À / À mice, respectively (fig. d ). in patients with pulmonary fibrosis, pulmonary function tests typically reveal a parenchymal-restrictive ventilatory defect due to decreased lung compliance . lung compliance is influenced by the underlying connective tissue, which is rich in extracellular matrix components such as collagen . because vim À / À mice exhibited less collagen deposition following treatment with either bleomycin or asbestos, we reasoned that lungs of these mice would maintain normal compliance. to test this hypothesis, we measured the lung mechanics of wt and vim À / À mice using a scireq ventilator days following the bleomycin administration. in comparison with saline treatments, lungs of wt mice exhibited a . -fold decrease in quasi-static compliance following the bleomycin administration, whereas the compliance of lungs from vim À / À mice decreased only . -fold (fig. e) . bleomycin administration creates heterogeneous regions of lung fibrosis in mice (fig. a) , which is a pathologic feature of the human disease as well . to assess focal changes in lung tissue stiffness, we performed regional nano-indentations on lung sections ( - mm thick) using atomic force microscopy (afm). the micro-indentations provide a measure of the stiffness or elastic modulus (e) of lung tissue, which is inversely related to lung compliance. elasticity maps from afm micro-indentation from bleomycin-treated wt lungs clearly displayed the wide ranges of tissue stiffness (fig. c) , which corresponded to the heterogeneity of collagen deposition (fig. a) . the median elastic modulus of lung parenchymal tissue from wt mice increased . -fold in response to bleomycin compared with control lung tissue ( to . kpa, respectively), whereas the elastic modulus of lung tissue from bleomycin-treated vim À / À mice was significantly decreased (po . ) compared with wt bleomycin-treated lung tissue (fig. f) . the wide range of e-values is reflected in the frequency of occurrence and in the median and interquartile ranges for each condition ( supplementary fig. b ). in addition, there was a strong correlation (pearson r ¼ À . ) between the mean compliance values for each condition and the mean e-values for each condition (for example, wt-bleomycin-afm versus wtbleomycin-scireq). thus, the mechanical properties of the lung were preserved in vim À / À mice following the bleomycin treatment, which is evident at both the global tissue scale and in focal regions of lung. injury and fibrosis reduced in vim À / À bone marrow chimeras. because multiple cell types contribute to the inflammatory and fibrotic responses, we next addressed the respective roles of bone marrow-derived cells in bleomycin-induced lung injury and fibrosis by generating bone marrow chimeras (fig. a) . reconstitution of bone marrow from wt donor mice into irradiated recipient mice (wt) resulted in protein accumulation in balf in response to bleomycin, whereas in recipient mice reconstituted with bone marrow from vim À / À donor mice (vim À / À ), the balf protein was unchanged from saline controls (fig. b) . secretion of il- b (fig. c ), il- ( fig. d ) and tgf-b (fig. e ) in the balf of wt mice significantly increased in response to bleomycin; the response in vim À / À mice was significantly attenuated. finally, wt mice displayed a significant degree of collagen deposition and fibrosis, as shown by masson trichrome wt and vim À / À mice were treated with pbs containing either mg of asbestos crocidolite or the control particle titanium dioxide (tio ), intratracheally. markers of inflammation and fibrosis were assessed and weeks after instillation, respectively. (a) total cell count (macrophages, neutrophils, eosinophils, erythrocytes and lymphocytes ) and (b) protein levels were assessed in balf collected from vim À / À mice weeks after asbestos administration. inflammasome activation in wt and vim À / À mice was measured by elisa for caspase- (c) and il- b (d) levels in balf at the same time point. collagen deposition was evaluated in asbestos-treated vim À / À and wt mice by masson's trichrome and picrosirius red staining of lung slices (e; scale bar, mm) and by measuring total collagen content by sircol assay (f). data are from two independent experiments n ¼ - animals per group, and presented as mean ± s.d. *po . , **po . , relative to wt versus vim À / À , by one-way analysis of variance with a correction provided by the bonferroni multiple comparisons test. sircol assay ( fig. f ), whereas this response was severely attenuated in vim À / À mice ( fig. f ,g and supplementary fig. c ). all together, these results suggest that vimentin-expressing bone marrow-derived cells are important for bleomycin-induced activation of the nlrp inflammasome and pulmonary fibrosis. loss of vimentin prevents nlrp activation. as stated above, nlrp inflammasome activation requires two distinct stimuli. an inflammatory stimulus, such as lps, primes cells to transcribe and synthesize pro-il- b (signal ) and then another stimulus such as extracellular adenosine triphosphate (atp), monosodium urate (msu) or asbestos (signal ) is necessary for inflammasome complex formation, caspase- activation and il- b maturation , , . to further investigate the possibility that nlrp inflammasome activation requires vimentin, we isolated primary alveolar macrophages from wt and vim À / À mice. macrophages were primed with lps and stimulated with atp as previously described . levels of mature caspase- and il- b were significantly increased in the supernatants collected from wt macrophages following lsp and atp treatment compared with saline treatment, but in the supernatant collected from vim À / À macrophages there was only a slight increase (fig. a,b) . there was no difference in pro-il- b levels in total cell lysates between activated wt and vim À / À alveolar macrophages ( fig. c ; full blots are presented in supplementary fig. ) . as an independent approach, we expressed a small hairpin rna (shrna) targeted to vimentin (vim kd ) or a scrambled shrna (ctrl) in j a. macrophages and treated the cells with atp. caspase- is required to cleave pro-il- b into its biologically active form and like other caspases is proteolytically activated from a pro-enzyme to produce a tetramer of its two active subunits, p and p (ref. ). the levels of mature caspase- p , but not pro-caspase- , were considerably reduced in vim kd cells (fig. d ,e; full blots are presented in supplementary fig. ) compared with ctrl cells treated with atp, further supporting the hypothesis that vimentin deficiency prevents nlrp inflammasome activation. uric acid released from cells exposed to bleomycin triggers nlrp inflammasome assembly leading to il- b maturation and inflammation in the lungs , . in an in vitro model, we examined whether silencing vimentin would impair nlrp inflammasome activation in response to msu. a human macrophage-like cell line was treated with silencing rna (sirna) targeted to vimentin (vim kd ) or a scrambled sirna (ct; fig. a ; full blots are presented in supplementary fig. ) and subsequently activated with msu. no differences were observed in the levels of pro-il- b between ct and vim kd cells (fig. a) , suggesting that vimentin deficiency does not impair signal . nlrp inflammasome activation was repressed in vim kd cells as assessed by il- b and caspase- levels in cell supernatants (fig. b,c) . similar results were obtained when ct and vim kd cells were activated with asbestos (fig. b,c) . in addition, bone marrow-derived macrophages (bmdms) were isolated from wt and vim À / À mice, primed with lps and activated with msu. caspase- activation was assessed using a specific fluorescent probe, fam-yvad-fmk . wt bmdms showed robust caspase- activation following treatment with msu, with caspase- forming aggregates throughout the cytoplasm. however, caspase- activation was severely reduced in bmdms isolated from vim À / À mice (fig. d) . no caspase- activation was observed in untreated bmdms isolated from either wt or vim À / À mice. vimentin interacts with inflammasome components. inflammasome activation involves the physical interaction of nlrp , asc (apoptosis-associated speck-like protein containing a card) and caspase- (ref. ), but the mechanism by which the inflammasome assembles is not clear. if the vimentin network serves as a protein scaffold upon which the nlrp inflammasome components are assembled, then vimentin should interact with inflammasome proteins. immunoprecipitation of caspase- and nlrp from human macrophage lysates resulted in a robust co-precipitation of vimentin, which was enhanced following activation of cells with atp ( fig. a ; full blots are presented in supplementary fig. ). these interactions were specific for vimentin, as no actin was detectable in immunoprecipitates. we also used solution-binding assays to demonstrate a direct protein-protein interaction between vimentin and nlrp . bacterially expressed and purified s-tag his-vimentin was incubated with extracts prepared from either control or msutreated human macrophage cells. the s-tag vimentin was precipitated using s-protein agarose. the precipitated proteins (c) representative elastographs from afm micro-indentation of lung tissue from wt and vim À / À animals. the colour bar indicates elastic modulus, e. the darkest red corresponds to elastic modulus values of kpa and above. the data represent indentations per region, with at least two regions per tissue section from at least three mice per group. (d) collagen content in lungs from wt and vim À / À mice assessed by sircol assay. (e) mice were ventilated days after intratracheal instillation of bleomycin or pbs. shown are quasistatic compliance measurements of wt and vim À / À lungs. (f) elastic modulus frequency plot obtained from live, unfixed lung tissue of saline and bleomycin-treated wt and vim À / À animals. microindentation data were fit using the hertz model to acquire the elastic modulus of regions of lung tissue. images in a-b represent data obtained from at least three animals per group; data shown in d-e are mean ± s.d. of at least five animals. **po . , ***po . relative to wt versus vim À / À , by one-way analysis of variance with a correction provided by the bonferroni multiple comparisons test. were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (sds-page), transferred to nitrocellulose and then immunoprobed with antibodies directed against nlrp . we observed a . ± . -fold increase in binding between vimentin and nlrp in extracts prepared from msu-treated cells, as compared with untreated control cells (supplementary fig. ). article a complementary method, bio-layer interferometry (bli), was also used to investigate the interaction between nlrp and vimentin. bli is an optical technique that analyses the interference pattern of white light reflected from two surfaces: a layer of immobilized protein on the biosensor tip and an internal reference layer . any change in the number of molecules bound to the biosensor tip causes a shift in the interference pattern that can be measured in real time, providing detailed information on the kinetics of association and dissociation between the two molecules (k a , k d and k d ). commercially available nlrp was bound to the biosensor tip, then various concentrations ( mm, mm, mm, . mm, nm, nm and . nm) of full-length vimentin were added to determine the association kinetics with nlrp . in agreement with other methods (fig. a ,b,d and supplementary fig. ), the assay demonstrated that nlrp binds to vimentin with a measureable affinity; a global dissociation constant (k d ) of nm was determined using blitz pro. consistent with the co-immunoprecipitation and solutionbinding results, we observed co-localization of nlrp and vimentin in stimulated alveolar macrophages by confocal immunofluorescence microscopy (fig. d) . following activation, the wt cells, but not the vim kd cells, were spread and displayed lamellipodia. furthermore, the vimentin network spanned the cytoplasm in the wt activated cells, whereas in unstimulated cells, the network appeared to be collapsed around the nucleus and lamellipodia were not observed (fig. d) . vimentin filaments (red) strongly co-localized with nlrp (green) in both perinuclear and distal regions of the cells. co-localization studies were performed using fiji . r ( -bit, win) and the coloc test . co-localization analyses were calculated on rois drawn around the lamellipodia, determined by the vimentin image. the thresholded manders co-localization scores were . ± . for vimentin and . ± . for nlrp . nlrp and asc also colocalized in stimulated macrophages ( supplementary fig. ); the score for nlrp co-localization with asc in untreated cells was . ± . , indicating weak co-localization. in contrast, the score for nlrp co-localization with asc in cells treated with atp was . ± . , indicating strong co-localization. however, knockdown of vimentin resulted in a lack of co-localization between nlrp and asc, even in activated macrophages ( supplementary fig. ). taken together, these results demonstrate that vimentin associates with components of the inflammasome and is required for inflammasome activation. inflammation, the process aimed at restoring homeostasis after an insult, can be more damaging than the insult itself if uncontrolled, excessive or prolonged. growing evidence indicates that il- b is a critical mediator of acute inflammation, remodelling and fibrosis in the lung. using three well-characterized murine models of ali and pulmonary fibrosis, which were previously shown to be dependent on the nlrp inflammasome , , , , we show that nlrp inflammasome activation, which leads to il- b maturation, is dependent on the type iii if protein vimentin. our data obtained in vimentin knockout mice and vimentin-null cells suggest that vimentin is required for nlrp inflammasome activation. dysregulated inflammation, excessive leukocyte accumulation and increased permeability of endothelial and alveolar epithelial barriers are the central pathophysiologic events in ali and its most severe form, the acute respiratory distress syndrome (ards) . all these end points were observed in wt mice challenged with lps, bleomycin and asbestos. in contrast, vim À / À mice exposed to the same treatments experienced mild increases in protein levels in balf and limited alterations in lung histopathology, suggesting that they were protected from lps-, bleomycin-and asbestos-induced ali. inflammasome-regulated cytokines have a key role in the initiation and propagation of the aforementioned features of ali . in fact, alveolar macrophages from patients with ards produce excessive amounts of il- b , and il- was elevated in the plasma of patients with ards, which correlated with increased morbidity and mortality . since vimentin-deficient mice were protected from ali, we speculated that failure to produce inflammasome-mediated cytokines (for example, il- b) caused this protection. in fact, vimentin-deficient mice failed to increase mature il- b levels following exposure to lps, asbestos or bleomycin. moreover, we demonstrated that caspase- activation and mature il- b production in vitro requires vimentin, as no increase was observed in activated macrophages either isolated from vim À / À mice or in which vimentin was silenced using rna interference. resolution of ali/ards depends on a precise balance of inflammatory and molecular signalling ; an imbalance in that process caused by il- b overproduction might prevent cellular restoration and lead to pulmonary fibrosis. in fact, il- b produced by the inflammasome has been recently identified as an initiator of fibrosis in response to bleomycin , and administration of il- b alone recapitulates much of the lung pathology caused by bleomycin . because vimentin-deficient mice did not produce the same amount of il- b as wt mice, we reasoned that vim À / À mice would be protected from bleomycin-and asbestos-induced pulmonary fibrosis. indeed, lung pathology was significantly reduced in vimentin-deficient mice, pointing to the essential role of vimentin in pulmonary fibrosis. we found substantially less collagen deposition in vim À / À mice compared with wt mice. the excessive collagen deposition in lungs of wt mice led to loss of mechanical compliance, whereas the lungs of vim À / À mice maintained compliance similar to that of saline-treated mice. these results are consistent with previous reports demonstrating decreases in the compliance of fibrotic lungs . the elastic modulus measurements strongly suggest that increased tissue stiffness at the microscale corresponds to areas of increased collagen deposition. importantly, macroscale measurements of lung compliance were highly correlated with the microscale elastic modulus measurements obtained by afm. a number of studies have demonstrated that il- b can induce ali and contribute to the progression of pulmonary fibrosis , , , . il- b-induced fibrosis is associated with an increase in tgf- b, demonstrating that ali initiated by proinflammatory cytokines can result in progressive fibrosis , . vim À / À mice were treated with recombinant mouse il- b (rmil- b . mg kg À body weight, intranasal (i.n.)), but we were unable to detect latent tgf-b in balf from vim À / À mice after i.n. rmil- b at days , and (data not shown), whereas latent tgf-b was detected days after bleomycin administration in wt mice (fig. ) . gasse et al. reported that collagen deposition was increased by rmil- b in wild-type mice; vim À / À mice treated with rmil- b had no increase in collagen deposition. we reason that the incomplete suppression of mil- b in vim À / À mice is a reflection of incomplete chimera, with only b % engraftment. studies with il- r À / À , myd À / À , asc À / À , caspase- À / À and nlrp À / À mice have suggested that uric acid (induced by bleomycin), asbestos and silica are detected by the nlrp inflammasome in macrophages, likely leading to il- r /myd signalling in pulmonary epithelial cells, then to inflammation, neutrophil and lymphocyte recruitment and fibroblast activation . lung fibroblast activation results in collagen deposition and pulmonary fibrosis. importantly, it was reported that vimentin is required for the stabilization of collagen mrnas . we reason that the vim À / À mice treated with either rmil- b or wt bone marrow failed to increase collagen deposition because vimentin knockout fibroblasts fail to produce type i collagen due to decreased stability of collagen a (i) and a (i) mrnas . protection from injury, inflammation and fibrosis has been observed in mice lacking any components of the nlrp inflammasome, similar to our observations of vim À / À mice following injury , , , , . these phenotypes led us to investigate whether vimentin might serve as a scaffold for the inflammasome by binding to one or more proteins in the inflammasome complex. several studies have suggested that ifs, including vimentin, act as scaffolds for signalling molecules , , . in fact, vimentin interacts with and is involved in the translocation of perk / to the nucleus , limits the ability of - - to interact with raf and cdk , and regulates the release and translocation of roka following rhoa activation. these findings exemplify how vimentin ifs can act as scaffolds for signalling molecules. recently, vimentin was reported to bind to nod (nucleotide-binding oligomerization domain-containing protein ), a member of the nlr family, via the leucin-richrepeat (lrr) . the lrr is a protein-binding domain shared by other nlr family members, including nlrp . therefore, we sought to determine whether vimentin interacts with nlrp . in our experiments, immunoprecipitation of both nlrp and caspase- in lysates from wt alveolar macrophages resulted in a robust co-precipitation of vimentin, which was enhanced following activation of the nlrp inflammasome. these data were confirmed by immunofluorescent confocal microscopy of human and murine macrophages. the co-localization score for vimentin with nlrp was . ± . , indicating strong colocalization . moreover, we were able to demonstrate a direct protein-protein interaction between vimentin and nlrp by bli assays, further establishing a role for vimentin in assembly of the nlrp inflammasome. intermediate filaments, including vimentin, have been shown to provide a scaffold whereby active subunits of caspase- can activate caspase- , which, in turn, can activate more caspase- resulting in an amplification loop , . caspase- , caspase- and caspase- have also been shown to interact with vimentin ; to our knowledge, we are the first to report an interaction between caspase- and vimentin. we can only speculate about where and how vimentin associates with nlrp and caspase- during inflammasome assembly, since the crystal structures of the vimentin dimer and all components of the inflammasome except for pyd are unknown [ ] [ ] [ ] . nlrp proteins have been shown to form inactive preassembled complexes in unstimulated cells [ ] [ ] [ ] . under stimulation, these proteins undergo conformational changes whereby the inflammasome is activated. the vimentin if network could potentially associate with the nlrp inflammasome through one or more domains of nlrp and mediate the conformation change or stabilization of nlrp that leads to activation. we reason that vimentin may interact with nlrp in two distinct regions: the nacht domain and the lrr; vimentin has been previously shown to interact with nod in the lrr domain . because asc is localized to the nucleus in unactivated cells, no interaction with vimentin is anticipated in nonactivated cells. furthermore, on the basis of the structure of asc, a pyd and card domain with a short linker, we do not anticipate a direct interaction with vimentin as vimentin lacks either of the asc domains, therefore, any asc signal following cell activation is anticipated to be due to vimentin interaction with other proteins in the inflammasome protein complex. an unresolved issue is how vimentin mediates inflammasome activation. mitochondrial-derived reactive oxygen species (ros) have been linked to inflammasome activation . vimentin if are known to modulate mitochondrial motility , and lack of vimentin results in increased ros production . this suggests that vimentin-deficient cells should have more robust inflammasome signalling, the exact opposite of what we have demonstrated. in a very provocative paper, however, bauernfeind et al. demonstrated that mitochondrial-derived ros is required for priming, not activation, of the inflammasome, as ros inhibitors blocked the priming step required for nlrp expression, but activation was not affected. this correlates with our findings that signal is unaffected by the lack of vimentin. further studies on the relationship between vimentin, mitochondria and ros will likely provide insights into the regulation behind both signals and during inflammation, but currently they are beyond the scope of this paper. in summary, this study demonstrates a novel function for the type iii if, vimentin, in innate immunity and inflammation leading to ali and pulmonary fibrosis. in our experiments, vimentin deficiency resulted in a blunted inflammatory response in the early stages of injury, which was consistent among the different animal models of lung injury used: lps, bleomycin and asbestos. we further demonstrate that vimentin is required for il- b maturation through its interaction with the nlrp inflammasome. vimentin may act as a scaffold for assembly of the inflammasome protein complex and thus regulate its function. overall, this study provides new insights into lung inflammation and fibrosis, and importantly, suggests that vimentin may be a key regulator of the nlrp inflammasome. mice and induction of acute lung injury. age-and sex-matched -to -weekold mice were used in all the experiments. the /sv vimentin-deficient (vim À / À ) mice were a gift from albee messing (madison, wi). bleomycin ( . units in ml of pbs; hospira) and asbestos ( mg in pbs; us epa) were administered intratracheally via two -ml aliquots. lps ( mg kg À , lethal dose; mg kg À , sublethal dose; sigma-aldrich) was administered via intraperitoneal injection. wt and vim À / À mice were treated with a single intratracheal injection of ml of phosphate-buffered saline (pbs) or bleomycin ( . units in ml of pbs; hospira). all mice were bred in our animal facility and the experiments were approved by the northwestern university animal care and use committee. histology. a -gauge angiocath was sutured into the trachea, heart and lungs were removed en bloc and inflated with . ml of % paraformaldehyde. the heart and lungs were fixed and embedded in paraffin; -mm sections were stained with h&e, picrosirius red or masson trichrome by the mouse histology phenotyping laboratory (northwestern university, chicago, il). sections were visualized using the tissuegnostics tissue/cell high throughput imaging analysis system (vienna, austria) and captured using tissuefaxs software (tissuegnostics, los angeles, ca) at the northwestern university cell imaging facility. specific regions of interest were visualized using a zeiss axioskop microscope and captured using the cri nuance spectral camera software suite. wet-to-dry weight ratios. mice were anaesthetised and lungs were surgically removed en bloc. the left lung was ligated, excised and weighed in a tared container. the left lung was then dried at °c in a speed-vac sc evaporator (thermo scientific, waltham, ma) until a constant weight was obtained, and the wet-to-dry weight ratio was calculated. bronchoalveolar lavage. to perform bronchoalveolar lavage (bal), a -gauge angiocath ligated into the trachea and ml of sterile pbs was instilled, then removed through the angiocath; the process was repeated three times. the samples were pooled and a ml aliquot of the bal fluid was placed in a cytospin and centrifuged at g for min. the pellet was re-suspended in ml of pbs, plated on glass slides, stained with crystal violet and subjected to a blinded manual cell count and differential. cytokine and chemokine levels in the supernatant were measured using the bd cytometric bead array (bd biosciences). samples were analysed in triplicate using the mouse inflammation kit (bd biosciences) according to the instructions provided. this kit detects interleukin (il)- , mcp- and tumour necrosis factor (tnf)-a. total transforming growth factor (tgf)-b was measured using the tgf-b rii duoset enzyme-linked immunosorbent assay (elisa, r&d systems, minneapolis, mn) according to the manufacturer's instructions. total interleukin (il)- b was measured using the il-b ready-set-go elisa (ebioscience, san diego, ca) according to the manufacturer's instructions. caspase- activity was measured using the caspase- fluorometric assay (r&d systems), according to the manufacturer's instructions. sircol assay. total collagen content was determined by harvesting lungs from mice d after treatment with bleomycin or pbs, or weeks after treatment with asbestos or tio . exsanguination was accomplished by a left nephrectomy, followed by perfusion of the right ventricle with ml of cold pbs. both lungs were removed and homogenized ( min with a tissue homogenizer followed by strokes in a dounce homogenizer) in ml of . n acetic acid supplemented with roche edta protease inhibitor. aliquots of lung homogenate were then assayed for total lung collagen levels and compared with a standard curve prepared from rat tail collagen by using the sircol collagen dye binding assay (biocolor ltd, newtownabbey, uk), according to the manufacturer's directions. compliance measurements. wt and vim À / À mice were anaesthetised with ketamine and xylazine ( mg per g of body weight) and a tracheotomy was performed. pancuronium was administered intraperitoneally ( . mg kg À of body weight). the mouse was mechanically ventilated on a computer-controlled piston ventilator (flexivent; scireq, montréal, québec, canada) with a tidal volume of ml kg À at a frequency of breaths per minute against - cm h o positive end-expiratory pressure. following two total lung capacity manoeuvres to standardize volume history, pressure and flow data (reflective of airway and tissue dynamics) were collected during a series of standardized volume perturbation manoeuvres. these data were used to calculate both total lung resistance (r) and elastance (e) using the single-compartment model and used to derive further parameters of respiratory function. the flexivent calibration procedure removes cannula impedance from the reported data. residual impedence (i) is therefore negligible and is not reported herein. atomic force microscopy measurements. lungs were used at - days following bleomycin challenge. following instillation of . % low-gel point agar ( ml kg À ), lungs were sectioned using a vibratome (leica vt s) into mm or -mm thick slices. these slices were used within h of harvest; microindentations were performed using a bruker bioscope catalyst located at the northwestern university nuance facility. modified probes with -mm spheres (novascan, ames, ia) were used to indent mm  mm areas on the lung slices. force and indentation depth were converted to elastic modulus using the hertz spherical indentation model , and a custom matlab program (generated by dr esra roan, university of memphis). a poisson ratio of m ¼ . was assumed for the tissue - . cell culture. to isolate bone marrow-derived macrophages (bmdm), bone marrow was extracted from mice femurs and tibia then purified through a ficoll-paque gradient. upon purification, cells were differentiated on charge-free plates in dmem containing % endotoxin-reduced fetal bovine serum and % l cell supernatant for days . peritoneal macrophages were obtained from untreated mice. briefly, the abdomen of anaesthetised mice was exposed and ml of sterile pbs was instilled intraperitoneally using a -gauge syringe. following agitation, the fluid was removed and centrifuged. the cells were plated in dulbecco modified eagle medium containing % fetal bovine serum and used for western blotting. alveolar macrophages were obtained from balf of untreated mice. briefly, ml of sterile pbs was instilled through a -gauge angiocath ligated into the trachea and the fluid then removed; this process was repeated three times. the fluid was centrifuged and cells were used for elisa. the second-generation lentiviral pgipz expression vectors encoding shrnas against mouse vimentin (clones v lmm_ , v lhs_ and v lhs_ ) and scrambled shrna control (catalogue no. rhs ) originated from the thermo fisher scientific shrna library (waltham, ma) and were provided by rnai/throughput robotics core of northwestern university (evanston, il). lentiviral stocks (with titres of - tu ml À ) encoding shrnas against mouse vimentin were produced by the dna/rna delivery core (skin disease research center, northwestern university, chicago, il). western blotting. primary murine macrophages were cultured overnight in % serum and treated or not with lps ( ng ml À ) for h. atp ( mm) was added to lps-stimulated cells during the last min. cells were lysed in sample buffer and equal volumes loaded in % sds-page gels transferred to nitrocellulose membranes. the presence of indicated proteins in cell lysates and medium was assessed by western blotting using the following antibodies: mouse monoclonal anti-vimentin (clone v ; : ; sigma-aldrich no. treated according to manufacturer's instructions. bound proteins were prepared for western blotting. protein-protein interaction. the interaction between nlrp and vimentin was analysed using a bli, blitz (fortebio, menlo park, ca). antibodies directed against nlrp (adipogen) were diluted : then attached to a protein a biosensor. next, commercially available, purified nlrp (abnova) was attached to the biosensor for min. finally, each labelled biosensor was placed into a specific concentration of purified vimentin and binding was measured for s followed by dissociation in pbs for s. at the start of each binding experiment, vimentin was diluted into pbs to assemble filaments real-time reverse transcriptase polymerase chain reaction. total rna extraction and quantitative pcr were performed as previously described (). briefly, total rna was isolated using the aurum total rna mini kit (qiagen). cdna was synthesized using the qscript cdna supermix (quanta biosciences) and amplified using -cycle two-step pcr with sequence-specific primer pairs (idt). sybr green fluorescence was quantified with a cfx real-time system thermal cycler (bio-rad) using ddct analysis. relative il- b mrna expression was determined via normalizing to b-actin mrna expression. statistical analysis. data are expressed as means ± s.d. or means ± s.e.m. differences between two groups were assessed by using a student's t-test. differences between three or more groups were assessed using one-way analysis of variance with a bonferroni multiple comparisons test. values of po . were considered to be significant. the log rank test, which calculates the chi-square (w ) for each event time for each group and sums the results, was used in the analysis of the kaplan-meier curve was used. all analyses were performed using graphpad prism software version . for windows (graphpad software, san diego, ca). wild-type j . cells and j . cells expressing shrna against vimentin were fixed in methanol ( À °c) for min and processed for indirect immunofluorescence as described previously , using the following antibodies: mouse monoclonal anti-nlrp (adipogen international no. ag- b- images of fixed, stained preparations were taken with either a zeiss lsm microscope or a nikon a r microscope immunoprecipitated caspase- in the right panel could not be detected due to masking by the signal from the heavy chain of the antibody. protein a/g agarose was incubated with cell lysates in the absence of an antibody to control for non-specific binding. to enable caspase- detection in immunoprecipitates, caspase- antibodies were crosslinked to protein a/g agarose using crosslink ip kit (thermo) cell mechanics and the cytoskeleton introducing intermediate filaments: from discovery to disease mice lacking vimentin develop and reproduce without an obvious phenotype impaired wound healing in embryonic and adult mice lacking vimentin a role for vimentin in crohn disease functions of the intermediate filament cytoskeleton in the eye lens if-pathies": a broad spectrum of intermediate filamentassociated diseases 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disease mechanisms of pulmonary fibrosis cutting edge: nitric oxide inhibits the nlrp inflammasome gout-associated uric acid crystals activate the nalp inflammasome cell volume regulation modulates nlrp inflammasome activation bio-layer interferometry for measuring kinetics of protein-protein interactions and allosteric ligand effects briding the gap between qualitative and quantitative colocalization results in fluorescence microscopy studies the acute respiratory distress syndrome inflammasome-regulated cytokines are critical mediators of acute lung injury elevated interleukin- release by human alveolar macrophages during the adult respiratory distress syndrome bleomycin and il- beta-mediated pulmonary fibrosis is il- a dependent transient expression of il- b induces acute lung injury and chronic repair leading to pulmonary fibrosis a novel role of vimentin filaments: binding and stabilization of collagen mrnas the highly conserved nuclear lamin ig-fold binds to pcna: its role in dna replication vimentin binding to phosphorylated erk sterically hinders enzymatic dephosphorylation of the kinase the intermediate filament protein, vimentin, is a regulator of nod activity intermediate filaments control the intracellular distribution of capases during apopptosis caspase cleavage of vimentin disrupts intermediate filaments and promotes apoptosis a role for mitochondria in nlrp inflammasome activation vimentin intermediate filaments modulate the motility of mitochondria vimentin is secreted by activated macrophages proapoptotic bid is required for pulmonary fibrosis norepinephrine increases alveolar fluid reabsorption and na,k-atpase activity poissons' ratio of lung parenchyma and parenchymal interaction with bronchi feedback amplification of fibrosis through matrix stiffening and cox- suppression oxidative stress, plasminogen activator inhibitor , and lung fibrosis a nuclear receptor atlas: macrophage activation shear stress induced reorganization of the keratin intermediate filament network requires phosphorylation by protein kinase c zeta vimentin is sufficient and required for wound repair and remodeling in alveolar epithelial cells structure and assembly properties of the intermediate filament protein vimentin: the role of its head, rod and tail domains vimentin intermediate filament formation: in vitro measurement and mathematical modeling of the filament length distribution during assembly dr esra roan (university of memphis, tn) generously assisted with the afm microindentation matlab code and analysis of results. we thank mr luke skertich for assistance with immunofluorescence confocal microscopy. histological staining was performed by the mouse histology phenotyping laboratory. imaging work was performed at the northwestern university cell imaging facility generously supported by nci ccsg p ca awarded to the robert h. lurie comprehensive cancer center. afm measurements were produced in the nifti facility (nuance center, northwestern university), which has received support from the nsf-nsec, nsf-mrsec, keck foundation, the state of illinois and northwestern university. key: cord- - nzr authors: sugiyama, michael g.; armstrong, susan m.; wang, changsen; hwang, david; leong-poi, howard; advani, andrew; advani, suzanne; zhang, haibo; szaszi, katalin; tabuchi, arata; kuebler, wolfgang m.; van slyke, paul; dumont, dan j.; lee, warren l. title: the tie -agonist vasculotide rescues mice from influenza virus infection date: - - journal: sci rep doi: . /srep sha: doc_id: cord_uid: nzr seasonal influenza virus infections cause hundreds of thousands of deaths annually while viral mutation raises the threat of a novel pandemic strain. antiviral drugs exhibit limited efficacy unless administered early and may induce viral resistance. thus, targeting the host response directly has been proposed as a novel therapeutic strategy with the added potential benefit of not eliciting viral resistance. severe influenza virus infections are complicated by respiratory failure due to the development of lung microvascular leak and acute lung injury. we hypothesized that enhancing lung endothelial barrier integrity could improve the outcome. here we demonstrate that the tie -agonist tetrameric peptide vasculotide improves survival in murine models of severe influenza, even if administered as late as hours after infection; the benefit was observed using three strains of the virus and two strains of mice. the effect required tie , was independent of viral replication and did not impair lung neutrophil recruitment. administration of the drug decreased lung edema, arterial hypoxemia and lung endothelial apoptosis; importantly, vasculotide is inexpensive to produce, is chemically stable and is unrelated to any tie ligands. thus, vasculotide may represent a novel and practical therapy for severe infections with influenza. whether as an agent of pandemics or as a seasonal pathogen, the influenza virus exacts a heavy toll on global public health. despite vaccination programs and antiviral drugs, seasonal influenza alone causes millions of cases of severe illness and hundreds of thousands of deaths annually , . there are concerns that ongoing mutation will lead to a novel strain of the virus that is both highly transmissible and highly virulent, as occurred in the pandemic leading to the deaths of million people . existing treatments for the virus are inadequate: antiviral drugs are not completely effective at reducing mortality , and exhibit declining efficacy unless given at the time of infection, a problematic limitation since the time of infection is usually unknown , . there is also the problem of antiviral resistance; of the two classes of drugs approved for use against influenza, one is largely ineffective due to widespread resistance, while sporadic cases of resistance to the other have been reported , . thus, there is a need for novel therapies; those that target the host rather than the pathogen may be ideal as they should be less susceptible to viral resistance. most deaths from influenza virus infection occur due to pulmonary complications, in particular the development of acute respiratory distress syndrome (ards) , , a potentially fatal syndrome of pulmonary edema that occurs due to increased permeability of the lung microvasculature , . blood vessels in the lung are lined by a continuous layer of endothelium; thus, loss of endothelial barrier integrity is a prerequisite for ards. the fact that mortality persists despite antiviral therapy suggests that elements of the host response may be maladaptive , . given the prominence of ards in severe infections, we hypothesized that enhancement of lung endothelial barrier function might improve survival. we tested the novel tie -agonist tetrameric peptide, vasculotide; this peptide has no sequence homology with any endogenous ligands, is easy to produce and is chemically stable . here we report that administration of vasculotide significantly improves survival from influenza virus infection, even when started several days post-infection. we first infected c bl/ mice with a lethal dose of influenza virus (hkx ;h n ) followed by daily intraperitoneal injection of vasculotide ( ng, see schematic, fig. a ). while no infected mice survived longer than days, treatment with vasculotide markedly improved survival even if started as late as hours post-infection ( % survival if started at hours after infection; % survival if at hours, p < . ); treatment starting hours after infection improved survival although this did not achieve protocol used to test vt in mice infected with influenza virus. arrows indicate the time after infection (hours) at which daily administration of vt was begun. c bl/ j mice were infected with mouseadapted influenza, strain x and received placebo or ng vt per day starting at the indicated times. (b) survival was monitored daily; numbers in parentheses indicate the number of mice per group. ***p < . vs. flu-alone mice. (c) arterial oxygen saturation on day after infection, ***p < . . (d) lung edema was measured by wet-to-dry ratio in mice sacrificed days after infection. (e) left ventricular ejection fraction on day after infection was measured by echocardiography. (f) c bl/ j mice were infected with mouseadapted influenza, strain pr and received placebo or ng vt daily starting at hours after infection, *p < . . scientific reports | : | doi: . /srep statistical significance (p = . ; fig. b ); treatment with a lower dose of vasculotide ( ng) did not appear to be as effective (supplemental figure ). prior to receiving vasculotide, mice displayed typical signs of progressive illness such as arterial hypoxemia, hypothermia, and declining body weight; these features are apparent as early as - hours after infection. vasculotide treatment started at hours post-infection is able to rescue a significant subset of infected mice (supplemental figures , ) . furthermore, virus-induced hypoxemia and lung edema were greatly ameliorated with the drug (fig. c-d) . echocardiography revealed that lung edema was not due to impairment of left ventricular systolic function by the virus, consistent with an increase in vascular leak from lung injury ; analogously, the reduction in lung edema by vasculotide was not from an improvement in left ventricular systolic function (fig. e) . of note, the drug was similarly effective against a lethal dose of pr (h n ), a second strain of influenza virus that is highly virulent in mice (fig. f) . next, we infected mice with the swine-origin pandemic h n influenza virus. although the mortality rate in these mice was only %, all of the vasculotide-treated mice survived (supplemental figure ) . thus, vasculotide appears to be effective against lung injury caused by multiple strains of influenza. in a clinical setting, an agent like vasculotide is most likely to be administered in combination with an antiviral drug. we therefore treated influenza virus-infected mice with amantadine alone or in combination with vasculotide. treatment with amantadine modestly but significantly improved survival (from to %, fig. a ). adjuvant vasculotide markedly increased survival even when started as long as hours after infection ( % survival) ( fig. a and supplemental figure ). this was in association with significant improvements in arterial hypoxemia (fig. b ), hypothermia and weight loss ( fig. c-d) . these findings are especially important because mortality from influenza virus persists despite antiviral therapy and because the efficacy of such therapy declines rapidly over time , , . to prove that the benefit of vasculotide is mediated through the tie receptor, and because homozygous deletion of tie is embryonically lethal , we obtained haploinsufficient tie +/− mice bred onto a cd background. these mice express significantly less tie on the lung endothelium . infection of cd wild-type mice with influenza virus (hkx ;h n ) resulted in significant lethality (only % survival) that was greatly improved by vasculotide ( % survival), even if started hours after infection (fig. a) . conversely, infection of haploinsufficient tie +/− mice resulted in a similar degree of mortality ( % survival) that was not significantly changed by the drug ( % survival), although there was a trend towards an intermediate phenotype (fig. b) . furthermore, in contrast to wild-type mice, vasculotide had no effect on influenza virus-induced hypoxemia or hypothermia in the haploinsufficient mice ( fig. c-d) . thus, the benefit of vasculotide is dependent on tie expression. while tie is widely thought to be almost exclusively expressed on endothelial cells , we considered the possibility that its benefit might reflect unanticipated activity on non-endothelial tissues or on the virus itself. we first established that vasculotide has no antiviral activity in vitro and in vivo (fig. a) . second, vasculotide did not affect chemotaxis of human and murine monocytes and neutrophils in vitro (fig. b-c and data not shown). to our surprise, despite significantly improved arterial oxygen saturation and body weight ( fig. d -e), vasculotide-treated mice exhibited no difference in the severity of lung injury determined by blinded quantification of lung histology at days post-infection ( fig. g ) (this timepoint was chosen as infected mice die soon afterwards). concordantly, while infection induced a marked increase in alveolar neutrophil recruitment, this was unaffected by treatment with vasculotide ( fig. f ); alveolar and serum cytokine levels on day post-infection were also unaffected (supplemental figure ). thus, the mechanism of benefit of vasculotide appears downstream of innate immune responses and instead involves the lung endothelial barrier. as expected, vasculotide induced tie phosphorylation and significantly attenuated thrombin-induced lung endothelial leak, as measured by electrical resistance (supplemental figure a -b). while the drug had no effect on human lung endothelial proliferation (supplemental figure ) , it significantly attenuated lung endothelial apoptosis in vitro in response to influenza virus, as assessed by cleavage of caspase- (supplemental figure c ); we observed a similar reduction in cleaved caspase- in lungs from infected mice who received vasculotide (supplemental figure d ). although the apoptotic cells in the lungs of infected mice undoubtedly reflect contributions from epithelium and leukocytes, we observed colocalization of cleaved caspase- with the endothelial-specific marker ve-cadherin, consistent with our in vitro data. finally, while influenza infection caused loss of tie from the lungs of infected mice, this was significantly attenuated by treatment with vasculotide. vasculotide treatment also markedly increased levels of phospho-akt in the lung, an event that is known to be downstream of tie activation and that acts as an endothelial pro-survival signal (supplemental figure ). our findings have a number of important implications. first, these data strongly implicate failure of the lung endothelial barrier as the cause of death in murine models of severe influenza, as vasculotide conferred a significant survival benefit against multiple strains of the virus in two strains of mice. the effect of the drug is tie -dependent, appears to be downstream of innate immune activation and does not require inhibition of viral replication. second, the enhancement of lung endothelial barrier integrity did not impair leukocyte recruitment to the lung, supporting the notion that vascular leak and leukocyte transmigration may be regulated independently . accordingly, administration of vasculotide at the time of infection (i.e. even before leukocyte infiltration could occur) was not harmful and still conferred great benefit (fig. b) . lastly, administration of vasculotide even - days after infection significantly improved survival, an observation with practical implications given that the moment of infection in patients is usually uncertain. while other ligands for tie have been studied as therapies for vascular leak (as reviewed in ), none have been reported in severe influenza virus infection and almost all required administration to be prophylactic or simultaneous with the time of infection , , limiting their clinical utility. the potential clinical use of recombinant angiopoietin , the endogenous ligand for tie , is limited by its tendency to bind to the extracellular matrix and to form undesirable aggregates ; furthermore, modified forms of the protein are reportedly difficult to synthesize and are unstable . in contrast, vasculotide was invented based on phage display experiments in which over billion unique peptides were screened to identify those capable of binding with high affinity to tie , . vasculotide bears no sequence homology to angiopoietin- and exhibits no activity against or binding to some cellular receptors (unpublished data); its specificity for tie is also strongly supported by our data using tie haploinsufficient mice. given the existing literature on ang and other putative barrier-enhancing agents , , , the ability of delayed administration of vasculotide to rescue mice dying of influenza (supplemental figure ) is unexpected and novel. this finding, combined with its relatively low cost of production and its chemical stability, suggests that the drug might constitute a practical therapy. our data indicate that vasculotide increases endothelial barrier integrity and reduces lung endothelial apoptosis, consistent with its agonism of tie . further work will determine whether it affects other mediators of vascular instability including angiopoietin- and ve-ptp . as its mechanism of action is independent of viral replication and instead involves modulation of the host response, it is possible that vasculotide may not engender viral resistance, but this hypothesis will require direct testing. since influenza virus infections are often complicated by secondary bacterial pneumonia , novel agents that impair the innate immune response may not be without risk. the fact that vasculotide does not impede neutrophil recruitment to the lung is therefore reassuring. finally, whether the impressive benefit of vasculotide in the therapy of the influenza virus carries implications for other infectious agents or non-infectious causes of ards will require further investigation. experimental design. fourteen-week old c bl/ j mice were purchased from jackson laboratories for all experiments, mice were sedated with % isoflurane and infected intranasally with influenza virus (see virus section, below) diluted in pbs to a final volume of μ l. after infection, mice were separated into weight-matched control and treatment groups; unless otherwise indicated, we used ten mice per group and mice were infected with hau of influenza virus, which caused greater than % mortality by day . in the first experiment, we included the following groups (see fig. b ): mice that received the influenza virus alone (flu) and infected mice that also received vasculotide ( ng in . ml pbs by intraperitoneal injection, the dose based on previous work ); of the latter, mice that received vasculotide were divided a priori into those who received it at the time of infection (vt ) and then once daily; those that in other experiments to test vt as an adjuvant therapy ( fig. and supplemental figure ), we divided mice into the following six groups: influenza-virus infected mice (flu); infected mice that received a dose of amantadine by oral gavage twice daily at a concentration of mg/kg/day (flu/amant); and infected mice that received amantadine and a daily intraperitoneal injection of vt starting , , to test the requirement for tie (fig. ) , cd- wildtype and tie +/− mice bred onto the cd- background were obtained from sunnybrook research institute (toronto, ontario); tie +/− mice were backcrossed onto the cd- background for a minimum of generations. these mice were divided into the following four groups, depicted in fig. : cd- wildtype mice infected with influenza virus (flu, fig. a) ; cd- wildtype mice that were infected and given vt daily starting hours after infection (flu/vt , fig. a) ; tie +/− mice infected with influenza virus (flu, fig. b) ; tie +/− mice that were infected and given vt daily starting hours after infection (flu/vt , fig. b) . in all experiments, mice were monitored times daily for the duration of the experiment ( - days after infection) and were scored for weight loss, hypothermia, hypoxemia, spontaneous activity (scored from (moribund) to (normal), as described in ) , and other clinical features of influenza infection. mice were euthanized if two or more of the following occurred: weight loss exceeded % of initial weight; temperature fell below °c; the animal appeared moribund. in some experiments, mice were sacrificed on the indicated day for collection of blood and tissue samples. . in vitro measurement of viral replication was also measured by qpcr as previously described . pulse oximetry measurements. arterial oxygen saturation was measured using the mouse ox plus device and software (starr life sciences, oakmont, pa) on awake (non-anesthetized) mice using either the small or medium collar clips for c bl/ j and cd- and tie +/− mice, respectively. for c bl/ j mice, a chemical depilatory cream was used to remove hair around the base of the neck several days before infection. for so measurements, mice were allowed to acclimate to the collar clip for several minutes in their home cage before recording the maximal so measurement. mice treated with or without vt starting hours after infection were sedated and sacrificed days after infection by cardiac puncture. this timepoint was chosen as infected mice die soon afterwards. after sacrifice, the trachea was exposed and the lungs were inflated with . ml cold pbs with . mm edta. after s, . ml balf was recovered and centrifuged at x g to pellet the cells. supernatant was collected and immediately frozen for analysis of balf cytokines. the balf pellet was resuspended in μ l pbs. neutrophils were stained with . measurement of edema. c bl/ j mice were infected with hkx and vt ( ng) or pbs was injected by ip injection once daily for days. on day , mice were sacrificed by cardiac puncture of the right ventricle. the circulatory system was flushed with ml cold pbs by instillation through the left ventricle. the entire right lung was removed, patted dry, and then weighed for determination of wet weight. lung tissues were dried for hours and then weighed for the dry weight. degree of lung edema is expressed as the wet-to-dry ratio of lung weights. echocardiography. c bl/ j mice were infected with hkx influenza and vt ( ng daily) or pbs treatment was started hours after infection. on day , mice were lightly sedated and a depilatory cream was used to remove hair from the ventral surface of the thorax and abdomen. on day , mice were lightly sedated and left ventricular function was measured by echocardiography as previously reported . histology and immunohistochemistry. hkx -infected c bl/ j mice (n = per group and scientific reports | : | doi: . /srep and eosin; a lung pathologist (d.h.) blinded to the experimental design scored acute lung injury based on consensus criteria, yielding a composite score between (no injury) to (highest degree of lung injury) . degree of lung injury was determined by scoring randomly selected high power fields ( x magnification) per mouse. for detection of cleaved caspase- , immunofluorescence microscopy was performed on formalin-fixed paraffin embedded lung tissue as previously described . sections were dual-stained with a goat polyclonal antibody directed against ve-cadherin (santa cruz biotechnology) and a rabbit polyclonal antibody directed against cleaved caspase- (cell signaling technology). slides were washed and subsequently incubated with alexa fluor donkey anti-goat and alexa fluor donkey anti-rabbit secondary antibodies, both from life technologies inc. (burlington, on, canada) . blinded quantification of cleaved caspase- was performed on randomly selected lung fields per mouse acquired by spinning disc confocal microscopy (zeiss axiovert m microscope, settings kept constant between conditions) and analyzed using imagej (nih). cell culture and reagents. primary human lung microvascular endothelial cells (hpmecs) obtained from promocell (heidelberg, germany) were cultured in ebm- media (lonza, basel, switzerland) with the recommended supplements and used in passages - . the thp- human monocytic cell line was a gift from amira klip (toronto). human neutrophils were obtained from healthy volunteers and were isolated from whole blood by density gradient separation . vasculotide, a pegylated tetrameric peptide agonist of the tie receptor, was synthesized as previously described and prepared to a concentration of ng/μ l in sterile phosphate-buffered saline (pbs) without calcium and magnesium. a working solution of vt was prepared by diluting the stock ten-fold in pbs. immunoblot. hpmec-l were grown to % confluency on -well plates and treated with x influenza or x influenza plus ng/nl vt for hours. lysates were prepared with lysis buffer ( . mm tris-hcl ph . , % sds, % glycerol, mm dtt). sds page was performed on a % polyacrylamide gel. immunoblotting was performed as previously described with the exception of the blocking step, which used % bovine serum albumin in tbs instead of % milk. in some experiments, lung homogenates were generated from infected mice as follows: after euthanasia, the circulation was flushed with ml ice-cold pbs. the lungs were homogenized in buffer containing mm nacl, mm edta, % glycerol, % triton x- , mm tris-hcl, mm sodium orthovanadate, and complete protease inhibitor cocktail tablets and separated using % polyacrylamide gels. proteins were transferred to nitrocellulose membranes, blocked for hour in % milk in tbs, and probed overnight with primary antibody at °c. after washing, blots were incubated with hrp-conjugated secondary antibodies for hour, washed, and then visualized by chemiluminescence (thermoscientific). band intensity was quantified using imagej (nih) and normalized to the loading control after background correction. the anti-phospho-akt (ser ) antibody was from cell signaling; the anti-tie (c ) antibody was from santa cruz; all other antibodies were from santa cruz biotechnology. chemotaxis assay. × neutrophils (isolated from healthy human volunteers) in μ l of dmem with low-glucose or × thp- cells in μ l of rpmi with % fbs and % penicillin/streptomycin containing ng/ml or ng/ml vt or pbs were seeded into the upper part of a transwell chamber ( -μ m pore size, . mm in diameter; corning life sciences). the lower chamber of the transwells was filled with μ l of dmem containing vehicle (dmso) or μ m fmlp for neutrophil chemotaxis or with μ l of rpmi , % fbs, % penicillin/streptomycin containing μ m atp for thp- chemotaxis. after h of incubation at °c, the migrated neutrophils or thp- cells were recovered from the lower chamber and counted using a hemocytometer. electric cell substrate impedance sensing (ecis). an ecis ztheta system (applied biophysics, troy, ny) was used to follow barrier function. hpmecs were seeded on applied biophysics ecis culture arrays pretreated with mm cysteine at . × /well and grown for h to allow the establishment of a confluent layer. next, the arrays were placed into the ecis system and impedance and capacitance (c) data were collected (and r values calculated by the software) continuously using the frequency scan mode. after obtaining a baseline, the measurement was paused and thrombin was added to the arrays in μ l medium to induce endothelial permeability, at a final concentration of unit/ml. some wells received vt alone or in combination with thrombin at a concentration of ng/ml. controls received μ l medium without thrombin. for each condition measurements were performed in duplicate. curves were normalized to the resistance level prior to thrombin administration using the ecis software. the ecis trace represents the data collected at hz and is representative of independent experiments. mtt and scratch assay. hpmecs were seeded on well tissue culture plates at a density of . × cells/ml ( wells per condition). cells were incubated for four hours to allow cells to attach. after hours (time ), the media was changed to egm- (control) or egm- with ng/ml vt. for baseline and endpoint measurements, mtt (sigma) was added to the cells at time and hours after treatment followed by a -hour incubation. mtt and media were aspirated and the cells were solubilized in ul dmso and shaken for minutes. absorbance was measured at nm. for the scratch assay, hpmecs were grown to confluency on -well tissue culture plates marked on the bottom with an open square to define the scratch area. a single scratch was made through the scratch area using a sterile p pipette tip. the initial scratch area was imaged by phase-contrast microscopy. cells were washed once with media and then treated with egm- or egm- with ng/ ml vt for hours. after hours the cells were imaged again to assess the degree of wound healing. phase-contrast images were exported to imagej for quantification of baseline and endpoint wound areas. wound healing is expressed as a fraction of the endpoint area occupied by cells over the baseline scratch area. quantification of wound healing was performed in a blinded fashion. statistics. all statistics were performed using graphpad prism (la jolla, ca) software. comparisons between two groups were made using unpaired, two-tailed student's t-tests with statistical significance set at p < . . comparisons of more than groups were made using one-way anova with post-hoc analyses applying bonferroni's adjustment for comparisons between selected groups. for comparing kaplan-meier survival curves, the log-rank test was used with p < . . statistics for ecis experiments were 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neutrophil isolation protocol co-regulation of transcellular and paracellular leak across microvascular endothelium by dynamin and rac this work was supported by grants from the canadian institutes of health research (ocn and mop ), the physicians' services incorporated foundation ( ) ( ) ( ) ( ) ( ) and an early researcher award (government of ontario), all to wll. the authors thank chris spring, pamela plant, xiaofeng lu, caterina di ciano-oliveira and judy trogadis from the research core facility at the keenan research centre for technical assistance; johnny su for assistance with densitometry, julie khang for assistance with luminex and qinghong dan for assistance with ecis. key: cord- -v r d a authors: chan, jasper fuk-woo; zhang, anna jinxia; chan, chris chung-sing; yip, cyril chik-yan; mak, winger wing-nga; zhu, houshun; poon, vincent kwok-man; tee, kah-meng; zhu, zheng; cai, jian-piao; tsang, jessica oi-ling; chik, kenn ka-heng; yin, feifei; chan, kwok-hung; kok, kin-hang; jin, dong-yan; au-yeung, rex kwok-him; yuen, kwok-yung title: zika virus infection in dexamethasone-immunosuppressed mice demonstrating disseminated infection with multi-organ involvement including orchitis effectively treated by recombinant type i interferons date: - - journal: ebiomedicine doi: . /j.ebiom. . . sha: doc_id: cord_uid: v r d a background: disseminated or fatal zika virus (zikv) infections were reported in immunosuppressed patients. existing interferon-signaling/receptor-deficient mouse models may not be suitable for evaluating treatment effects of recombinant interferons. methods: we developed a novel mouse model for zikv infection by immunosuppressing balb/c mice with dexamethasone. results: dexamethasone-immunosuppressed male mice ( – weeks) developed disseminated infection as evidenced by the detection of zikv-ns protein expression and high viral loads in multiple organs. they had ≥ % weight loss and high clinical scores soon after dexamethasone withdrawal ( dpi), which warranted euthanasia at dpi. viral loads in blood and most tissues at dpi were significantly higher than those at dpi (p < . ). histological examination revealed prominent inflammatory infiltrates in multiple organs, and cd + and cd + inflammatory cells were seen in the testis. these findings suggested that clinical deterioration occurred during viral clearance by host immune response. type i interferon treatments improved clinical outcome of mice ( % vs % survival). conclusions: besides virus dissemination, inflammation of various tissues, especially orchitis, may be potential complications of zikv infection with significant implications on disease transmission and male fertility. interferon treatment should be considered in patients at high risks for zikv-associated complications when the potential benefits outweigh the side effects of treatment. zika virus (zikv) is an emerging flavivirus that has been largely neglected for n years after its discovery due to its restricted geographical distribution and its presumed low clinical significance (chan et al., a) . since , large-scale outbreaks of zikv infection have occurred in the pacific islands, latin america, and most recently, usa and southeast asia (duffy et al., ; musso and gubler, ; zhu et al., ) . as of october , n countries/territories have ebiomedicine ( ) - reported continuing mosquito-borne transmission of zikv (world health organization. zika situation report. october , ) . in addition to mosquito-borne transmission, sexual and transplacental transmissions of zikv have also been reported (chan et al., a; musso et al., a; foy et al., ; calvet et al., ) . these non-vectorborne transmission routes render the control of the continuing epidemic more complicated. zikv was not considered as an important human pathogen in the past as most infected adult patients were asymptomatic or developed a self-limiting acute febrile illness which resolved within - weeks (chan et al., a; duffy et al., ). however, it has been recently recognized that infected mothers may transmit the virus transplacentally to developing fetuses, leading to congenital malformations, including microcephaly, cerebral malformations, ophthalmological and hearing defects, and arthrogryposis (chan et al., a; mlakar et al., ; de paula et al., ; leal et al., ) . some infected adults may also develop severe neurological complications, such as guillain-barré syndrome, meningoencephalitis, and myelitis (cao-lormeau et al., ; carteaux et al., ; mecharles et al., ) . moreover, zikv-related fatalities have been increasingly recognized. most of the patients with fatal infection had underlying medical conditions and some were markedly immunosuppressed, including a patient with systemic lupus erythematosus and rheumatoid arthritis who was on corticosteroid therapy and died of disseminated infection with detectable zikv rna in blood, brain, spleen, liver, kidney, lung, and heart obtained at postmortem examination (pan american health organization/world health oganization (paho/who), ; sarmiento-ospina et al., ; arzuza-ortega et al., ) . a number of animal models have been developed for studying the pathogenesis and evaluating countermeasures for zikv infection. rhesus macaques with subcutaneous zikv inoculation develop mild clinical signs that resemble the self-limiting illness in most infected immunocompetent adults (dudley et al., ) . this non-human primate model provides a robust platform for the evaluation of vaccines and host immune response (abbink et al., ) . however, the mild clinical disease in these primates is suboptimal for antiviral treatment evaluation. moreover, expertise and facilities for working with non-human primates are not available in most research laboratories. wild-type adult balb/c mice are not susceptible to intraperitoneal zikv inoculation (dick, ) . suckling and young mice with intracerebral zikv inoculation develop disease that is localized to the central nervous system (dick, ; way et al., ; weinbren and williams, ; bell et al., ) . pregnant mice and fetal mice with partially intact type i interferon signaling response (fetuses of female mice deficienct in type i interferon signaling response crossed to wild-type male mice) were used to study pathogenesis in pregnancy and maternalfetal transmission, but these models are technically more demanding (miner et al., ; cugola et al., ) . type i/ii interferon-signaling-/ receptor-deficient mice with intraperitoneal or subcutaneous zikv inoculation develop fatal, disseminated infection (lazear et al., ; dowall et al., ; aliota et al., ; rossi et al., ) . these models are useful for the evaluation of countermeasures for zikv infection as the protective effects of antivirals drugs and vaccines are more easily observed in treated mice. however, such models have complete/nearcomplete deficiency in interferon response and do not resemble the real clinical situation in immunosuppressed humans. moreover, these mice are suboptimal for the study of host immune response and may be too expensive for laboratories in resource-limited areas. because of these limitations and knowledge gaps, we developed and characterized a more readily available mouse model which resembles immunosuppressed hosts with disseminated infection. we showed that these mice developed inflammation in multiple organs, including the testes, which may have important implications on zikv's longterm outcome and effects on fertility. we also utilized this novel animal model to show that early treatment with clinically approved recombinant type i interferons improved the clinical outcome of these mice. a clinical isolate of zikv (puerto rico strain prvabc ) was kindly provided by brandy russell and barbara johnson, centers for disease control and prevention, usa. the virus was amplified by three additional passages in vero cells (atcc) in minimum essential medium (mem) supplemented with % fetal calf serum and units/ml penicillin plus μg/ml streptomycin to make working stocks of the virus. for virus titration, aliquots of zikv were applied on confluent vero cells in well plates for % tissue culture infectious dose (tcid ) assay as we previously described with slight modifications (zhou et al., ) . briefly, serial -fold dilutions of zikv were inoculated in a vero cell monolayer in quadruplicate and cultured in penicillin/streptomycinsupplemented mem. the plates were observed for cytopathic effect for days. viral titer was calculated with the reed and münch endpoint method. one tcid was interpreted as the amount of virus that causes cytopathic effect in % of inoculated wells. approval was obtained from the committee on the use of live animals in teaching and research of the university of hong kong. male and female balb/c mice, - weeks old, were obtained from the laboratory animal unit of the university of hong kong. the mice were kept in biosafety level- housing and given access to standard pellet feed and water ad libitum. virus inoculation experiments were performed in a biosafety level- animal facility according to the standard operating procedures approved by the committee on the use of live animals in teaching and research of the university of hong kong as we described previously (zhang et al., ) . the mice were randomly divided into groups and given different regimens of virus inoculation, dexamethasone, and recombinant interferon treatment (table ) . phosphate-buffered saline (pbs) was used to dilute the virus stocks to the desired concentration, and inocula were back-titrated to verify the dose given. on the day of virus inoculation, a dose of the virus equivalent to × tcid ( . × plaque forming units) in μl of pbs was inoculated via the intraperitoneal route into mice under ketamine ( mg/kg) and xylazine ( mg/kg) anesthesia. mice in the negative-control groups (groups to ) were injected with the same volume of pbs. mice were monitored three times each day for clinical signs of disease and a numerical score was assigned at each observation as previously described (dowall et al., ; graham et al., ) . their body weight and survival were monitored for days post-inoculation (dpi) or until euthanasia. three mice in each group (except groups and which included mock-infected control mice without dexamethasone immunosuppression and group which included zikv-inoculated, dexamethasone-immunosuppressed mice without dexamethasone withdrawal) were sacrificed at dpi for virological, histological, and immunohistochemistry analyses. the remaining mice were sacrificed at dpi or euthanized when there was a % weight loss or % weight loss with ≥ clinical sign (dowall et al., ) . samples of brain, testis/ epididymis (male), prostate (male), ovary/uterus (female), kidney, urinary bladder, spleen, liver, pancreas, intestine, heart, lung, and salivary gland were collected at necropsy. the specimens were separated into two parts, one immediately fixed in % pbs-buffered formalin, the other immediately frozen at − °c until further experiments. blood samples were also collected for rna extraction and real-time pcr analysis. paraffin-embedded tissues were cut into - μm sections, mounted on slides, and stained with hematoxylin and eosin (h&e) for light microscopy examination as we previously described (zheng et al., ) . for immunohistochemical staining of zikv-ns antigen, mouse antiserum against zikv-ns protein prepared as we previously described was used as primary antibody (chan et al., b) . de-paraffinized and rehydrated tissue sections were treated with antigen unmasking solution according to manufacturer's instructions (vector laboratories inc., burlingame, ca, usa) and then stained with mouse on mouse polymer ihc kit (abcam, cambridge, united kingdom). the primary antibody mouse anti-zikv-ns antiserum ( : dilution with % bsa/pbs) was incubated at °c overnight. this was followed by mouse on mouse hrp polymer kit (abcam) with horseradish peroxidase-conjugated secondary antibody for min. color development was performed using , ′-diaminobenzidine (dab) (vector laboratories, burlingame, ca, usa). for immunohistochemical staining of cd and cd , the sections were incubated at °c for overnight with primary antibody (rabbit anti-mouse cd , or rat anti-mouse cd α (abcam) after antigen unmasking and blocking. this was then followed by incubation with biotin-conjugated goat anti-rabbit igg or goat anti-rat igg (calbiochem, darmstadt, germany) for min at room temperature. streptavidin/peroxidase complex reagent (vector laboratories) was then added and incubated at room temperature for min. color development was done with dab (vector laboratories). all tissue sections were examined microscopically by two pathologists in an operatorblinded manner. images were captured with nikon i imaging system equipped with spot-advance computer software. total nucleic acid (tna) was extracted from the blood and necropsied tissues using ez virus mini kit v . and qiasymphony dsp virus/pathogen mini kit (qiagen, hilden, germany), respectively, as we previously described (zheng et al., ; chan et al., b; chan et al., a) . zikv envelope gene was measured by using quantinova probe rt-pcr kit (qiagen) in lightcycler real-time pcr system (roche diagnostics, basel, switzerland). μl of purified tna was amplified in a μl-reaction containing μl of × quantinova probe rt-pcr master mix, . μl qn probe rt-mix, . μm forward primer, . μm reverse primer, and nm probe. forward primer ( ′-cgytgcccaacacaagg- ′), reverse primer ( ′-ccacyaaygttcttttgcabaca- ′), and probe ( ′-hex-agcctaccttgayaagcartcagacactc-iabkfq- ′) targeting the zikv envelope gene as we previously described were used (chan et al., b) . reactions were incubated at °c for min, followed by °c for min, and then thermal cycled for cycles ( °c for s, °c for s). internal control β-actin gene was measured by using quantinova sybr green rt-pcr kit (qiagen) in lightcycler real-time pcr system. μl of purified tna was amplified in a μl-reaction containing μl of × quantinova sybr green rt-pcr master mix, . μl qn sybr green rt-mix, . μm forward primer ( ′-acggccaggtcatcactattg- ′) and . μm reverse primer ( ′-caagaaggaaggctggaaaag- ′) for the β-actin gene. reactions were incubated at °c for min, followed by °c for min, and then thermal cycled for cycles ( °c for s, °c for s). a series of -fold dilutions equivalent to × to × copies/reaction mixture were prepared to generate standard curves and run in parallel with the test samples. all data were analyzed with graphpad prism software (graphpad software, inc). kaplan-meier survival curves were analyzed by the log rank test, and weight losses were compared using two-way anova. student's t-test was used to determine significant differences in virus titers, and tukey-kramer post hoc tests were used to discern differences among individual treatment groups as previously reported rossi et al., ) . p-values b . were considered statistically significant. to establish a novel mouse model for zikv infection, we compared the clinical, histological, and virological findings of male (group ) and female (group ) mice with dexamethasone immunosuppression and zikv inoculation with those of the appropriate controls (groups to ) (table ). in terms of the clinical parameters, the dexamethasone-immunosuppressed mice developed mild (~ %) weight loss (fig. a) and no mortality at dpi ( fig. b and c) . the weight losses of the dexamethasone-immunosuppressed mice with zikv inoculation (groups and ) table eleven groups of mice receiving different regimens of virus inoculation, dexamethasone, and antiviral treatment in this study a . group gender routes and inoculum of zikv ( dpi) dexamethasone antiviral treatment b date of sacrifice/euthanasia m ip × tcid mg/kg q h ip, from days before to dpi inclusively no (n = ) and (n = ) dpi c f ip × tcid mg/kg q h ip, from days before to dpi inclusively no (n = ) and (n = ) dpi m ip × tcid no no (n = ) and (n = ) dpi f ip × tcid no no (n = ) and (n = ) dpi m no mg/kg q h ip, from days before to dpi inclusively no (n = ) and (n = ) dpi f no mg/kg q h ip, from days before to dpi inclusively no (n = ) and (n = ) dpi no (n = ) dpi m ip × tcid mg/kg q h ip, from days before to dpi inclusively no (n = ) dpi m ip × tcid mg/kg q h ip, from days before to dpi inclusively pegylated ifn-α b iu/dose q h sc at , , and dpi (n = ) and (n = ) dpi m ip × tcid mg/kg q h ip, from days before to dpi inclusively ifn-β b , iu/dose q h ip at , , , , and dpi (n = ) and (n = ) dpi abbreviations: dpi, days post-inoculation; f, female; ifn, interferon; ip, intraperitoneal; m, male; sc, subcutaneous. a - week-old balb/c mice were used in all the groups. b the preparations of pegylated ifn-α b and ifn-β b used in this study were pegintron (merck & co., inc., whitehouse station, nj, usa) and betaferon (bayer schering pharma ag, berlin, germany), respectively. c the mice in group were euthanized at dpi as they had ≥ % weight loss and ≥ clinical symptom. were consistently more significant than those of their comparators, including the zikv-inoculated mice without dexamethasone immunosuppression (groups and ) and mock-infected mice without dexamethasone immunosuppression (groups and ) starting at dpi (p b . ). minimal histological changes and inflammatory infiltrates were seen in the tissues of the male and female mice with dexamethasone immunosuppression and zikv inoculation (groups and ). on the other hand, zikv-ns protein expression was detected by immunohistochemical staining in most tissues of these mice, but not in dexamethasone-immunosuppressed mice with mock infection (groups and ), suggesting that the viral protein expression was specific and not related to dexamethasone effects (fig. ) . the dexamethasone-immunosuppressed mice with zikv inoculation (groups and ) also had high mean viral loads in blood and most tissues at dpi, especially in the testis/epididymis, ovary/uterus, prostate, spleen, and pancreas (figs. a and b and s a and b). these findings at dpi were suggestive of disseminated but non-lethal zikv infection involving different organs with minimal inflammatory response due to dexamethasone immunosuppression. to investigate the possible effects of immune reconstitution in the dexamethasone-immunosuppressed mice, dexamethasone was stopped after dpi. this led to prominent weight loss and increased symptoms in the dexamethasone-immunosuppressed mice (groups and ). the most prominent body weight loss was observed in the male mice with dexamethasone immunosuppression and zikv inoculation (group ), with all mice having weight loss of ≥ % at dpi (fig. a) . all of the female mice with dexamethasone immunosuppression and zikv inoculation (group ) also had progressive weight loss and / ( . %) of them had ≥ % weight loss at dpi. in contrast, none of the mice with dexamethasone immunosuppression from days before to days post-infection (group ) developed abrupt weight loss between dpi and dpi (fig. a) . the weight loss of mice in groups and became consistently more than those of their comparators in the other control groups (groups to ), including those in the dexamethasone-immunosuppressed mice with mock infection (groups and ) since dpi (p b . ). together, these findings suggested that the combination of immune reconstitution after dexamethasone withdrawal and disseminated virus infection were responsible for the abrupt clinical deterioration. all of the mice in groups and developed rapid breathing, lethargy, and/or ruffled fur since dpi (group ) or dpi (group ), shortly after dexamethasone was stopped (fig. b) . the reasons for the earlier onset of weight loss and symptoms in the male mice were not fully understood, but might be related to the higher cumulative dose of dexamethasone because of their higher baseline body weights and/or possible effects of androgen on virus replication (tian et al., ) . based on the predefined criteria, all ( %) male and / ( . %) female mice were euthanized at dpi and dpi, respectively (fig. c) . comparatively, all the mice in the other control groups (groups to ) had either gained weight or had b % weight loss with spontaneous recovery at dpi (fig. a) , remained asymptomatic (fig. b) , and survived through the study period (fig. c) . at euthanasia ( - dpi), h&e staining of the necropsied tissues of these mice showed prominent acute inflammatory reactions with predominantly lymphocytic infiltrates. the most prominent inflammatory changes were seen in the brain (cortical parenchymal and perivascular lymphocytic infiltrates) (fig. a to c), kidney (acute tubulitis and interstitial inflammation) (fig. d to f), and testis (necrotic and hemorrhagic seminiferous tubules with marked lymphocytic infiltration in the perimeter of the tubules and the interstitium) (fig. a to d) . zikv-ns protein expression was still visible, but to a lesser degree, in the immunohistochemical staining of the testis/epididymis, ovary/uterus, kidney, spleen, small intestine, pancreas, and salivary gland of the dexamethasone-immunosuppressed mice with zikv inoculation at - dpi compared with dpi. in contrast, no inflammatory reaction and viral protein expression were seen in any organ of the control mice with zikv inoculation alone (groups and ) or dexamethasone immunosuppression alone (groups and ) ( fig. c and d) . these findings confirmed that mice with zikv inoculation but no dexamethasone immunosuppression were not susceptible to infection as previously reported, and that the histological changes in the model mice (groups and ) were unrelated to dexamethasone-induced effects such as drug-induced testicular toxicity (lazear et al., ; dowall et al., ; aliota et al., ; rossi et al., ; khorsandi et al., ) . the absence of inflammatory infiltrates in zikv-inoculated, dexamethasone-immunosuppressed mice without dexamethasone withdrawal (group ) supported the role of the host immune response in eliciting the clinical and histological changes in the zikv-inoculated mice with dexamethasone withdrawal (groups and ). to further confirm the presence of inflammatory infiltrates and characterize the cell types involved in the host immune response, we stained the necropsied testis of the dexamethasone-immunosuppressed mice with zikv inoculation and those of the dexamethasoneimmunosuppressed mock-infected control mice with cd (pan-leukocyte) and cd (cytotoxic t lymphocyte) antibodies. corroborative to the histological findings, only the testis of the dexamethasone-immunosuppressed mice with zikv inoculation, but not those of the control mice, stained positive for cd ( fig. e and f) and cd antibodies ( fig. g and h). these findings confirmed the presence of inflammatory infiltrates and especially cd + t lymphocytes in the testis of the zikv-infected mice. the dexamethasone-immunosuppressed mice with zikv inoculation (groups and ) also had significantly lower mean viral loads in blood and most tissues at euthanasia at - dpi as compared with those collected at dpi (↓ - log copies/ β-actin at - dpi) (figs. a and b and s a and b). at euthanasia ( - dpi), viral rna was still detectable in most tissues of the male mice (up to log copies/ β-actin), but viremia was absent. the control mice with zikv inoculation but no dexamethasone immunosuppression had undetectable viral rna in blood and most tissues, which was consistent with previous reports (lazear et al., ; dowall et al., ; aliota et al., ; rossi et al., ) . overall, these findings were suggestive of multi-organ inflammation upon immune reconstitution with partial viral clearance in the mice after withdrawal of dexamethasone immunosuppression. we next evaluated the effects of recombinant type i interferon treatment in our mouse model. we used male mice as they had earlier onset of weight loss and clinical symptoms requiring necropsy at dpi. the mice were treated with pegylated interferon-α b (pegintron®, merck & co., inc., whitehouse station, nj, usa) iu/dose every h subcutaneously at dpi, dpi, and dpi (group ) or interferon-β b (betaferon®, bayer schering pharma ag, berlin, germany) , iu/dose every h intraperitoneally at dpi, dpi, dpi, dpi, and dpi (group ). as shown in fig. a , the mice treated with pegylated interferon-α b (group ) or interferon-β b (group ) had b % weight loss with spontaneous recovery at dpi. the weight loss of the untreated group became significantly more than those of the mice treated with either interferon-α or interferon-β b starting at dpi (p b . ). all of these mice remained asymptomatic and survived through the study period ( fig. b and c) . none of their tissues showed prominent inflammatory reactions in h&e staining at dpi or dpi. zikv-ns protein expression was only rarely seen in the immunohistochemical staining of the testis/epididymis, kidney, spleen, small intestine, lung, and pancreas collected at dpi, and testis, epididymis, kidney, and spleen at dpi. they had reduced mean viral loads in blood and all the tissues (↓ - log copies/ β-actin) as compared with those of the untreated mice at dpi and dpi ( fig. a and b) . the reductions were most significant in the tissues with high viral loads, such as the spleen, testis, pancreas, and prostate (p b . ). overall, these findings suggested that early use of systemic recombinant type i interferons improved the clinical, histological, and virological parameters of mice with disseminated zikv infection. the full spectrum of clinical manifestations and complications of zikv infection remains incompletely understood as of today. the previous assumption that zikv infection is an entirely self-limiting disease without severe or long-lasting sequelae has been overturned by the increasing recognition of congenital malformations, neurological complications, immune-mediated thrombocytopenia, and even fatality in some immunosuppressed patients (pan american health organization/ a b fig. . viral loads in the blood and major organs of dexamethasone-immunosuppressed balb/c male and female mice with zikv inoculation. mice ((a) male ( dpi, n = from two independent experiments; dpi, n = from two independent experiments) and (b) female ( dpi, n = from two independent experiments; dpi, n = from two independent experiments)) with dexamethasone immunosuppression had higher blood and tissue viral loads at dpi while they were on dexamethasone than at euthanasia ( dpi for male mice and dpi for female mice) after dexamethasone was stopped ( dpi). zikv rna copies in the blood and tissues of the mice were determined by real-time rt-pcr and normalized by β-actin as described in the text. * denotes p-values of b . . *** denotes p-values b . . error bars represent standard error of the mean. world health oganization (paho/who), ; sarmiento-ospina et al., ; arzuza-ortega et al., ; duijster et al., ) . notably, patients with severe non-pregnancy-related complications of zikv often deteriorated suddenly after an initially mild disease phase as the viral load began to decrease (cao-lormeau et al., ; mecharles et al., ; sarmiento-ospina et al., ) . this has led us to hypothesize that, like many other flavivirus infections, including yellow fever, dengue, and west nile virus infection, the host immune response may also play a role in these zikv-associated complications, especially during the viral clearance phase by the host immune system (quaresma et al., ; screaton et al., ; wang et al., ) . in this study, we characterized a novel and readily available mouse model for severe zikv infection which attempts to provide an alternative venue for studying the host immune response of and evaluating countermeasures for zikv infection. the findings in our study have important implications on the pathogenesis, potential complications, and treatment of zikv infection. the dexamethasone-immunosuppressed mice with zikv inoculation in our study developed disseminated infection with viremia and multi-organ involvement, including the brain, urogenital tract, intestine, liver, spleen, pancreas, heart, lung, and salivary gland as evident by zikv-ns protein expression on immunohistochemical staining and/or detectable viral load in these tissues. immunohistochemistry staining of the testis confirmed the presence of inflammatory cell infiltrate (pan-leukocyte marker cd +) with predominantly cd + t lymphocytes. clinically, the male mice developed earlier onset of disease than the female mice, with ≥ % weight loss and ≥ clinical sign, which warranted euthanasia at dpi. their weight loss, clinical scores, and histological evidence of inflammatory reactions were most severe soon after dexamethasone withdrawal, when viral loads had already decreased by about - log copies/ β-actin. overall, these findings suggested that, like the other related flaviviruses, the host immune response might have led to marked clinical deterioration in the face of disseminated zikv infection at the time when immune-mediated clearance of the virus began. our findings provided an additional explanation for the pathogenesis of fatal zikv infection, which has been proposed to be related to uncontrolled virus dissemination in previously described mouse models utilizing types i/ii interferon-signaling-/receptor-deficient mice that were unable to mount a robust host innate immune response. our mouse model is also useful for studying zikv's tissue tropism and potential complications of severe zikv infection. in addition to the reported findings of detectable virus particles and/or rna in the brain, spinal cord, kidney, spleen, liver, testis, ovary, heart, lung, muscle, and blood of types i/ii interferon-signaling-/receptor-deficient mice with zikv infection, our study identified intestine, pancreas, and salivary gland as other possible tissues and anatomical sites for virus infection (dick, ; lazear et al., ; dowall et al., ; aliota et al., ; rossi et al., ) . this tissue tropism of zikv in our mouse model concurs with the in-vitro observation that zikv efficiently replicates in diverse cell types of neuronal, testicular, prostatic, renal, intestinal, hepatic, and placental origin (chan et al., b; brault et al., ; hughes et al., ) . such degree of virus dissemination and multiorgan involvement is also compatible with the clinical findings in patients with severe and/or fatal zikv infection, in whom viral particles and/or rna were detected in multiple organs at post-mortem examination (pan american health organization/world health oganization (paho/who), ; sarmiento-ospina et al., ; arzuza-ortega et al., ) . while inflammatory neurological complications, such as guillain-barré syndrome, meningoencephalitis, and myelitis, have been recently reported in patients with zikv infection, inflammatory disorders of the other non-neuronal tissues were not well recognized (cao-lormeau et al., ; carteaux et al., ; mecharles et al., ) . our findings showed that inflammation could be observed in multiple organs including the testis, kidney, spleen, liver, intestine, pancreas, lung, and salivary gland outside the nervous system. among these non-neuronal tissues, the inflammatory reactions were most prominent in the testis of our model mice. some patients with zikv infection reported hematospermia, pelvic pain, and dysuria with detectable viral particles and/or rna in their semen (chan et al., a; musso et al., a; foy et al., ) . histological evidence of orchitis has not been reported due to the difficulty in obtaining the patients' testicular tissues for histological examination. previous mouse fig. . representative histological findings in the brain and kidney of dexamethasone-immunosuppressed balb/c mice with zikv inoculation and dexamethasone-immunosuppressed mock-infected control mice. the brain and kidneys of all sacrificed mice were examined. each organ was entirely embedded in one paraffin block, and one full-face paraffin section at the maximum diameter of each organ was examined per block. sections of the brain ( dpi) of a dexamethasone-immunosuppressed mouse with zikv inoculation showing (a) moderate degree of perivascular lymphocytic infiltrate and (b) marked lymphocytic infiltration in the cortical parenchyma (h&e, original magnification × ). section of the brain ( dpi) of dexamethasone-immunosuppressed mock-infected mouse showing normal architecture in the parenchyma (c) (h&e, original magnification × ). sections of the kidney ( dpi) showing (d) acute tubulitis with a large amount of inflammatory exudation in tubular lumens and (e) moderate degree of interstitial inflammation (h&e, original magnification × ). (f) section of the kidney ( dpi) of a dexamethasone-immunosuppressed mock-infected mouse showing normal architecture (h&e, original magnification × ). models for zikv infection utilizing types i/ii interferon-signaling-/receptor-deficient mice have also showed that viral particles and rna could be detected in the mice's testes, but histological analysis were not reported (lazear et al., ) . the markedly necrotic and hemorrhagic seminiferous tubules observed in our mice are highly alarming as orchitis may have long-term effects on fertility. these changes were not accountable by dexamethasone-induced testicular toxicity, as they were morphologically different from the latter, and were not present in any of the testes of the control mice with dexamethasone treatment and mock infection (khorsandi et al., ) . during revision of this work, similar findings were reported in the testes of c bl/ mice treated with anti-ifna blocking monoclonal antibody and inoculated with zikv . clinical studies to confirm the presence of orchitis and to assess the fertility of convalescent male patients should be conducted to ascertain the long-term consequences of zikv infection regarding reproductive and hormonal derangements. inflammation of other organs, such as acute tubulitis, interstitial nephritis, sialadenitis, hepatitis, enteritis, and acute pancreatitis have been reported in patients with zikv or other flavivirus infections (chan et al., a; sarmiento-ospina et al., ; arzuza-ortega et al., ; duijster et al., ; bonaldo et al., ; gourinat et al., ; musso et al., b; mercado et al., ; bhagat et al., ; torres et al., ; macnamara, ; chatterjee et al., ) . these potential complications may be increasingly recognized as the zikv epidemic continues to expand into developed countries with a large ageing and immunosuppressed population. finally, our mouse model also provided a novel avenue for the evaluation of anti-zikv treatment. type i interferons have broad-spectrum antiviral activities including those against zikv, but type i interferonsignaling-/receptor-deficient mice were not suitable for evaluation of the effects of recombinant type i interferons. we therefore evaluated the antiviral effects of two commercially available preparations of recombinant type i interferons in this new mouse model (hamel et al., ; zumla et al., ; chan et al., ; chan et al., b) . we showed that the early use of either drug was associated with improved clinical outcome with no fatality ( % fatality in untreated mice), markedly decreased inflammatory response after dexamethasone withdrawal, and reduced viral loads in various tissues of the mice as compared to those of the untreated mice. the viral load reductions were especially significant in the early phase of the disease ( dpi), when the mice were on dexamethasone. these findings suggested that the early use of recombinant interferons might help to control viral replication during the initial phase of infection, and prevent the subsequent development of severe complications related to an exaggerated immune response in the presence of high viral loads as seen in the untreated mice. it is important to further confirm these results in our mouse model using different zikv strains and in clinical trials because zikv antagonizes mouse stat less efficiently than human stat , and thus may be more susceptible to type i interferons in mice (grant et al., ) . while most patients with mild zikv infection may not require systemic interferon treatment, clinical trials should be considered to evaluate the benefits of the early use of interferon treatment in patients at risk of developing severe zikv-associated complications, such as those with underlying comorbidities (sarmiento-ospina et al., ) . the increased risk of fetal loss and low birth weight associated with interferon therapy in the first trimester of pregnancy may be outweighed by the risk of congenital malformations due to zikv infection. the optimal timing of treatment commencement should be further investigated as late commencement of interferon treatment may be useless or deleterious and should be avoided (solomon et al., ) . in summary, this novel mouse model is useful for investigating host immune response-associated damage of and evaluating countermeasures for zikv infection. inflammation of different visceral organs may be important complications of zikv that should be further studied in infected humans. long-term monitoring of the testicular function of zikvinfected male patients should be considered. clinical trials should be , inc., whitehouse station, nj, usa) iu/dose every h subcutaneously at dpi, dpi, and dpi or interferon-β b (betaferon®, bayer schering pharma ag, berlin, germany) , iu/dose every h intraperitoneally at dpi, dpi, dpi, dpi, and dpi. no interferon treatment group (n = ), interferon-α b treatment group (n = ), and interferon-β b treatment group (n = ). results were combined from two independent experiments. p-values b . are indicated by (no interferon treatment versus interferon-α b treatment) and * (no interferon treatment versus interferon-β b treatment). abbreviation: ifn, interferon. clinical scores: normal = ; ruffled fur = ; lethargy, pinched, hunched, wasp waisted = ; labored breathing, rapid breathing, inactive, neurological = ; and immobile = . considered for evaluating the effects of recombinant interferon treatments in patients at high risk for zikv-associated complications when the potential benefits may outweight the side effects of treatment. supplementary data to this article can be found online at http://dx. doi.org/ . /j.ebiom. . . . jfwc, ajz, ccsc, and kyy designed the study. ajz, ccsc, hz, and vkmp performed infections. ccyy, jolt, kkhc, and khc prepared virus stocks and viral titrations. ajz, wwnm, vkmp, and rkhay prepared histology and immunohistochemistry slides. ccyy, kmt, zz, and jpc performed viral load studies. jfwc, ajz, rkhay, vkmp, and kyy acquired images at the microscope, analyzed, and quantified the data. fy, khk, dyj provided technical assistance and edited the manuscript. jfw, ajz, and kyy wrote the manuscript. jasper f.w. chan has received travel grants from pfizer corporation hong kong and astellas pharma hong kong corporation limited, and was an invited speaker for gilead sciences hong kong limited. the other authors declared no conflict of interests. the funding sources had no role in study design, data collection, analysis or interpretation or writing of the report. the corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. we are grateful to can li, andrew chak-yiu lee, and shuofeng yuan for their facilitation of the study. this work was partly supported by the donations of larry chi-kin yung, and hui hoy and chow sin lan charity fund limited; and funding from the consultancy service for enhancing α β α β a b fig. . viral loads in the blood and major organs of dexamethasone-immunosuppressed balb/c mice with zikv inoculation with or without recombinant type i interferon treatment. male mice with interferon-α b or -β b treatment had reduced zikv blood and tissue viral loads as compared to untreated mice at (a) dpi (n = per group from two independent experiments) and (b) dpi (n = - per group from two independent experiments). zikv rna copies in the blood and tissues of the mice were determined by real-time rt-pcr and normalized by β-actin as described in the text. * denotes p-values of b . . error bars represent standard error of the mean. protective efficacy of multiple vaccine platforms against zika virus challenge in rhesus monkeys characterization of lethal zika virus infection in ag mice fatal sickle cell disease and zika virus infection in girl from colombia zika virus infection of the central nervous system of mice acute glomerulonephritis in dengue haemorrhagic fever in the absence of shock, sepsis, haemolysis or 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americas immunity and immune response, pathology and pathologic changes: progress and challenges in the immunopathology of yellow fever characterization of a novel murine model to study zika virus zika virus associated deaths in colombia new insights into the immunopathology and control of dengue virus infection interferon alfa- a in japanese encephalitis: a randomised double-blind placebo-controlled trial enhancement of hepatitis b virus replication by androgen and its receptor in mice acute parotitis due to dengue virus cd + t cells mediate recovery and immunopathology in west nile virus encephalitis comparative studies of some african arboviruses in cell culture and in mice zika virus: further isolations in the zika area, and some studies on the strains isolated zika situation report toll-like receptor agonist imiquimod in combination with influenza vaccine expedites and augments humoral immune responses against influenza a(h n )pdm virus infection in balb/c mice delayed antiviral plus immunomodulator treatment still reduces mortality in mice infected by high inoculum of influenza a/ h n virus active replication of middle east respiratory syndrome coronavirus and aberrant induction of inflammatory cytokines and chemokines in human macrophages: implications for pathogenesis comparative genomic analysis of pre-epidemic and epidemic zika virus strains for virological factors potentially associated with the rapidly expanding epidemic coronaviruses -drug discovery and therapeutic options key: cord- -r wkx ml authors: jacobs, sophie; wavreil, fanny; schepens, bert; gad, hans henrik; hartmann, rune; rocha-pereira, joana; neyts, johan; saelens, xavier; michiels, thomas title: species specificity of type iii interferon activity and development of a sensitive luciferase-based bioassay for quantitation of mouse interferon-λ date: - - journal: j interferon cytokine res doi: . /jir. . sha: doc_id: cord_uid: r wkx ml the type iii interferon (ifn-λ) family includes ifn-λ subtypes in man. in the mouse, only the genes coding for ifn-λ and -λ are present. unlike mouse and human type i ifns (ifn-α/β), which exhibit strong species specificity, type iii ifns were reported to act in a cross-specific manner. we reexamined the cross-specificity and observed that mouse and human ifn-λ exhibit some species specificity, although much less than type i ifns. mouse ifn-λ displayed clear species specificity, being -fold less active in human cells than the closely related mouse ifn-λ . this specificity likely depends on amino acids in α helices a and f that diverged from other ifn-λ sequences. human ifn-λ , in contrast, retained high activity in mouse cells. we next developed a firefly luciferase-based reporter cell line, named fawa-λ-luc, to detect ifn-λ in biological fluids with high specificity and sensitivity. fawa-λ-luc cells, derived from mouse epithelial cells that are responsive to ifn-λ, were made nonresponsive to type i ifns by inactivation of the ifnar gene and strongly responsive to ifn-λ by overexpression of the mouse ifnlr . this bioassay was as sensitive as a commercially available enzyme-linked immunosorbent assay in detecting mouse ifn-λ in cell culture supernatant, as well as in serum and bronchoalveolar lavage samples of virus-infected mice. the assay also enabled the sensitive detection of human ifn-λ activity, including that of the divergent ifn-λ with a bias, however, due to variable activity of ifn-λ subtypes. t ype i and iii interferons (ifns) are typically produced in response to viral infection, and these cytokines induce an antiviral state in target cells (isaacs and lindenmann ; kotenko and others ; sheppard and others ) . type i ifns consist of ifn-a subtypes and ifn-b, -o (human) , and -z (mouse) -e and -k. the type iii family of ifns in humans comprises functional genes that express ifn-l (il- ), ifn-l (il- a), and ifn-l (il- b) (kotenko and others ; sheppard and others ) . a fourth ifn-l subtype (ifn-l ) is present in a part of the human population, depending on a dinucleotide frameshift polymorphism upstream of the ifnl gene, which creates or disrupts the open reading frame (orf) encoding ifn-l (prokunina-olsson and others ) . in the mouse, ifnl is a pseudogene, and only ifn-l and ifn-l are expressed. unlike mouse and human type i ifns that exhibit strongly species-specific activity (veomett and veomett ) , type iii ifns were reported to act on cell types from both origins (lasfar and others ; hermant and others ) . the type i ifn family members signal through a unique heterodimeric receptor (ifnar), composed of the ifnar and ifnar subunits. type iii ifns engage a distinct receptor (ifnlr), composed of chains: the ifn-l-specific ifnlr , and il rb which is shared by other il -related cytokines (kotenko and others ; sheppard and others ) . while ifnar is ubiquitously expressed, ifnlr is expressed by a restricted range of cell types and mostly acts at mucosal surfaces. epithelial cells are well-established targets of ifn-l in vivo (sommereyns and others ) , although some immune cells such as neutrophils and dendritic cells have been characterized as ifn-l responders (koltsida and others ; blazek and others ; broggi and others ; espinosa and others ) . although type i and type iii ifns act on distinct receptors, they activate a similar jak-stat transduction pathway, leading to the phosphorylation of stat and stat that associate with irf to form the isgf complex. type i and type iii ifn signaling leads to the transcription of an overlapping set of ifn-stimulated genes (isgs) (dumoutier and others ; ank and others ) . type i ifn in biological samples can be measured by a variety of bioassays, but efficient techniques for type iii ifn quantification are largely lacking. enzyme-linked immunosorbent assay (elisa) for ifn-l detection is time and cost intensive and fails to detect ifn-l . conventional cytopathic effect reduction bioassays to quantify antiviral activity as a proxy for the presence of ifn require the manipulation of infectious virus. luciferase reporter cells that have previously been used for recombinant human ifn-l detection were still responsive to type i ifn and would not allow specific ifn-l detection from biological samples (uze and monneron ) . in this work, we reexamined the species specificity of ifn-l activity, and we developed a very sensitive luciferase-based bioassay specific for type iii ifn detection. the lkr cell line (kind gift from guido bommer, de duve institute, brussels, belgium) is derived from lung adenocarcinoma tissues from a k-rasla mouse ( johnson and others ) . a cells (atcc) were kindly provided by pierre coulie, balb/ t fibroblasts (aaronson and todaro ) those cells, and derivatives, were maintained in dulbecco's modified eagle's medium (dmem) (lonza, vervier, belgium) containing . g/l glucose, supplemented with % fetal calf serum (fcs) (sigma-aldrich, overijse, belgium). african green monkey kidney (vero) cells (atcc) were cultured in dmem supplemented with % fcs, nonessential amino-acid, l-glutamine, and sodium pyruvate. bhk- cells (atcc) were cultured in glasgow's minimum essential medium (gibco; thermo fisher scientific, asse, belgium) supplemented with % newborn calf serum and . g/l tryptose phosphate broth. all media were supplemented with u/ml penicillin and mg/ml streptomycin (lonza). expression vectors used in this study are listed in table . plasmids psj and psj are pcdna derivatives (invitrogen; thermo fisher scientific) used for mouse ifn-l and ifn-l expression in t cells. these plasmids were constructed by cloning the orf encoding ifn-l (psj ) and between the bamhi and xbai sites of the vector. coding sequences were polymerase chain reaction (pcr)-amplified from liver cdna samples of a c bl/ mouse infected with influenza turh (h /n ) strain (hermant and others ) , using the following primers: forward (fw): bamhi-agei-kozak-mifn-l / , ¢-aaa agg atc cac cgg tgc cac cat gct cct cct gct gtt gcc tct g- ¢; reverse (rev): mifn-l / -stop-xbai, ¢-aaa atc tag att atc aga cac act ggt ctc cay tgg c- ¢. the sequence of psj matches the genomic ifnl sequence but diverges from a few nucleotides from that of the previously constructed pcs plasmid (sommereyns and others ) . both plasmids encode functional ifn-l . pph was obtained by pcr-cloning the ifna orf from hela-m cell cdna, between the ecori and noti sites of pcdna (fw: ecori-kozak-ifna , ¢-aaa aga att cac cat ggc ctt gac ctt tgc ttt- ¢; rev: ifna - noti, ¢-aaa agc ggc cgc tca ttc ctt act tct taa act tt- ¢). pmk is a lentiviral vector, derived from ptm , that carries the mouse mx gene promoter driving the expression of the firefly luciferase gene. it is derived from pcclsin. cppt.hpgk.gfp.pre (follenzi and others ) in which a cloning polysite was first inserted to replace the coding sequences, yielding ptm . the firefly luciferase gene from pgl . (promega) was inserted between the xhoi and xbai sites of the vector, and the mx promoter was then cloned from pbsk-mx , a gift from peter staeheli (freiburg university, freiburg, germany), as a bamhi/bsabi fragment. the lentiviral vector psj , used for expression of the mouse ifn-l receptor, was obtained by cloning the ifnlr orf between the bamhi and xbai sites of ptm , a lentiviral vector allowing the coexpression of the cloned gene and of mcherry (hermant and others ) . the ifnlr orf sequence was subcloned in this plasmid from pcr . -licr , kindly provided by laure dumoutier (de duve institute, brussels, belgium). gene inactivation was done with px plasmid (pspcas n- a-gfp) coding for the cas nickase and green fluorescent protein (gfp) (ran and others a). the single guide rnas (sgrnas) were designed using the mit clustered regularly interspaced short palindromic repeats (crispr) design tool website (http://crispr.mit.edu). the selected sgrna pair (sgrna -fw: ¢-cac cgt caa att ctg gcg gct caa g- ¢; rev: ¢-aaa cct tga gcc gcc aga att tga c- ¢; sgrna -fw: ¢-cac cga gac cac ata aac gtg acg a- ¢; rev: ¢-aaa ctc gtc acg ttt atg tgg tct c- ¢) was targeting exon of the mouse ifnar gene (genbank: y . ) and exhibited no expected off-target cleavage site. the sgrnas were cloned into px to form the plasmids psj and psj . these constructs were cotransfected in lkr cells, using transit Ò -lt transfection reagent (mirus bio llc, madison), according to the manufacturer's instructions. after h, gfp-positive cells were sorted by fluorescence activated cell sorting (facs aria iii; bd biosciences) and cloned in -well plates. clones were screened for loss of type i ifn response with an antiviral assay. genome editing of the targeted exon was further confirmed by sequencing (genewiz). isg expression was measured by reverse transcriptionquantitative pcr. ifnar -knockout (ko) and wild-type (wt) lkr cells were treated with u/ml mouse ifn-aa, pg/ml mouse ifn-l , or control supernatant (mock) for h before rna extraction. total rna extraction, reverse transcription, and sybr green quantitative pcr for mrna encoding mouse b-actin, oasl , and usp were performed as previously described (paul and michiels ) . for infection analysis, cells were dissociated with trypsin-edta and suspended in phosphate-buffered saline (pbs) containing % of filtered fcs and . % of paraformalde-hyde. data acquisition was done with an lsrfortessa flow cytometer (bd biosciences) using facsdiva software. data were analyzed using flowjo . . . the rate of infection was defined as the percentage of mcherry-positive cells h postinfection with . pfu/cell tm . for cell sorting, transduced cells were suspended in pbs containing % fcs and mm edta. mcherry-or gfppositive cells were cloned at cell per well in -well plates using the facs aria iii (bd biosciences). immunoblotting stat , p-stat , and b-actin were detected by western blot using sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels containing % acrylamide and run in a tris-glycine buffer. blots were probed with anti-stat polyclonal (sc- ; santa cruz biotechnology, heidelberg, germany), p-stat monoclonal (# ; cell signaling technology, leiden, the netherlands), and anti-b-actin monoclonal (a ; sigma-aldrich) antibodies. mouse ifn-aa, ifn-b, ifn-l , ifn-l , and human ifn-a were produced as described previously from t cells transfected with pcdna -ifn-aa, pcdna -ifn-b (van pesch and others ), pcdna -ifn-l (psj ), and pcdna -ifn-l (psj ). human ifn-a was produced similarly, using pcdna -ifn-a (pph ). supernatant collected from t cells transfected in parallel with the empty pcdna vector was used for control treatment (mock) of cells and diluted as for ifns. recombinant mouse ifn-l ( -ml- ) and human ifn-l ( -il- ), ifn-l ( -il- ), and ifn-l ( -il- ) were purchased from r&d (r&d systems, minneapolis). recombinant human ifn-l was produced as described (hamming and others ) . mouse (ref - ) and human (ref - ) ifn-g were purchased from pe-protech (london, united kingdom). genbank accession numbers for mouse and human ifn-l are listed in table . ifns were diluted in culture medium for cell treatment or in reagent diluent for elisa. mouse ifn-l and ifn-l were quantified by elisa. mouse ifn-aa and human ifn-a antiviral activities were quantified, as described previously, by a cytopathic effect reduction assay in mouse balb- t and human hela-m cells, respectively, using mengovirus (van pesch and michiels ) . similar assays were conducted in human a cells and mouse lkr cells for quantification of ifn-l cross-species activity. ifn- l was quantified by a cytopathic effect reduction assay in a cells, using recombinant human ifn-l as a standard, which was reported to have a similar specific activity (hamming and others ). mouse ifn-l / measurement by elisa was performed using the mouse ifn-l / duoset (r&d systems), according to the manufacturer's protocol. mouse sera were diluted -to -fold, and bronchoalveolar lavage fluids (balfs) were diluted -fold. when required (in case of samples derived from infected cells or mice), infectious virus present in biological samples was ultraviolet light (uv)-inactivated. for uv inactivation, . mm thick fluid samples were exposed at fixed uv dose ( . - . - - j/cm ) with the uv irradiation system biolink (vilber lourmat, eberhardzell, germany), either in -( ml) or in -well ( ml) plate. uv-exposed samples were titrated on bhk- cells by a standard plaque assay to confirm virus inactivation. to confirm that the uv irradiation procedure that was established for picornaviruses effectively inactivates respiratory syncytial virus (rsv), samples of ml containing . · pfu of rsv were exposed to j/cm with the uv irradiation system bio-link at room temperature in a -well plate (uv irradiated samples). as controls similar samples of ml containing . · pfu of rsv were incubated at room temperature in a -well plate (untreated samples). the titers of replicating rsv in the uv irradiated and untreated samples were determined by plaque assay using vero cells. cells were seeded at , cells per well in -well plates for cell supernatant and recombinant ifn analysis or at , cells per well in -well plates for mouse serum and bal analysis. forty-eight hours after seeding, cells were treated with ifn-l / or mock-treated or incubated with uv-treated mouse serum ( -and -fold dilutions) or bal ( -fold dilutions). samples were diluted in culture medium. recombinant mouse ifn-l provided in the elisa kit was used as a standard. firefly luciferase activity was measured h after treatment using the luciferase assay system (promega). twenty microliters and -ml lysis buffer were used in -and -well plates, respectively; ml of the lysate was mixed with ml of substrate for detection. luminescence was measured with a glomax / luminometer (promega). the limit of detection (lod) for each test was established based on the mean of mock-treated samples, plus standard deviations, in all assays. tm is a theiler's murine encephalomyelitis virus (tmev) (strain da) derivative that carries a capsid adapted to infect l cells and the orf encoding the mcherry fluorescent protein cloned as a xbai/bsiwi fragment to replace codons - of the leader protein coding region, in the pkj vector ( jnaoui and michiels ) . mengovirus (a strain of encephalomyocarditis virus) used for ifn bio-assay is an attenuated variant that has been described previously (hermant and others ) . those viruses were quantified by plaque assay on bhk cells. rsv propagation and enrichment were performed as described in schepens and others (schepens and others ) . mouse experiments were conducted according to the national (belgian law / / and / / , belgian royal decree / / ) and european (eu directives / /eu, / /eeg) animal regulations. animal protocols were approved by the ethics committee of ghent university (permit no. la , approval id - ). all efforts were made to avoid or ameliorate suffering of animals. specific pathogen-free female balb/c mice at the age of - weeks were purchased from charles river. the mice were housed in a specific-pathogen-free temperature controlled environment with -h light/ -h dark cycles and given water and food ad libitum. mice were used at weeks of age after adaptation in the animal room for week. for challenge, the mice were sedated with isoflurane and infected intranasally with · pfu of human rsv. mock infection of the control group was performed with hank's balanced salt solution. five days postinfection, bal was isolated under anesthesia with an intraperitoneal injection of avertin ( . % in pbs). a gauge cannula was inserted into the trachea, and cells were collected by washing the airway lumen twice with . ml pbs containing . mm edta. after removing the cells by centrifugation ( min at g), the balf was stored at - °c. serum samples from norovirus-infected and plasmidelectroinjected mice were reused from a previously published experiment (rocha-pereira and others ) to minimize animal experimentation. statistical analysis was performed using prism software (graphpad software, san diego, ca). [***p < . , **p < . , *p < . , and ns no statistically significant difference (p ‡ . )]. unlike mouse and human type i ifns (ifn-a/b) that exhibit strong species specificity, type iii ifns were reported to act in a cross-species manner. to confirm whether a mouse cellbased bioassay would permit the detection of ifn-l subtypes from different mammalian species, the species specificity of mouse and human type iii ifns was reexamined. crossreactive antiviral activity was systematically compared in a cytopathic effect reduction assay, using epithelial cell lines from mouse (lkr ) and human (a ) origin. as expected, type i human (ifn-a ) and mouse (ifn-aa) ifns were extremely species-specific in the antiviral assay, with an activity difference higher than , -fold when applied to mouse and human cells. ifn-l exhibited some level of species specificity although much less than type i ifns (fig. a) . mouse ifn-l displayed the most pronounced species specificity. for a quantity that yielded the same antiviral activity in mouse cells, ifn-l was times less active in human cells than the closely related mouse ifn-l . human ifn-l , ifnl- and, to a lesser extent, ifnl- exhibited significant antiviral effect on mouse epithelial cells. as ifn-l has been shown to have a specific activity similar to that of human ifn-l in human cells, it was quantified accordingly using the antiviral assay (hamming and others ) . remarkably, human ifn-l displayed much more antiviral activity on mouse cells than equivalent amounts of human ifn-l . accordingly, treatment of lkr cells with concentrations of human ifn-l and ifn-l that yielded equivalent antiviral activities in human cells resulted in clear stat phosphorylation after ifn-l but not after ifn-l treatment (fig. b) . in line with their epithelial origin, mouse lkr cells respond to ifn-l. to ensure a selective detection of type iii ifns, the gene coding for the ifnar subunit of the type i ifn receptor was inactivated using the double nickase crispr/crispr-associated (cas) technology (ran and others b). an lkr -ifnar -ko clone was selected for the absence of response to type i ifn and intact response to type iii ifn. sequencing of the targeted exon revealed frameshift mutations in both ifnar alleles, resulting in premature stop codon appearance. in contrast to ifn-l treatment, ifn-a treatment of this clone failed to induce the expression of the ifn-stimulated genes, oasl ( fig. a) and usp (fig. b) , and to protect against infection with tm , a tmev derivative expressing mcherry (fig. c) . to develop ifn-l reporter cells, the lkr -ifnar -ko clone was transduced with a lentiviral vector encoding the firefly luciferase gene under the control of the mx pro-moter. among the clones tested for luciferase activity induction after ifn-l treatment, the best one displayed not more than -fold luciferase activity induction. to try to boost the reporter gene responsiveness to ifn-l, this clone was transduced with sj , a lentiviral vector that coexpresses the mouse ifnlr and mcherry. transduced cells were sorted, based on mcherry expression, and cloned. a selected clone, named ''fawa-l-luc,'' responded vigorously to ifn-l . this clone displayed increased constitutive stat expression and strong stat phosphorylation after ifn-l but not after ifn-a treatment (fig. d) . a significant luciferase activity increase was measured in fawa-lluc cells as soon as h after treatment with pg/ml (quantified by elisa) of mouse ifn-l . maximal induction was reached within h and lasted up to h posttreatment (fig. a) . the sensitivity of the fawa-l-luc assay was compared to that of an available elisa test for mouse ifn-l. mouse ifn-l and - produced by transfected t cells and recombinant mouse ifn-l were quantified in parallel by elisa and the fawa-l-luc assay. in the elisa, responses were linear between , and . pg/ml, the experimental lod of this test (fig. b ). in the fawa-l-luc assay, linearity was reached in a narrower concentration range ( . - . pg/ml for mouse ifn-l ; . - pg/ml for mouse ifn-l ), but a higher sensitivity was observed with the detection limit being below . pg/ml and . pg/ml, for ifn-l and - , respectively (fig. c, d) . based on elisa quantification, mouse ifn-l bioactivity in this assay was -fold higher than that of mouse ifn-l . importantly, after up to passages, the intensity of the luciferase signal in the fawa-l-luc cells tended to decrease, but the sensitivity of the bioassay was preserved because table showing the relative antiviral activity of mouse and human ifn-l on mouse lkr and human a cells. species specificity index was calculated as the ratio between the relative antiviral activity on cells of homologous to nonhomologous species (eg, for mouse ifn: relative activity in mouse cells/relative activity in human cells). relative activities in a given cell line were calculated as the ifn dilutions (starting from ng/ml) that yielded similar antiviral activities. *due to the low amount of ifn-l available, the initial concentration of this ifn was estimated by comparison with human ifn-l antiviral activity that was reported to have a similar specific activity. (b) western blot showing stat phosphorylation in mouse lkr cells min after treatment with control medium (mock) or ifn-l. concentrations of human (hu) ifn-l ( pg/ml) and ifn-l that yielded the same antiviral activity on human a cells were used. as a control, mouse ifn-l was used at a concentration ( . ng/ml) showing equivalent antiviral activity as human ifn-l on mouse cells. results are representative of experiments. the background activity also decreased with high passage numbers. to confirm the specificity of fawa-l-luc cells for ifn-l, we also evaluated any possible luciferase induction after treatment with type i and type ii (ie, ifn-g) ifns. as expected, no signal was observed after treatment with up to , iu/ml of either mouse ifn-aa or ifn-b. human ifn-g also failed to induce a detectable luminescent signal in the fawa-l-luc cells in the tested concentration range ( - ng/ml). the lod for mouse ifn-g was . ng/ml, a concentration at least -fold higher than what is observed in mouse fluids in infectious contexts (pomeroy and others ; claser and others ) . ifn-g is thus not expected to interfere with ifn-l detection in biological samples. we tested the sensitivity of our bioassay for human ifn-l detection. responses were analyzed individually for all human ifn-l subtypes (fig. a-d) . as their cross-species activity differed, different detection sensitivities were reached with our mouse cell-based reporter assay: . pg/ml for ifn-l , pg/ml for ifn-l , . pg/ml for ifn-l , and . pg/ml for ifn-l . the bioassay turned out to be extremely sensitive for human ifn-l detection. it is, however, worth noting that the recombinant ifn-l stock concentration was determined by comparison of its activity with that of a human ifn-l standard. when testing biological samples, potential occurrence of infectious virus may interfere with the viability of reporter cells. it is therefore important to inactivate infectious viruses in such samples. as ifn-l had previously been shown to be acid labile (kugel and others ) , uv inactivation of the virus was preferred. we thus tested whether virucidal uv doses would affect ifn-l activity. to this end, tm virus, mouse ifn-l , and mouse ifn-l were irradiated with increasing uv doses. mock-and uv-exposed samples were then analyzed with the bioassay for mouse ifn-l and ifn-l detection and by plaque assay to determine viral titers. a j/cm uv exposure was sufficient to ensure a virus titer reduction of more than , -fold ( . · pfu to < pfu). at this uv dose, mouse ifn-l activity was not significantly reduced and mouse ifn-l showed a bioactivity reduction of less than % (fig. a) . similarly, ifn-l and ifn-l bioactivities were reduced by %, while human ifn-l and ifnl- were slightly more sensitive to irradiation, with about -fold activity decrease (fig. b) . we then compared the sensitivities of the fawa-l-luc and of the elisa assays to detect ifn-l in mouse serum and bal samples. ifn-l was first quantified in the serum of mice that were either injected intramuscularly with an ifn-l expressing plasmid (pcs ), thus expected to produce circulating ifn-l, or infected with mouse norovirus (rocha-pereira and others ). a preliminary test revealed that the minimal serum dilution that did not interfere with spiked-in ifn-l detection was fold for the bioassay and -fold for the elisa (fig. c, d) with both the fawa-l-luc and elisa assays. ifn-l was clearly detected at day and in the serum of mice that were electroinjected with the ifn-l expressing plasmid, as well as at day postnorovirus infection (fig. a, b) . at day after a single ifn-l injection, the cytokine was detectable in out of mice by elisa and in out of mice by the bioassay. the detection limit was higher for the elisa ( pg/ml) than for the bioassay ( . pg/ml), showing the higher sensitivity of the luciferase-based bioassay (fig. a, b) . next, we compared ifn-l detection by the fawa-l-luc assay and by elisa in balf of balb/c mice that were mock infected or infected with rsv. balf and lungs were collected days postinfection. plaque assay revealed that balf of all infected mice contained between . · and . · pfu/ ml of live replicating virus. the used uv irradiation procedure proved to readily inactivate rsv (rsv titer reduction of more than , -fold; . · pfu to < pfu). five-fold diluted control balf did not modify ifn-l / detection in any of the assays. using -fold dilutions of the balf as in the bioassay, we failed to detect any ifn-l by elisa (fig. c ). in contrast (fig. d) , ifn-l was detected by fawal-luc assay at a very low concentration in the balf of the rsv infected mice ( / ) and not detected in the control group. percentage of ifn-l activity (mean and sd) remaining after uv treatment (n = ) at j/cm . ifn activity was measured in fawa-l-luc cells for ifn concentrations that yielded equivalent luciferase activities ( , rlu) before uv treatment ( pg/ml mifn-l and mifn-l , pg/ml human ifn-l , ng/ml huifn-l , pg/ml huifn-l , and . pg/ml huifn-l ). (c, d) influence of serum dilution on ifn-l detection by fawa-l-luc cells (c) and elisa (d). (c) fawa-l-luc cells were treated in triplicate with fixed doses of and pg/ml mifn-l supernatant and with -fold serial dilutions ( - -fold) of control mouse serum. (d) pg/ml recombinant mifn-l was mixed with -fold serial dilutions of control mouse serum ( . - -fold) before detection by elisa. (a-c) reporter cells were exposed to ifn for h before luciferase assay. student's t-test: */**/***denotes a significant difference in signal compared to no uv exposure (a) or the absence of serum (c). uv, ultraviolet light. we conclude that the fawa-l-luc-based assay described in this study allows to quantify ifn-l from biological samples in a highly sensitive way. we reexamined the species specificity of ifn-l and highlighted a previously overlooked difference in bioactivity between mouse and human type iii ifns. mouse ifn-l displayed a surprising species specificity, with a -fold difference in relative antiviral activity when applied to lkr (mouse) and a (human) cells. this contrasted strongly with the closely related mouse ifn-l ( % amino acid sequence identity), which displayed little species specificity and was times more active in human cells than mouse ifn-l . in contrast, human ifn-l displayed a strikingly strong activity on mouse cells compared to human ifn-l . although ifn-l is not expressed in mouse and rat, it is highly conserved in many mammalian species (key and others ) where it was shown to be cross-reactive. the nonhuman ifn-l orthologs were reported to activate ifnlr in human cells, sometimes with a higher efficacy than human ifn-l (eg, dog ifn-l ) (paquin and others ). the mouse cell response to human ifn-l is thus in line with the ability of ifn-l to be cross-reactive among mammalian species, although we do not have any physiological explanation for this phenomenon. ifn-l proteins follow the typical class ii cytokine structure, consisting of secondary structure elements (a-f) (pestka and others ) . helix a is involved in both ifnlr and il rb binding, while helix d binds il rb and helix f binds ifnlr (gad and others ). among amino acid residues that have been characterized as crucial for ifnlr binding and activation (gad and others ), a few divergences are observed between sequences from mouse and human ifn-l (fig. ) . notably, the more species-specific mouse ifn-l has amino acid residues in a helices a and f that diverge from the other ifn-l sequences, including the related mouse ifn-l . in helix a, gly uniquely replaces the asp residue present in the other sequences. in helix f, residues are unique to mouse ifn-l : asp (ala / asp), gln and bioassay (b) in the serum of ag mice or days after electroinjection of mouse ifn-l (mifn-l ) expressing (pcs ) or empty (pcdna ) plasmids, days after injection of pcs , or days after infection with mouse norovirus. ifnl detection in the serum by elisa was performed without uv exposure to keep maximal sensitivity. (c, d) ifn-l / detection by elisa (c) and bioassay (d) in the bronchoalveolar lavage of balb/c mice, days postinfection with rsv, compared to control mice (mock). balf were uv-exposed before testing. (a-d) the horizontal dotted line represents the lod. mann-whitney: */**indicates a significant difference compared to pcdna group at days or (a, b) or compared to mock (d). balf, bronchoalveolar lavage fluid; rsv, respiratory syncytial virus. (arg / gln), and leu (thr / leu). future site-directed mutagenesis studies could help defining the key residues involved in the species specificity. we designed a highly sensitive bioassay named ''fawa-lluc'' based on luciferase reporter cells, specific for ifn-l detection and quantification. the bioassay is based on a cell line that is naturally responsive to ifn-l in which the type i ifn receptor gene was inactivated. overexpression of the mouse ifnlr receptor in those cells led to increased induction of the reporter gene after ifn-l treatment. unlike previously described bioassays, such as hl- fibroblasts stably transfected with the human ifnlr (uze and monneron ), fawa-l-luc cells permit the selective detection of type iii ifn because they lack the type i ifn receptor. they also fail to respond to ifn-g concentrations that are reached in infected mouse serum. this novel bioassay is efficient in measuring ifn-l from mouse bal and serum. ifn-l activity was hardly affected by uv exposure at virucidal doses, thus allowing detection in infected biological fluids. the high sensitivity of the assay permits sparing biological material as -fold more diluted serum samples could be used for bioassay detection ( - -fold dilution) compared to the elisa ( - -fold). when cell toxicity of the tested samples is suspected, cell viability may independently be confirmed with nonlytic viability assays such as resazurin-based tests, which are compatible with luciferase detection. importantly, our bioassay offers a physiologic analysis, attesting of the functionality of the ifn-l present in the samples, irrespective of specific activity. the bioassay also allows to detect human ifn-l. given the divergent cross-species activity and the higher uv lability of the human type iii ifns, the bioassay might be used for individual subtype analysis, but would not fit for their detection in complex biological samples. finally, it offers a sensitive detection of the divergent ifn-l , for which no efficient commercial test is available. development of t -like lines from balb-c mouse embryo cultures: transformation susceptibility to sv lambda interferon (ifn-lambda), a type iii ifn, is induced by viruses and ifns and displays potent antiviral activity against select virus infections in vivo ifn-lambda resolves inflammation via suppression of neutrophil infiltration and il- beta production ifn-lambda suppresses intestinal inflammation by non-translational regulation of neutrophil function host resistance to plasmodiuminduced acute immune pathology is regulated by interleukin- receptor signaling basis for regulated rna cleavage by functional analysis of rnase l and ire p role of the interleukin (il)- receptor tyrosine residues for antiviral and antiproliferative activity of il- /interferon-lambda : similarities with type i interferon signaling type iii interferon is a critical regulator of innate antifungal immunity gene transfer by lentiviral vectors is limited by nuclear translocation and rescued by hiv- pol sequences the structure of human interferon lambda and what it has taught us interferon lambda signals via the ifnlambda receptor to regulate antiviral activity against hcv and coronaviruses ifn-l sequence alignments. sequences of human and mouse ifn-l regions implicated in receptor binding were aligned. key amino acid residues involved in receptor activation that differs between mouse and human ifn-l and ifn-l sequences are indicated in bold in mouse sequences. residues unique to mouse ifn-l in helices a and f are indicated in bold red. *indicates identical amino acids between human ifn-l and ifn-l human but not mouse hepatocytes respond to interferon-lambda in vivo ifnepsilon is constitutively expressed by cells of the reproductive tract and is inefficiently secreted by fibroblasts and cell lines virus interference. i. the interferon adaptation of theiler's virus to l cells: mutations in the putative receptor binding site on the capsid map to neutralization sites and modulate viral persistence somatic activation of the k-ras oncogene causes early onset lung cancer in mice selection on a variant associated with improved viral clearance drives local, adaptive pseudogenization of interferon lambda (ifnl ) il- a (ifn-lambda ) modulates lung dc function to promote th immune skewing and suppress allergic airway disease ifn-lambdas mediate antiviral protection through a distinct class ii cytokine receptor complex novel nonviral bioassays for mouse type i and type iii interferon characterization of the mouse ifn-lambda ligand-receptor system: ifn-lambdas exhibit antitumor activity against b melanoma comparative functional analysis of mammalian ifn-lambda orthologs cardiovirus leader proteins are functionally interchangeable and have evolved to adapt to virus replication fitness interferons, interferonlike cytokines, and their receptors role of interferon-gamma in murine cytomegalovirus infection a variant upstream of ifnl (il b) creating a new interferon gene ifnl is associated with impaired clearance of hepatitis c virus double nicking by rna-guided crispr cas for enhanced genome editing specificity genome engineering using the crispr-cas system interferon lambda (ifn-lambda) efficiently blocks norovirus transmission in a mouse model protection and mechanism of action of a novel human respiratory syncytial virus vaccine candidate based on the extracellular domain of small hydrophobic protein il- , il- and their class ii cytokine receptor il- r ifnlambda (ifn-lambda) is expressed in a tissue-dependent fashion and primarily acts on epithelial cells in vivo il- and il- : newcomers to the interferon family characterization of the murine alpha interferon gene family characterization of interferonalpha , a novel constitutive murine interferon-alpha subtype species specificity of interferon action: maintenance and establishment of the antiviral state in the presence of a heterospecific nucleus the authors are grateful to nicolas dauguet for his help in flow cytometry (ludwig institute for cancer research). work was supported by the eos joint programme of fonds de la recherche scientifique-fnrs and fonds wetenschapellijk onderzoek-vlaanderen-fwo (eos id: ), by interuniversitary attraction poles program initiated by the belgian science policy office (iap-p / belvir), by actions de recherche concertées (arc), and by a pdr grant (t. . ) of fnrs to t.m., and b.s. is a doctoral assistant at the department of biomedical molecular biology of ghent university. no competing financial interests exist. key: cord- - gt fwpy authors: meseda, clement a.; atukorale, vajini; kuhn, jordan; schmeisser, falko; weir, jerry p. title: percutaneous vaccination as an effective method of delivery of mva and mva-vectored vaccines date: - - journal: plos one doi: . /journal.pone. sha: doc_id: cord_uid: gt fwpy the robustness of immune responses to an antigen could be dictated by the route of vaccine inoculation. traditional smallpox vaccines, essentially vaccinia virus strains, that were used in the eradication of smallpox were administered by percutaneous inoculation (skin scarification). the modified vaccinia virus ankara is licensed as a smallpox vaccine in europe and canada and currently undergoing clinical development in the united states. mva is also being investigated as a vector for the delivery of heterologous genes for prophylactic or therapeutic immunization. since mva is replication-deficient, mva and mva-vectored vaccines are often inoculated through the intramuscular, intradermal or subcutaneous routes. vaccine inoculation via the intramuscular, intradermal or subcutaneous routes requires the use of injection needles, and an estimated to % of the population of the united states has needle phobia. following an observation in our laboratory that a replication-deficient recombinant vaccinia virus derived from the new york city board of health strain elicited protective immune responses in a mouse model upon inoculation by tail scarification, we investigated whether mva and mva recombinants can elicit protective responses following percutaneous administration in mouse models. our data suggest that mva administered by percutaneous inoculation, elicited vaccinia-specific antibody responses, and protected mice from lethal vaccinia virus challenge, at levels comparable to or better than subcutaneous or intramuscular inoculation. high titers of specific neutralizing antibodies were elicited in mice inoculated with a recombinant mva expressing the herpes simplex type glycoprotein d after scarification. similarly, a recombinant mva expressing the hemagglutinin of attenuated influenza virus rga/viet nam/ / (h n ) elicited protective immune responses when administered at low doses by scarification. taken together, our data suggest that mva and mva-vectored vaccines inoculated by scarification can elicit protective immune responses that are comparable to subcutaneous vaccination, and may allow for antigen sparing when vaccine supply is limited. the eradication of smallpox, a disease that caused the death of hundreds of millions of people over many centuries, was accomplished primarily by the use of replication-competent vaccinia virus strains as vaccines. traditional (first-generation) smallpox vaccines, as well as more recently developed cell culture-derived second-generation smallpox vaccines such as acam [ , ] , the currently licensed smallpox vaccine in the united states, are inoculated into vaccine recipients by scarification of the skin surface, also known as percutaneous, skin or cutaneous vaccination [ ] . rare but severe adverse reactions caused by these vaccines, including generalized vaccinia, eczema vaccinatum, and the more recently recognized cases of myopericarditis [ , , , ] , limit the use of these vaccines for routine preventative vaccination of the general populace in the absence of any immediate risk of exposure to variola virus (the etiologic agent for smallpox) or other pathogenic orthopoxviruses such as monkeypox virus. thus, as early as the s, efforts were made to develop safer smallpox vaccines by attenuating existing strains of vaccinia virus [ , ] . as part of this effort, the modified vaccinia virus ankara (mva) was developed in the early s. mva was derived from the chorioallantois vaccinia virus ankara (cva) strain of vaccinia virus, by more than passages in chick embryo fibroblast (cef) cells [ ] . during the course of passage of cva in cef cells, several genes (mainly host-range and immunomodulatory genes) were lost, resulting in the severely attenuated mva. about % of the viral genome was lost during passage in cef cells, and mva does not replicate productively in most mammalian cells [ , , ] . mva has been extensively evaluated in different animal models [ , , , ] and in clinical trials, and found to be less reactogenic when compared with replication-competent first and second generation smallpox vaccines [ , ] . mva is licensed as a smallpox vaccine in europe and canada, and currently undergoing clinical development in the united states. the severe attenuation of mva and its consequent loss of the capacity to replicate efficiently in mammalian cells is evident in its inability to produce a "vaccine take", a pustular lesion that develops at the inoculation site, when vaccinia virus is inoculated on the skin surface. apart from its potential use as a smallpox vaccine in immunocompromised individuals, mva has the capacity to accommodate heterologous dna, and express encoded proteins, thus serving as a useful viral vector in vaccine development against different types of pathogens. several recombinant mva vectors expressing heterologous proteins of different human pathogens are at various phases of clinical development [ , ] some of the mva-vectored vaccines in clinical trials include those expressing human immunodeficiency virus antigens [ , , ] , mycobacterium tuberculosis a antigen [ , , ] , malaria antigens [ , , ] , human papilloma virus antigen [ ] , hepatitis c antigens [ , ] , respiratory syncytial virus antigens [ ] , influenza virus antigens [ , , ] , epstein-barr virus antigen [ , ] and more recently, ebola virus antigens [ ] . several other mva-vectored vaccines have also been evaluated in preclinical studies [ , , ] . in most preclinical and clinical studies, mva or recombinant mva vectors, unlike replication-competent vaccinia virus strains, are inoculated into subjects via the intramuscular, intradermal or subcutaneous routes. although mva has been demonstrated to have a better safety profile than replication-competent vaccinia virus, a relatively large inoculum volume of . to . ml and . to ml of mva or recombinant mva is typically used in small animal models and in non-human primates/humans, respectively. this often results in local reactions at the site of inoculation, including muscle ache, pain, and tenderness [ , ] . in addition, the inoculation of prophylactic or therapeutic regimens with needles and syringes can be problematic for some people, a global problem commonly called needle phobia or fear of the needle in common phraseology. although the use of needle-free injection devices such as the jet injector [ ] has become increasingly popular, hypodermic syringes and needles remain in wide use for the delivery of prophylactic and therapeutic remedies. previously, we [ ] described a recombinant vaccinia virus, a r/b rko, that was severely attenuated for plaque formation in permissive cell lines due to deletions of the a r and b r genes, encoding the a and b proteins, respectively, of the extracellular virion form of vaccinia virus. the severe attenuation and growth characteristics of the a /b rko virus is reminiscent of the properties of mva. a r/b rko elicited vaccinia-specific igg and neutralizing antibodies when balb/c mice were inoculated by scarification at the base of the tail. in an intranasal challenge model, using the western reserve strain of vaccinia virus, the a r/ b rko virus conferred comparable levels of protection on mice as those vaccinated with a clonal isolate of dryvax, dv- . during the course of the work above [ ] , antibody [ ] and robust cell-mediated immune responses after the inoculation of recombinant mva vectors through the skin, were also reported [ , , ] , suggesting that percutaneous inoculation of mva may elicit equivalent or higher immune responses than subcutaneous injection. in the work described here, we demonstrate in mouse models that percutaneous inoculation of mva elicited protective immune responses against lethal intranasal challenge with the western reserve (wr) strain of vaccinia virus, and at low doses of mva, lower morbidity was recorded in mice that were vaccinated via the percutaneous route than in those immunized via the intramuscular or subcutaneous routes. in addition, we show in two models that percutaneous inoculation of recombinant mva expressing heterologous antigens elicited specific immune responses, including neutralizing antibodies, at levels that are comparable to subcutaneous inoculation. a recombinant mva expressing herpes simplex virus (hsv- ) glycoprotein d elicited gd -specific igg and hsv- neutralizing antibodies, and a recombinant mva expressing the hemagglutinin of influenza rga/vietnam/ / , h n , elicited protective immune responses when inoculated by the percutaneous route. our data suggest that vaccination via the percutaneous route is efficient in stimulating protective immune responses, and may find clinical relevance in immunizations with mva and mva-vectored vaccines. the modified vaccinia virus ankara (mva; atcc # vr- ) was provided by drs. linda wyatt and bernard moss (niaid/nih) and vaccinia virus strain western reserve (vv-wr; atcc # vr- ) was provided by dr. bernard moss. we have previously described the construction of a recombinant mva expressing the herpes simplex virus type glycoprotein d (mva-gd ), in which the us gene of hsv- (strain ms) was inserted into the deletion ii region in mva by homologous recombination [ ] . expression of glycoprotein d is driven by the synthetic vaccinia early/late promoter [ ] . recombinant mva expressing the hemagglutinin (h ) of influenza virus rga/viet nam/ / (h n ) (mva-ha) was constructed by homologous recombination of the h gene into the deletion iii region of mva [ ] . expression of the influenza h is driven by the vaccinia h r promoter. mva and recombinant mva vectors were prepared from primary chick embryo fibroblast cells (cef) or df- cells (atcc # crl- ) that had been infected with the appropriate virus as previously described [ ] , and partially purified viruses were obtained by passing infected cell lysates through a % sucrose cushion. mva and mva recombinants were titered on df- cell monolayers. vv-wr was prepared from infected bsc- cells (atcc # ccl- ) , and was also partially purified through a % sucrose cushion, and titered on bsc- cell monolayers (atcc # crl- ). the attenuated influenza virus rga/viet nam/ / (h n ) was grown in the allantoic cavity of embryonated eggs and titrated on mdck cells. cells were cultivated and regularly maintained in dmem containing % fetal bovine serum ( % for mdck cells) and μg/ml gentamicin. balb/c mice ( - weeks old) were obtained from the jackson laboratories, bar harbor, maine. mice received feed and water freely. the animal study protocol for the work described in this manuscript was approved by the institutional animal care and use committee (iacuc) of the center for biologics evaluation and research, usfda (cber/fda). intramuscular inoculation into the muscles of the hind legs and subcutaneous inoculation at the base of the tail using ml tuberculin syringes affixed with -gauge needles, were performed as previously described [ ] . tail scarification of anesthetized animals was also performed as previously described [ ] . briefly, the inoculum was diluted in sterile endotoxin-free phosphate-buffered saline (pbs) such that the desired unit dose is contained per μl. mice were anesthetized by intraperitoneal injection of x avertin ( , , ,-tribromoethanol in tert-amyl alcohol (sigma-aldrich, st. louis, missouri)) diluted in pbs at μl per gram body weight. using a -gauge needle, to needle scratches/puncture were made at the base of the tail and μl of the inoculum was applied to the scarified surface. vaccinia virus (strain wr) and attenuated influenza a virus (rga/viet nam/ / (h n )), a + reassortant vaccine strain bases on influenza a/puerto rico/ / , were used in challenge experiments. for intranasal mouse challenge, a dose of ten % lethal dose ( ld ) (equivalent to . x pfu) of vv-wr was used. for challenge with rga/viet nam/ / (h n )), a dose of pfu was used. we previously determined this dose to be lethal in our influenza virus challenge model. mice were anesthetized by intraperitoneal injection of x avertin ( μl per gram body weight), followed by inoculation of the challenge virus in a total of μl suspension into the nares ( μl per naris) as previously described [ ] . mice were monitored and weighed daily for two weeks post challenge. mice that lost % of their initial body weight were considered to have reached the study endpoint, and were humanely euthanized per the iacuc-approved animal study protocol. testing of antisera for antigen-specific antibodies (igg) was performed by standard enzymelinked immunosorbent assay (elisa). elisa for vaccinia-specific antibodies was performed using psoralen/uv-inactivated vaccinia virus (dryvax) as the antigen, as previously described [ ] . hsv- gd-specific igg elisa using partially-purified hsv- glycoproteins ( ng/well) as the antigen, and hsv- neutralization assay were performed in -well immulon hb plates (fisher scientific) and -well tissue culture plates (corning), respectively, as previously described [ ] . influenza virus h -specific igg was quantified using sanofi pasteur's inactivated rga/viet nam/ / vaccine (cber reference antigen # ) as the coating antigen. immulon hb plates were coated with cber reference antigen at μg/well, and plates were stored at °c overnight. plates were washed with phosphate-buffered saline containing . % tween- (pbst), and then blocked with pbst containing % fetal bovine serum for hours. subsequent incubation of the antigen with the test serum samples and completion of the assay followed standard elisa protocol as previously described [ ] . testing of antisera for the neutralization of influenza a virus rga/viet nam/ / (h n ), an attenuated vaccine strain generated by reverse genetics, was performed using a microneutralization assay as previously described [ ] . the presence of virus was detected using biotin-conjugated antibody to influenza np (clone a; milipore, billerica, ma, usa) followed by hrp-labeled streptavidin (kpl, gaithersburg, md, usa). mice were vaccinated with pfu of mva-gd via the subcutaneous or percutaneous route. a control group was vaccinated with pfu of mva. seven ( ) days after vaccination, mice were euthanized, spleens were collected from dissected mice, and lymphocytes were isolated from spleen homogenates as previously described [ ] . spleen cells were cultured in -well tissue culture plates and re-stimulated with live hsv- (strain ms) at a multiplicity of infection of . . culture supernatants were harvested after hours, clarified of cells by centrifugation, and tested for il- and ifn-γ by capture elisa as described [ ] , and reagents obtained from bd pharmingen. unpaired, two-tailed student's t-test for statistical comparison of antibody titers was performed using graphpad prism . software (graphpad software, inc.). the kaplan-meier survival logrank test was performed using the sigmaplot . software (systat software, inc.), and was used to compare differences in the number of surviving animals in the various treatment groups after virus challenge. in all cases, a p value < . indicates statistically significant differences between treatment groups. in a preliminary experiment to investigate the utility of the percutaneous route for the delivery of mva, we observed that mva delivered by tail scarification, while statistically insignificant (p = . ), elicited a higher vaccinia-specific igg response and protection in mice than the same dose ( pfu) delivered by the intramuscular route (s fig) . the experiment using pfu of mva did not allow us to observe any differences in antibody response, disease progression and protection between the two immunization routes. thus in subsequent experiments, lower doses of mva were evaluated. groups of mice were vaccinated with pfu of mva via the intramuscular, subcutaneous, or percutaneous routes. for comparison, a set of three groups of mice were similarly vaccinated with pfu of the licensed acam smallpox vaccine, via the same three routes. an untreated group was included as a control. three weeks after vaccination, serum samples were obtained from all mice and tested for vaccinia-specific antibodies by elisa, using inactivated dryvax as the antigen. among mice in the mva treatment cohort, an igg response was detectable in / mice in the subcutaneous group, and / in the percutaneous group. the untreated mice and all mice in the mva intramuscular group had no detectable igg at this time point. by contrast, all but three mice ( / and / in the intramuscular and subcutaneous groups, respectively) in the acam cohort had detectable levels of igg (fig a) . at weeks postimmunization, all mice were challenged intranasally, with a lethal dose ( ld ) of vv-wr. all mice in the untreated group showed severe symptoms of infection, reaching the study endpoint of % weight loss by day post-challenge, and had to be euthanized (fig b & c) . except for a mouse in the mva-intramuscular group, all other mice vaccinated with mva or acam , survived. among the mva vaccinated animals, mice in the intramuscular group lost the most weight (fig b) , with a mean peak loss of about % on day post-challenge. weight loss among the mva subcutaneous and percutaneous groups were similar, with peak losses of . % (day ) and . % (day ), respectively. however, mice in the mva percutaneous group recovered more quickly ( . % of original mean body weight on day ) than the subcutaneous group ( . % mean weight on day- ). among the acam treatment groups ( fig c) , the average peak weight loss was . % (day- ), . % (day- ), and . % (day- ), for the intramuscular, subcutaneous, and percutaneous groups, respectively. in another experiment, mice in groups of five were vaccinated with pfu or pfu of mva by scarification. two other groups were similarly vaccinated with pfu or pfu of acam , and a control group was scarified with pbs. antisera were collected after three weeks and mice were challenged with ld of vv-wr. none of the mice in the pbs group had detectable igg and all succumbed to vv-wr infection ( table ). all mice in the pfu mva group had no detectable igg and / in the mva group had detectable igg. however, / and / of mice survived in the pfu and pfu mva, respectively. in the acam cohort, / and / of mice in the pfu and pfu groups, respectively, were seropositive. three of five ( / ) and . morbidity, as measured by mean weight changes post-challenge, is shown for the mva treatment groups (b), and for the acam treatment groups (c). the "untreated" control group was the same for both the mva and acam groups. a "+" sign represents a mouse that succumbed to infection. / of mice in the acam cohort survived vv-wr challenge (table ) . these sets of data suggest that in this mouse model, mva inoculation by the percutaneous route elicits equivalent or greater protective immune responses than inoculation via the intramuscular or subcutaneous routes. percutaneous vaccination with recombinant mva-gd elicits hsv- -specific immune responses mva is an attractive vector being used for the expression of transgenes and has been used in the expression of antigens of a variety of pathogens. similar to studies investigating mva as a smallpox vaccine, preclinical and clinical evaluation of mva-vectored vaccines in development has relied predominantly on the use of intramuscular, intradermal or subcutaneous routes of mva delivery. in order to determine whether the percutaneous route will be useful for the evaluation of mva-vectored recombinant vaccines, a recombinant mva (mva-gd ) expressing the glycoprotein d of herpes simplex virus type- (hsv- , strain ms) was evaluated for immunogenicity in the balb/c mouse model. in this recombinant mva, the hsv- us gene encoding glycoprotein d was inserted into the deletion ii site in mva by homologous recombination [ ] . groups of mice were vaccinated with mva-gd at three dose levels: pfu, pfu, and pfu; with each dose level administered subcutaneously or percutaneously. the control group received pfu of mva subcutaneously. all treatment groups were vaccinated using a prime/boost immunization strategy as previously described [ ] . antisera were collected weeks after the priming vaccination, as well as at weeks after the boost, and were tested for hsv- -specific igg at both time points, using partially-purified hsv- glycoproteins as the antigen (fig a) . antisera collected at the -week time point were also tested for hsv- neutralizing antibodies (fig b) . antisera obtained from mice vaccinated with the mva vector had no detectable hsv- specific antibodies at both time points. hsv- specific antibodies were detected in antisera obtained from mice vaccinated with mva-gd at both time points (fig a) . the mean igg titers (log the serum samples obtained at the -week time point were tested for the ability to neutralize hsv- infectivity in vero cells. similar to the igg elisa result, antisera from the mva control group did not neutralize hsv- (mean serum neutralization (sn) titer was below the level of quantitation of . log ). low to modest neutralizing antibody titers were detected in mva-gd vaccinated mice (table ). in the subcutaneous vaccination sub-groups, mean sn titers (log ) of . (± . ), . (± . ), and . (± . ), were obtained for the pfu, pfu, and pfu groups, in another experiment, cellular immune response to mva-gd was evaluated. mice were vaccinated with pfu of mva subcutaneously, or with pfu of mva-gd either subcutaneously or percutaneously. spleen cells were harvested from mice days after vaccination and tested for cytokine (il- and ifn-γ) secretion as previously described (meseda et al., ) . spleen cells were re-stimulated in vitro by live infection with hsv- (strain ms) at a multiplicity of infection of . . supernatants were collected from the cultured spleen cells and tested for levels of il- and ifn-γ. whereas the levels of il- and ifn-γ in the supernatants from the spleen of mva-infected mice were below detection, all mice in both mva-gd groups had detectable levels of il- and ifn-γ, ( table ). mean il- levels of . ± pg/ml and . ± . pg/ml were obtained for the mva-gd subcutaneous and percutaneous groups, respectively. similarly, ifn-γ levels were . ± . pg/ml, and . ± . pg/ml, for the subcutaneous and percutaneous mva-gd groups, respectively. taken together, this set of data suggests that the inoculation of recombinant mva-gd by scarification is capable of eliciting antigen-specific immune responses that are comparable or higher than delivery by subcutaneous inoculation. mva is used as a vector for the expression of heterologous antigens. the deletion sites in mva, including the deletion ii and deletion iii sites, are commonly used for the insertion of transgenes. in order to broaden our understanding of the utility of the percutaneous route for the delivery of mva-vectored vaccines, we further evaluated a recombinant mva, mva-ha, in which the hemagglutinin gene of influenza a virus rga/viet nam/ / (h n ), was inserted in the deletion iii site of mva. in a series of experiments, the antibody response following vaccination via the subcutaneous or percutaneous routes was characterized, and the protective effectiveness of vaccination via these routes was evaluated in a mouse intranasal challenge model. in the first experiment, groups of mice (five per group) were vaccinated with , , or pfu of mva-ha on a prime-boost schedule at an interval of weeks between vaccinations. each dose of mva-ha was administered via the subcutaneous or percutaneous routes. a control group was vaccinated with pfu of mva via the subcutaneous route. three weeks after vaccination, serum samples were obtained from mice and tested for h -specific igg, and all mice were challenged with pfu of attenuated influenza rga/viet nam/ / (h n ) via the intranasal route. except for a mouse in the mva control group that had a low level of non-specific igg, all other mice in the control group had no h -specific igg, and / (including the one with detectable igg) succumbed to influenza virus challenge. all mice that were vaccinated with mva-ha, irrespective of the route, had high levels of h -specific igg titers in the second experiment, mice in groups of mice (five per group) were vaccinated with , , or pfu of mva-ha via the subcutaneous or percutaneous route on a prime-boost schedule at an interval of weeks between vaccinations. a control group was vaccinated with pfu of mva, subcutaneously. antisera were obtained from mice three weeks after the booster vaccination, and all mice were challenged with pfu of influenza rga/viet nam/ / . all mice in the mva group had no detectable h -specific igg. by contrast, all mice inoculated with mva-ha, irrespective of the dose, had high titers of h -specific igg (fig a) . the differences in igg levels between the subcutaneous and percutaneous cohorts at each dose level of mva-ha were not statistically significant, although mean igg titers were slightly higher in the subcutaneous cohort. following intranasal challenge with influenza rga/viet nam/ / , all mice in the mva group succumbed to infection, and all mice vaccinated with mva-ha, irrespective of the dose, survived with varying degrees of morbidity. among mva-ha vaccinated mice, the pfu/subcutaneous group recorded the severest weight loss (fig b) , and the difference in weight changes between the subcutaneous and percutaneous groups vaccinated with pfu was statistically significant (two-tailed p-value = < . ). a summary of the neutralizing antibody titers of pooled antisera for each treatment group from the two mva-ha experiments described above is presented in table . the mva control group had no detectable neutralizing antibody in the serum samples obtained at any time point. among the groups vaccinated with mva-ha, neutralizing antibody was below detection in post-prime antisera, except in the pfu subcutaneous group where a titer of was obtained. however, following the administration of booster inoculations, all mva-ha treatment groups had detectable levels of neutralizing antibody that increased with increase in vaccine dose. neutralizing antibody titers in mice in the subcutaneous cohort were , , and , for the , , and pfu, respectively. similarly, neutralizing antibody titers among the percutaneous cohort were , , and , for the , , and pfu, respectively. interestingly, the levels of neutralizing antibody for the percutaneous treatment groups were similar to the subcutaneous group at the same mva-ha dosage, in spite of slightly higher total h -specific igg levels in the subcutaneous cohort (difference is not statistically significant). this set of data suggests that the antibody response, both total igg and neutralizing antibodies, elicited by mva-ha was comparable between mice that were inoculated via the subcutaneous route and those inoculated via the percutaneous route. further, we observed that all mice inoculated with pfu of mva-ha by prime-boost, were protected from influenza virus challenge. in the experiments with mva-ha described above, all mice that were vaccinated on a primeboost schedule with pfu of mva-ha elicited antibody responses and protection that were indistinguishable between subcutaneous and percutaneous treatment cohorts. in order to further scrutinize the differences between the two inoculation routes, lower doses of mva-ha were used in experiments. in one experiment, groups of mice (five per group) were vaccinated with mva-ha at doses of , or pfu, each dose administered via the subcutaneous or percutaneous route. a control group was inoculated subcutaneously with pfu of mva. booster inoculations in the same amount of mva-ha or mva were administered three weeks after mice were primed. at three weeks after the booster doses, mice were challenged with attenuated rga/viet nam/ / , at pfu per mouse, and were evaluated daily for two weeks as described above. none of the animals vaccinated with mva survived. all mice vaccinated with pfu mva-ha in this prime/boost schedule survived. in the pfu mva-ha group, / and / survived in the subcutaneous and percutaneous groups, respectively. influenza virus pathogenesis in these mice, as measured by weight loss (fig ) shows a doseresponse with respect to mva-ha, with weight loss being inversely proportional to the dose of mva-ha. there were no major differences in survival rates between mice in the subcutaneous and percutaneous groups inoculated with the same dose of mva-ha. at pfu of mva-ha, the mean weight loss was higher in the percutaneous group than the subcutaneous group, but the difference was not statistically significant (two-tailed p-value = . ). finally, in two independent experiments, mice in groups of five in each experiment were vaccinated with low doses of mva-ha that were administered once, and were challenged three weeks after vaccination. groups of mice were inoculated at doses of , , or pfu of mva-ha subcutaneously or percutaneously. control groups received pfu of mva subcutaneously. a summary of the number of surviving mice is presented in table . none of the mice vaccinated with mva survived. among mice in the mva-ha subcutaneous vaccination cohort, / , / , and / survived in the pfu, pfu, and pfu vaccination groups, respectively. similarly, among mice in the percutaneous vaccination cohort, / , / , and / survived viral challenge. the mean weight loss among mice in these experiments are shown in fig . statistical comparisons of the number of surviving mice show that differences in survival between mice that were vaccinated with pfu of mva-ha (irrespective of vaccination route) and the mva control group, were statistically significant (table ). however, a comparison of the observed differences in survival between the percutaneous and subcutaneous groups at the pfu dose level indicates the difference is not statistically significant. this set of data suggests that even at low vaccination doses, differences between mouse groups vaccinated via the subcutaneous and percutaneous routes are not apparent in this challenge model. the modified vaccinia virus ankara (mva) is licensed in europe and canada as a third generation smallpox vaccine, and currently in clinical development for licensure in the united states. the relatively better safety record of mva compared to first and second generation smallpox vaccines is well documented. this, in addition to its large capacity to accommodate heterologous genes, express encoded proteins, and elicit both humoral and cell-mediated immune responses also makes mva an attractive vector for the delivery of several candidate vaccines for a variety of infectious and non-infectious human and veterinary diseases [ , , , , ] . evidence for the delivery of antigens through the skin in asia dates back to the s with the practice of variolation and continued with the advent of the smallpox vaccine in the late th century [ ] . thus replication-competent smallpox vaccines, including those that were used in the successful eradication of smallpox, such as dryvax, lister, livp, temple of heaven, and em- , were mostly administered by skin scarification [ ] . the current us-licensed secondgeneration smallpox vaccine, acam , is also administered by skin scarification, a procedure that is believed to be partly responsible for the success of the global eradication of smallpox by provoking robust innate and adaptive immune responses [ ] . due to the severe attenuation of mva, as epitomized by its inability to replicate productively in many mammalian cells [ , , ] , mva and mva-vectored vaccines are usually administered via routes other than percutaneous in preclinical studies. clinical investigations of mva-vectored vaccines have mostly used intramuscular [ , , , ] and intradermal routes [ , ] , and to a lesser extent, the subcutaneous injection route [ ] . local reactogenicity following vaccination with mva or mva-vectored vaccines is believed to be more severe with subcutaneous and intradermal inoculations than via intramuscular route [ , , ] . in a comparison of the safety and immunogenicity of an mva-vectored hiv vaccine, individuals vaccinated with mva.hiva by the subcutaneous and intradermal routes were found to develop more severe local reactions than those vaccinated via the intramuscular route [ ] . however, intramuscular and subcutaneous tissues have relatively fewer antigen presenting cells than the skin tissue and may not be adequate for optimal immune responses [ ] . administering vaccines against infectious diseases through the skin has generated significant interest in recent years, including its use in the delivery of the bcg tuberculosis vaccine [ ] , and has been further boosted by the development of the microneedle patch technology, which delivers vaccines intradermally. microneedle inoculation of vaccines has been used in preclinical evaluation of several vaccines, including inactivated polio vaccine [ ] , influenza vaccine [ , , ] , and measles vaccine [ ] . clinical application of vaccines to the skin has also been documented for a number of vaccines, including influenza vaccine [ , ] , and rabies vaccine [ ] . recent studies have suggested that vaccine delivery through the skin takes advantage of the abundant presence of skin-resident antigen-presenting cells, including different subsets of dendritic cells and langerhans cells, as well as infiltrating antigen presenting cells, to provoke robust immune responses that include both humoral and cell-mediated immune responses [ ] , and induce long-lived cd + t cell memory [ , ] . moreover, data on the delivery of different types of vaccines through the skin suggest that both live vaccines and subunit vaccines can be administered through the skin, with successful immunization outcomes [ - , , ] . earlier data from our laboratory [ ] as well as from clinical trials [ , ] suggest that delivery of the modified vaccinia virus ankara into the intradermal layer of the skin elicited robust immune responses that were higher than intramuscular or subcutaneous inoculations, and protected mice from intranasal challenge with vaccinia virus [ ] . we further showed that a severely attenuated recombinant vaccinia virus that fails to form visible plaques in several mammalian cell lines, reminiscent of mva, elicited protective immune responses when used to vaccinate mice by scarification [ ] . in the work described here, we expanded our investigation on the delivery of mva as well as mva-vectored antigens through the skin. in a preliminary experiment, we observed that igg titers were higher in mice that received pfu of mva by skin scarification than in mice that received the same dose of mva by intramuscular inoculation. in subsequent experiments, antibody responses and protection of mice that were vaccinated with mva subcutaneously or by tail scarification were higher than in those vaccinated via the intramuscular route. melamed et al. [ ] compared the antibody response elicited in response to mva and two recombinant mvas that had been genetically modified to replicate in vero and bsc- cells, after inoculating mice by intramuscular injection or tail scarification. their data indicate that tail scarification was efficient at inducing an antibody response, although the intramuscular route elicited higher geometric mean titers of antibody and conferred higher survival rates. the difference between their observation and the one reported here may be due to differences in experimental procedures and/or assay methods. for instance, in our work, mva for tail scarification is typically in μl volume per dose, making it easier to handle than the μl used by melamed et al [ ] . in subsequent experiments, the route comparison was limited to subcutaneous versus percutaneous routes, since the subcutaneous route is more commonly used in vaccination studies of mva vectors. as the utility of mva as a viral vector for the expression of heterologous antigens is expanding [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] ] , we also compared the antibody responses and protection conferred by vaccination with two mva recombinants, one expressing the hsv- glycoprotein d, and the other expressing the h hemagglutinin of influenza virus rg/a viet nam/ / (h n ). mice that were vaccinated with mva-gd by tail scarification, elicited higher than or similar titers of hsv- gd -specific igg and neutralizing antibodies to those vaccinated by subcutaneous inoculation. the observed differences in igg titers were not statistically significant between the two routes at or pfu, but were statistically significant at pfu, suggesting that the percutaneous delivery of mva-gd may be more effective than subcutaneous inoculation in eliciting hsv- neutralizing antibodies at lower vaccine doses. consistent with previous reports [ , ] , percutaneous inoculation of mva-gd also elicited cell-mediated immune responses, as evident in the secretion of ifn-γ and il- by re-stimulated immune splenocytes. mva vectors expressing influenza antigens have been shown to elicit protective immune responses in animal models [ ] , including mice [ ] [ ] [ ] [ ] , ferrets [ ] and macaques [ , ] . in the second recombinant mva vaccine model, mva-ha, expressing influenza virus h , was used to vaccinate mice by subcutaneous injection or by tail scarification, and the h -specific antibody response and protective effectiveness against intranasal challenge with the homologous attenuated influenza virus rga/viet nam/ / , were assessed. the data indicate that comparable levels of antibody titers and protection were conferred by the two immunization routes. interestingly, higher survival rates among mice vaccinated by tail scarification were recorded at low vaccine doses. among the advantages attributed to skin delivery of vaccines is the possibility of antigen dose sparing [ , ] . the data described in this manuscript support these earlier reports as lower doses of mva or mva-gd or mva-ha were found to elicits full or partial protection of mice. in summary, we showed that mva, and recombinant mva vectors expressing hsv- gd or influenza virus h elicited protective immune responses in the mouse model. taken together, the data presented in this work suggest that mva and mva-vectored vaccines can be effective when delivered through the skin. with the advantage that antigen delivery to the skin requires a volume that is at least times (in murine models) to times (in humans) less than the volume used in subcutaneous vaccination, a more comprehensive investigation of the clinical benefit of delivering mva and mva-vectored vaccines through the skin is necessary. apart from its efficiency in provoking robust immune responses, it may also help to ameliorate or obliterate some of the commonly reported volume-related local reactions associated with subcutaneous or intramuscular vaccine delivery, such as pain at the site of injection, and may be more acceptable in people with needle phobia, thus enhancing compliance with scheduled immunization programs. although the preclinical evaluation of vaccines by skin scarification, as described in our study, involves the use of improvised needles for the scarification process prior to the application of vaccines, advances in the development of the microneedle patch [ , , ] should facilitate painless application of vaccines to the skin without the use of hypodermic injection needles or the bifurcated needle used in administering smallpox vaccines. in preclinical studies, microneedle delivery of mva-vectored vaccines has been shown to be effective in eliciting robust immune responses against malaria [ ] that are comparable to the levels attained by intradermal vaccination. thus with further refinement, the use of microneedle delivery appears to hold a promising future for the application of viral-vectored vaccines through the skin. were vaccinated subcutaneously or percutaneously with , , or pfu of mva-ha by prime-boost at an interval of weeks between vaccinations. a control group received pfu of mva prime-boost, subcutaneously. serum samples obtained weeks after priming (week- ) and weeks after boosting (week- ) were tested for h -specific igg (a). error bars represent standard deviation. mice were subsequently challenged with pfu of influenza rga/viet nam/ / , and weighed daily for two weeks (b). a "+" sign represents a mouse that succumbed to infection. (tif) acam clonal vero cell culture vaccinia virus (new york city board of health strain)-a second-generation smallpox vaccine for biological defense acam : a newly licensed cell culture-based live vaccinia smallpox vaccine cutaneous vaccination: antigen delivery into or onto the skin cardiac adverse events following smallpox vaccination-united states myopericarditis following smallpox vaccination among vaccinia-naive us military personnel incidence and followup of inflammatory cardiac complications after smallpox vaccination smallpox vaccination-associated myopericarditis is more common with the newest smallpox vaccine jennerian prophylaxis by means of intradermal injections of culture vaccine virus smallpox vaccination and its consequences: first experiences with the highly attenuated smallpox vaccine mva the smallpox vaccination strain mva: marker, genetic structure, experience gained with the parenteral vaccination and behavior in organisms with a debili modified vaccinia virus 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microneedle arrays for transcutaneous delivery of live virus vaccines microneedle array design determines the induction of protective memory cd + t cell responses induced by a recombinant live malaria vaccine in mice the authors wish to thank drs. bernard moss and linda wyatt, niaid/nih, for the mva and vv-wr viruses. we also thank dr. maryna eichelberger and dr. alonzo garcia, cber/ fda, for reviewing this manuscript. this work was supported by intramural research funds key: cord- - yh k jk authors: patton, john b.; bennuru, sasisekhar; eberhard, mark l.; hess, jessica a.; torigian, april; lustigman, sara; nutman, thomas b.; abraham, david title: development of onchocerca volvulus in humanized nsg mice and detection of parasite biomarkers in urine and serum date: - - journal: plos negl trop dis doi: . /journal.pntd. sha: doc_id: cord_uid: yh k jk background: the study of onchocerca volvulus has been limited by its host range, with only humans and non-human primates shown to be susceptible to the full life cycle infection. small animal models that support the development of adult parasites have not been identified. methodology/principal findings: we hypothesized that highly immunodeficient nsg mice would support the survival and maturation of o. volvulus and alteration of the host microenvironment through the addition of various human cells and tissues would further enhance the level of parasite maturation. nsg mice were humanized with: ( ) umbilical cord derived cd (+) stem cells, ( ) fetal derived liver, thymus and cd (+) stem cells or ( ) primary human skeletal muscle cells. nsg and humanized nsg mice were infected with o. volvulus infective larvae (l ) for to weeks. when necropsies of infected animals were performed, it was observed that parasites survived and developed throughout the infection time course. in each of the different humanized mouse models, worms matured from l to advanced fourth stage larvae, with both male and female organ development. in addition, worms increased in length by up to -fold. serum and urine, collected from humanized mice for identification of potential biomarkers of infection, allowed for the identification of o. volvulus-derived proteins found specifically in either the urine or the serum of the humanized o. volvulus-infected nsg mice. conclusions/significance: the newly identified mouse models for onchocerciasis will enable the development of o. volvulus specific biomarkers, screening for new therapeutic approaches and potentially studying the human immune response to infection with o. volvulus. a a a a a onchocerciasis, caused by the parasitic filarial nematode onchocerca volvulus, remains a significant source of morbidity throughout sub-saharan africa [ ] . o. volvulus infection is commonly diagnosed through the presence of microfilariae in skin snips, but skin samples can be further analyzed by qpcr for enhanced sensitivity [ ] . antibody tests (e.g. ov [ , ] ) are available but do not have the ability to differentiate between past and present infections which is problematic in areas where the infection is endemic [ ] . recently, a limited number of biomarkers have been identified in the urine that can distinguish between o. volvulus-infected and non-infected individuals [ ] [ ] [ ] . a significant obstacle for studying the biology of o. volvulus and for the development of new therapeutics and diagnostics has been the absence of small animal models. the only susceptible animal hosts for o. volvulus are chimpanzees [ , ] and mangabey monkeys [ ] . chimpanzees infected with o. volvulus had patent infections that lasted between to years with adult-worm bundles located in deep tissues with microfilariae in skin snips being detected - months post infection [ , ] . while immunologically intact mice are resistant to infection with the infective larvae (l ) of o. volvulus [ ] , adult worms within nodules have been successfully transplanted into scid mice (nod.cb -prkdc scid /j) with the worms surviving greater than weeks [ ] . this observation was confirmed by the successful transplantation of adult onchocerca ochengi into scid mice [ ] . as an alternative approach, o. volvulus l were implanted in primates and rodents within diffusion chambers that consist of a lucite ring enclosed with permeable membranes, allowing for migration of cells and other humoral factors into the diffusion chamber with simultaneous containment of the parasites. o. volvulus in diffusion chambers implanted in multiple species of rodents and primates showed limited growth of larvae in all host species [ ] . several strategies have been employed to overcome murine resistance to infection with various human pathogens. the collaborative cross (cc) is a large group of inbred mouse strains that were developed to address many of the different shortcomings found within the existing experimental mouse populations, including small numbers of homozygous strains, limited genetic diversity, and non-ideal population structures. based on the hypothesis that there is a genetic basis for mouse susceptibility and resistance to infection, novel strains of cc mice have been identified that are susceptible to specific bacteria, viruses, and parasites of humans [ ] [ ] [ ] [ ] [ ] [ ] . as an alternative approach to overcome murine resistance to infection, mice have been developed with greatly diminished immune responses. scid mice were shown to be susceptible to infection with brugia malayi while immunocompetent mice were resistant to the infection [ ] . nod.cg-prkdc scid il rg tm wjl /szj (nsg) mice are a highly immune-compromised strain of mice that have profound defects in the adaptive and innate immune responses [ ] . the most notable defects include those in: ) macrophages, dendritic cells and in the complement cascade [ ] [ ] [ ] ; ) maturation of t and b cells [ ] ; ) nk cells; ) signaling of different cytokines [ ] and ) the presence of eosinophils in the peripheral circulation and in tissue [ ] . nod-rag tm mom il rg tm wjl mice (nrg) are phenotypically similar to nsg mice with disruption in the b and t-cell production [ ] . interestingly, nsg mice can support the complete lifecycle of the human nematode strongyloides stercoralis, whereas immunologically intact mice cannot [ ] . a third strategy to enhance pathogen survival in mice has been to add human-derived cells required for survival and growth [ ] . nsg mice have the unique ability to support several different xenografts including human hematopoietic stem cells (cd + stem cells) that allow for the development of an immature partially-functional human immune system [ , , , ] . nod.cg-prkdc scid il rg tm wjl tg (cmv-il , csf , kitlg) eav/mloyszj (sgm) mice have an additional three human genes il , csf , and kitlg under the cmv promoter to enhance the overall microenvironment for the development of human xenografts. this results in increased numbers of cd + myeloid cells, b-cells, t-cells, and hematopoietic stem cells [ ] . humanized blt mice are nsg mice that received a xenograft of human cd + stem cells and a transplant of human fetal thymus and liver implanted under the kidney capsule, which results in the formation of a "human immune organ" [ ] . control and potential elimination of onchocerciasis has been significantly impeded by the limited number of available drugs and the development of resistance to those therapies [ , ] . in addition, biomarkers to assess the infection status of treated individuals or macrofilaricidal activity are sorely lacking [ ] [ ] [ ] . one of the critical barriers blocking drug and biomarker development has been the absence of suitable small animal hosts for experimentation. hence, this study was focused on the development of a small animal model that would support the growth and maturation of o. volvulus and could serve to identify parasite specific biomarkers. to this end we tested multiple genetically defined mouse strains and xenografted (with human cells) immunodeficient mice to identify those microenvironments suitable for o. volvulus development. in so doing, we were able to develop convenient and tractable murine models that support the development of o. volvulus l into advanced larval stages. moreover, we were able to use these o. volvulus-infected animals to identify parasite-derived biomarkers measurable in both urine and serum. the parasite material was collected during the years - in the research facility at the tropical medicine research station, kumba, cameroon. the procedures used for the production of o. volvulus forest strain third-stage-larvae (l ) were approved by an nih accredited institutional review board of the medical research council kumba, cameroon (protocol ). the protocol was reviewed and approved annually. l were collected from black flies (simulium damnosum) that were fed on consenting infected donors. after seven days the flies were dissected and the developed l were collected, cleaned and cryopreserved. the cryopreserved l were shipped to the new york blood center in liquid nitrogen and upon arrival in new york were stored in liquid nitrogen. all protocols using the l cryopreserved samples in this study were approved by the new york blood center's irb (protocol and protocol - ). all l samples were anonymized. all experimental procedures in mice were performed in compliance with the ethical and regulatory standards set by the nih for animal experimentation. the animal use protocol ( ) was approved by the thomas jefferson university institutional animal care and use committee. the animal care and use protocol adhered to the "guide for the care and use of laboratory animals" published by the national research council, usa. cryopreserved l were prepared as previously described [ ] [ ] [ ] . briefly, black flies (simulium damnosum) were fed on consenting donors infected with o. volvulus, and after days the developed l were collected from dissected flies, cleaned, and cryopreserved in dimethyl sulfoxide and sucrose using biocool ii computerized freezing equipment (fts systems inc., stone ridge, ny) [ ] . cryopreserved l were removed from liquid nitrogen storage and placed on dry ice for minutes followed immediately by a ˚water bath. the l were then washed times in a : mixture of nctc- and iscove's modified dulbecco's medium (sigma, st. louis mo) supplemented with u penicillin, μg streptomycin (corning, tewksbury ma) μg gentamicin and μg chloramphenicol per ml (sigma). l isolated from different collection days were tested first for viability in diffusion chambers implanted in balb/byj for days, as previously described [ ] . batches of l with viabilities greater than % at days post implantation were used in these studies. one hundred worms (except where noted) were then counted and loaded into ml tuberculin syringes with g needle for subcutaneous injection of the larvae into the nape of the neck. all mice were housed in micro-isolator boxes in a pathogen-free room at the laboratory animal science facility at thomas jefferson university (philadelphia, pa). collaborative cross (cc) mouse strains, cast/eij, il (cc /tauunc), au (cc /geniunc), au (cc /geniunc) and or (cc /unc), were purchased and imported from the systems genetics core facility of university of north carolina (unc-chapel hill). information about the cc strains can be found on the unc systems genetics website at http:// csbio.unc.edu/ccstatus/index.py. the mice were kept under temperature, humidity and light cycle-controlled conditions and fed autoclavable rodent chow and given water ad libitum. nod-scid il rg null (nsg), nod-rag null il rg null (nrg), and nod-scid il rg null - / gm/sf (sgm) mice were obtained from the jackson laboratories (bar harbor, me). an nsg, nrg, and sgm mouse breeding colony was maintained in the laboratory animal science facility, at thomas jefferson university with breeding trios given acidified water and low fat k animal chow (labdiet, st. louis, mo). the following human cell types were individually transferred into nsg mice: ( ) human keratinocytes (hacat) (atcc, manassas, va), ( ) bovine embryo skeletal muscle cells (besm) in the initial experiments, mice were injected with × besm, hacat, lec, or huskmc cells subcutaneously weekly throughout the experiment. the frequency of injection was subsequently determined by in vivo imaging experiments. genes encoding green fluorescent protein (gfp) and luciferase were inserted into huskmc cells using lentiviral vectors following the manufacturer's recommendations (cell biolabs, inc, san diego, ca). cells expressing gfp were isolated using the gfp marker by fluorescence-activated cell sorting using a bd facs aria (bd biosciences, franklin lakes, nj). the isolated cells were grown in huskmc media as described above and × cells were injected subcutaneously into nsg mice. mice were injected with vivoglo (promega, madison, wi) and imaged following manufacturer's recommendations on an ivis lumina xr (promega). two approaches were used to create humanized mice containing multiple human-cell types [ , ] . human umbilical cord blood was obtained through collaboration with thomas jefferson university hospital department of obstetrics and gynecology from full term natural deliveries. cd + stem cells were isolated from cord blood using magnetic assisted cell sorting (macs) and cryopreserved until use. sgm, nrg and nsg mice were humanized with cd + umbilical cord derived stem cells by intrahepatic injection of x cd + stem cells into -hour old pups that were irradiated with . gray. six weeks following injection of the stem cells, peripheral blood from the mice was screened for the presence of human cells and mice with counts greater than human cd + hematopoietic cells per μl of whole blood were used for experimentation, following previously published protocols [ ] . blt mice were purchased from the jackson laboratories or were prepared following previously established protocols [ ] . briefly, nsg mice ( -to -week old) were implanted with mm sections of fetal thymus and liver (advanced biomedical resources, alameda, ca) under the kidney capsule. two weeks post-implantation the mice were treated with busulfan (sigma) ( mg/kg ip) and were injected retro-orbitally with x cd + stem cells, isolated from the donor fetal liver using macs, (miltenyi biotec inc. auburn, ca). eight weeks following the stem cell xenograft the peripheral blood from the blt mice was screened for the presence of human cells. blt mice were screened and selected using the same protocol described above for the cd + cord blood mice. pcr screening for o. volvulus dna was performed on all the infected mouse tissues to identify the presence of current or past o. volvulus larvae in that location. mice were anesthetized and exsanguinated, and the internal organs were removed, and the skin was removed from the muscle. the muscle and skin were then divided into different sections and individually frozen in . ml eppendorf tubes. dna was extracted from the tissue sections using the promega genomic dna kit a following the manufacturer's directions. realtime pcr was performed using custom taqman probes (integrated dna technologies, coralville, ia) against the ov- [ ] [ ] [ ] repeats and an abi onestep-plus (thermofisher). mice were necropsied following previously established protocols for the isolation of filarial worms from tissues [ , ] . briefly, mice were anesthetized using isoflurane gas and exsanguinated. the head was removed from the body of the mouse and discarded. the remaining internal organs and skin were removed from the muscles, and the muscle was divided into upper and lower sections at the bottom of the rib cage. all portions of the mouse (muscle, skin, and all internal organs with the exception of the head) were soaked overnight in rpmi containing % fbs and with u penicillin, μg streptomycin (corning), and emerging parasites were then collected and enumerated. infected mice were evaluated using two criteria: ) percent established, measured the proportion of mice in a group of infected animals from which live parasites were recovered; and ) the geometric mean number of live worms recovered per mouse within the group. recovered worms were placed in boiling fixative consisting of % ethanol (deacon labs, king of prussia, pa) and % glycerol (fisher, fair lawn, nj). after allowing the alcohol to evaporate, glycerol was added, and the worms were transferred to glycerin jelly (gelatin g, ddh o . ml, glycerine . ml, phenol . ml). fixed worms were measured using an olympus szx dissecting scope connected to a dp camera (olympus, center valley, pa). cellsens dimensions software (olympus) was used to measure the length of the recovered worms. serum and urine were collected and frozen as terminal procedures during necropsy. serum was thawed on ice and μl removed for processing from each mouse. sera from mice from each group/strain were pooled for maximizing the protein identifications. abundant proteins were depleted using an affinity chromatography (mars-ms- , agilent) according to the manufacturer's directions. urine was thawed on ice, centrifuged and then filtered through a . μm filter (corning). serum and urine samples were prepared for mass spectrometry by digestion using the filter-assisted sample preparation (fasp) method [ ] . briefly, the samples brought to % sodium deoxycholate (sdc), mm tris-hcl, ph . , mm dithiothreitol, sonicated briefly, and incubated in a thermo-mixer at o c, , rpm for min. samples were centrifuged to clarify and the supernatant was transferred to a passivated kd mwco device (millipore, merck kgaa, darmstadt, germany) and centrifuged at , g for min. the remaining sample was buffer exchanged with % sdc, mm tris-hcl, ph . , then alkylated with mm iodoacetamide. the sdc concentration was reduced to . %. samples were digested using trypsin at an enzyme to substrate ratio of : , overnight, at o c in a thermo-mixer at , rpm. digested peptides were collected by centrifugation and the filter washed with . nacl to elute electrostatically bound peptides. digested peptides were desalted using reversed phase stop-and-go extraction tips [ ] . peptides were eluted with % acetonitrile, . % formic acid and lyophilized in a speedvac (thermo savant, holbrook, ny) to near dryness, approximately h. each digestion mixture was analyzed by ultra-high performance liquid chromatography tandem mass spectrometry (uhplc-ms/ms). lc was performed using an easy-nlc uhplc system (thermo fisher scientific, waltham, ma). mobile phase a was . % milliq water, % acetonitrile, . % formic acid. mobile phase b was . % acetonitrile, . % formic acid. the min lc gradient ran from % b to % b over min, then to % b for the remaining min. samples were loaded directly to the column. the column was cm x um i.d. and packed with μm c media (thermo easy spray pepmap). the lc was interfaced to a quadrupole-orbitrap mass spectrometer (q-exactive, thermo fisher scientific, waltham, ma) via nano-electrospray ionization using a source with an integrated column heater (thermo easy spray, thermo fisher scientific, waltham, ma). the column was heated to ˚c. an electrospray voltage of . kv was applied. the mass spectrometer was programmed to acquire, by data-dependent acquisition, tandem mass spectra from the top ions in the full scan from - m/z. dynamic exclusion was set to s, singly-charged ions were excluded, isolation width was set to . da, full ms resolution to , and ms/ms resolution to , . normalized collision energy was set to , automatic gain control to e , max fill ms to ms, max fill ms/ms to ms and the underfill ratio to . %. mass spectrometer raw data files were converted to mzml format using msconvert [ ] . mgf files were generated from mzml using the peak picker hires tool, part of the openms framework [ ] . all searches were performed on amazon web services-based cluster compute instances using the proteome cluster interface. detailed search parameters are printed in the search output xml files. briefly, all searches required ppm precursor mass tolerance, . da fragment mass tolerance, strict tryptic cleavage, up to missed cleavages, fixed modification of cysteine alkylation, variable modification of methionine oxidation and protein-level expectation value scores of . or lower. proteome cluster builds species-and genus-specific protein sequence libraries from the most current uniprotkb distribution [ ] . mgf files were searched using the most recent protein sequence libraries available from uniprotkb using x!tandem [ ] and omssa [ ] . xml output files were parsed and non-redundant protein sets determined using proteome cluster based on previously published rules [ ] . ms -based isotopoic features were detected and peptide peak areas were calculated using the featurefindercentroid tool, part of the openms framework [ ] . proteins were required to have or more unique peptides across the analyzed samples with e-value scores of . or less. geometric means (gm) were used as measures of central tendency. data were analyzed for larval growth by multifactorial analysis of variance anova with post-hoc fisher's least significant difference (lsd) testing in systat v. (systat inc., evanstown, il, usa). probability values less than . were considered statistically significant. all experiments were performed a minimum of times. to determine if there was an underlying genetic basis for the resistance of mice to infection with o. volvulus [ ] , mouse strains having a wide range of genetic diversity from the cc (cast/eij, il , au , au and or ) [ ] were screened for their susceptibility to o. volvulus. five mice from each of the different strains were infected with o. volvulus l and necropsied at -weeks post infection. none of the strains of cc mice tested was susceptible to infection with o. volvulus l . to assess the role of the mouse immune system in mediating resistance to o. volvulus, immunodeficient mouse strains were assessed for their susceptibility to infection with o. volvulus. in a preliminary set of studies, o. volvulus l were injected into nsg mice. after -weeks the skin and muscle from the mice was divided into anatomically distinct sections and qpcr for o- was performed on extracted dna from each section. twenty-three of the sections were positive from, spatially widespread regions of the body. it was concluded that parasites survived in nsg mice and had the ability to migrate extensively. this indicated that all regions of the mice had to be inspected for the presence of parasites following infection. nsg mice were infected with o. volvulus l and necropsied at -and -weeks following infection. infected mice had an established infection rate of % with a gm worm recovery of . (range to ) worms recovered at -weeks following infection. at -weeks, % of mice had an established infection, with a gm recovery of . (range to ) worms per mouse ( fig a) . the recovered worms were measured and found to be significantly increased in size (p< . ; min: μm, max μm, gm: μm) at -weeks compared to l . they also significantly increased in size between and weeks (p< . ) reaching a maximum of , μm (min: μm, gm: μm) (fig ) . table) . mice engrafted with lec had % established infection and gm of worms recovered per mouse with a range of to worms per mouse (s table) . hacat cell engrafted mice had a % established infection and gm recovery . worms recovered per mouse with between and worms per mouse (s table) . huskmc cell engrafted mice had an % estab- (fig b) . at each time point tested the parasites in huskmc-engrafted mice demonstrated continued parasite growth. at -weeks recovered parasites had gm lengths of μm (min: μm, max: μm), at -weeks lengths of μm (min: μm, max: , μm), and at -weeks the gm length was , μm with a maximum length of , μm observed (min: μm), representing a -fold increase in length over l (fig ) . these growth rates represented significant changes between l and -week worms (p = . ) and between -and -week worms (p< . ). sgm, nrg and nsg (hunsg) mice humanized with cd + umbilical cord derived stem cells were infected with o. volvulus l . each of these humanized mice had human hematopoietic lineage cells at a concentration greater than cells per μl of blood. while a complete picture of the cell populations in these specific mice was not determined, based upon flow analysis during the screening process all humanized mice had both human b and t-cells present in their blood. at -weeks post-infection humanized sgm mice contained a gm of . (range - ) worms/mouse, humanized nrg mice had a gm of . (range to ) worms/ table) . hunsg at -weeks post-infection had a % established infection rate with a gm of . (range - ) worms/mouse, and at -weeks post infection hunsg mice had a % established infection rate and a gm of . (range - ) worms/mouse (fig c) . larval growth in hunsg mice was comparable to that seen in nsg and in nsg mice engrafted with huskmc (fig ) . a significant increase in length was seen between the l and -week recovery ). after -, -or -weeks the percent established (the proportion of mice in a group of infected animals from which live parasites were recovered) (fig a- d ) and the geometric mean number of live worms recovered per mouse within the group was determined (fig e- h) . https://doi.org/ . /journal.pntd. .g humanized nsg (hunsg) mice: nsg mice that had received a human cd + stem cell transfer, ( ) blt: nsg mice that had been engrafted with human fetal liver derived cd + stem cells and engrafted with fetal thymus and liver tissues. after , or -weeks, animals were necropsied and worms were recovered and measured. solid colored bar is the geometric mean of the lengths of larvae recovered. solid black line is the geometric mean of the length of l recovered from black flies and dotted line is the th confidence interval. � asterisk represents statistical difference, p value � . , in length of larvae recovered from mice. complete statistical analyses for all groups are included on s blt mice humanized with fetal thymus, liver and cd + stem cells, which display an enhanced repertoire of the developing human cells [ ] , were infected with o. volvulus l and then necropsied at -and -weeks post infection. at -weeks post infection blt mice had an established infection rate of % with a gm of . (range - ) worms/mouse. at -weeks post infection blt mice had an established infection rate of % with a gm of . (range - ) worms/mouse (fig d) . growth of the parasites was equivalent to that seen in the nsg mice and the other humanized models with the maximum length reaching , μm at -weeks (min: μm, gm: μm) and , μm at -weeks (min: μm, gm: μm) (fig ) . the overall growth was significant between the l and worms -weeks post infection (p< . ) and between worms recovered at the -and -week time points (p< . ). during necropsy, mice were sectioned into groupings: upper muscles, lower muscles, skin, and the complete set of internal organs. no nodules were found in any of these tissues upon necropsy. worms were recovered from all four of the different tissue groupings with no apparent preference for any region of the animal in all of the mice tested. detailed morphological analyses focused on worms recovered from blt mice infected for -weeks and huskmc humanized mice infected for -weeks. although there were clear differences in lengths of these worms, their morphological characteristics were similar. no differences in the ratio of males and female worms recovered from the mice was observed, however it was noted that most of the longer worms were females. both the anterior and posterior ends in both sexes were bluntly rounded and only slightly tapered (fig a, b and f ). other than growth in length, the major change from l was development of the reproductive systems. in the l , both the female and male systems are rudimentary genital primordia consisting of only several cells. in the - -week old worms, the female ovejector had formed and had attached to the body wall. the ovejector was ovoid in shape, relatively large and filled the body cavity, and had a distinct lumen (fig c and d) . rudimentary cellular growth of the reproductive tubes was also evident (fig d) . in males, the testis, located at approximately mid-body, had become elongate in shape and had looped posteriorly to form a classic shepherd's crook (fig e) . in addition, the spicule pads were well developed and demarcated (fig f) but were still oval in shape and had not yet started to take on the shape of the spicules nor was there any evidence of cuticularization. these observations are consistent with parasite development into advanced fourth stage larvae (l ). global proteomic analyses were performed with serum and urine collected from blt mice infected for -weeks and huskmc humanized mice infected for -weeks. a total of , proteins were identified based on the spectral matching to a combined protein database of human, mouse, o. volvulus and its wolbachia (wov) endosymbiont. because of the ambiguity in distinguishing certain spectral matches for proteins commonly found in both humans and mice, these proteins were grouped as non-o. volvulus proteins ( , in serum, , in urine, s development of onchocerca volvulus in nsg mice serum and urine of the infected mice, the blt and huskmc mice had proteins (ovoc , ovoc , ovoc , ovoc and ovoc ) in common in the serum and (ovoc , ovoc , ovoc , ovoc and ovoc ) in the urine (fig b) . almost all the proteins identified have been shown through rnaseq to be transcribed by various stages of the o. volvulus parasite (fig b) . the objective of this project was to identify small animal models that would support the development of black-fly derived o. volvulus l into advanced mammalian-adapted stages of the parasite. these small animal models are critically needed for identifying biomarkers released from the early stages of the infection and for screening potential new anthelmintics. published findings on the susceptibility of mice to infection with the l of o. volvulus suggest that mice are resistant to infection when the larvae were injected subcutaneously [ ] . however, o. volvulus l have been shown to survive and develop in mice when implanted within diffusion chambers at rates comparable to those seen in susceptible primates [ ] . genetic traits can play a significant role in the susceptibility of animals to infection as has been clearly demonstrated by the diversity of susceptibility of different mouse strains to infection with litomosoides sigmodontis [ ] . the cc mouse project was developed to produce an extremely diverse set of inbred animals that could be used for mapping different genetic traits [ ] . five different cc mouse strains, selected based on their diverse genetic backgrounds, were tested for susceptibility to o. volvulus and were completely resistant to the infection. this observation suggests that either mice are missing some integral factors required for parasite growth or the immune responses in mice are effective at eliminating the infection. the question remains as to why parasites are recovered live from diffusion chambers implanted in mice but not when injected into the tissues. there are several possible explanations including: ( ) the diffusion chamber acts as a barrier from the immune response creating an immune privileged site, ( ) the larvae within the diffusion chamber are blocked from migrating through the tissue releasing excretory and secretory products and thereby eliciting an immune reaction, or ( ) the diffusion chamber attracts host components to the parasite microenvironment that are beneficial for parasite development. to test the hypothesis that mouse-intrinsic immune responses control o. volvulus infections, nsg mice that lack both functional innate and adaptive immune systems were infected with o. volvulus l . advanced stages of the parasites were consistently recovered from the infected nsg mice, and parasites survived and developed over the -week time course into advanced l . these findings demonstrate that the mouse immune response was capable of controlling infection with o. volvulus, with elements of the mouse immune response eliminating the infection in immunologically intact mice. many mechanisms have been described for innate immune control of nematode infections in mice [ , [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] all or some of which may be effective against o. volvulus. interestingly, tissues and cells in nsg mice provide required factors for parasite development and based on pcr analyses, the larvae actively migrated far from the infection site. the present study did not identify the point at which o. volvulus ceased surviving and developing in nsg mice. studies with the human parasite s. stercoralis have demonstrated that the entire parasite life cycle will develop in nsg mice within -weeks [ ] . given the significant difference in time that it takes for o. volvulus adults to develop ( - months in chimpanzees [ , ] ) and their size as mature adults (females are cm [ ] ) it is unlikely that the entire o. volvulus life cycle, including mating and development of microfilariae, will occur in nsg mice. in vitro studies on the development of filarial worms including o. volvulus [ , ] and brugia malayi [ ] have demonstrated that host cells are needed in the culture wells to optimize parasite growth and development. furthermore, optimal development and survival of larval t. spiralis in mice requires the presence of mouse eosinophils [ ] . it was thus hypothesized that adding human cells to the nsg mice, from the tissues that the parasites are normally found juxtaposed in humans, might provide additional required nutritional or developmental elements found in humans required for parasite development and survival. four different single cell xenografts were screened: huskmc, lec, hacat and besm. of these four cell lines, huskmc was found to support the highest average percent survival of the implanted worms and consistent infection rates over a -week time period (figs and ) as an alternative to adding single cell populations to the nsg mice, multipotential umbilical cord stem cells were transferred to the immunodeficient mice. nsg, nsg-sgm, and nrg mice, all of which lack functional immune responses, were humanized with cd + umbilical cord stem cells. the humanization of the various immunocompromised mouse strains resulted in the development of an immature human immune system. the developing immune system in these mice displays a t-independent response, limited antigen-specific igm responses, and the presence of multiple innate immune cells has been noted [ ] . when humanized nsg, nsg-sgm, and nrg mice were infected with o. volvulus l , higher gm parasite recoveries were observed when compared to nsg mice without any human cells but these enhancements were not significant. although nsg-sgm did have consistent infection rates with o. volvulus we had significant difficulties establishing reliable engraftment of human cells in this strain of mice. extending this concept further, blt mice which contain cd + stem cells in addition to fetal tissue were used. blt mice are known to develop a more mature version of a human immune system. limited t-dependent recognition is seen within these mice and better overall functionality of both the b and t-cells has been documented [ ] . blt mice supported the highest average parasite recoveries of any mouse model tested at -weeks, although the average fell to be in line with the hunsg and huskmc models by -weeks post infection. the mean lengths of the parasites recovered from -and -week time points from the nsg mice were comparable to those recovered from blt mice. this suggests a link between the enhanced survival, may be related to the presence of the human immune cells, but the growth of the parasites that survive may not be related to the human cell byproducts. although cellular engraftments levels in blt and hunsg mice were not rechecked at the end of the experiment previously published data have shown that these animals reliably hold their engraftments for extended periods of time [ , ] . the mouse models developed in this study offer a number of advantages over the models that currently exist. l implanted within diffusion chambers in both non-human primates and mice successfully molt into l but the lengths of the recovered parasites were significantly shorter than those recovered at and weeks post infection from the mice tested in this study [ ] . while non-human primates can support the development of the parasites from l to microfilariae producing adults, cost and ethical considerations limit the utility of primates for drug discovery and antigen identification [ , ] . nodules containing adult worms recovered from humans have been implanted into scid mice and the female worms survived and released microfilariae [ ] . this method allows for identification of adult antigens and biomarkers, but lacks the intermediate l and l stages of development. finally, an alternative model using adult male o. ochengi implanted into scid mice has been developed for the identifying filaricides [ ] , which may also be effective against o. volvulus. the nsg models developed in this study have the critical advantage of working with o. volvulus, thereby allowing species-specific screening of filaricides and identification of biomarkers. it was of interest to note that the immune response found in normal mice was highly efficient at eliminating the l of o. volvulus, but the human immune cells in nsg mice were supportive rather than destructive of the parasites. it is possible that the mouse immune cells were evolutionally adapted to eliminate the parasites, whereas the human cells were evolutionally adapted to support the parasites as observed in nature. a comparison between mouse and human immune reactions to the worms might yield important new insights into the etiology of resistance and susceptibility to infection with o. volvulus. the source of the l used in these studies was from parasites cryopreserved in liquid nitrogen. after defrosting, individual parasites were selected, attempting to identify only the viable/undamaged l . it is reasonable to predict that a percentage of larvae exiting from the mouth parts of a black fly have the potential to resume development in the human host and that the cryopreservation process damaged some of those worms. approximately percent of the larvae recovered after cryopreservation survived in diffusion chambers implanted in mice, which may explain the overall number of worms recovered from the different mouse models in this study. while minor differences in the overall larval recovery levels were observed between individual batches of cryopreserved larvae, multiple batches were combined before implantation to help ensure a consistent viability level going into the animal hosts. even with the combination of multiple batches of larvae it cannot be ruled out that the overall viability of the injected larvae played a role in the observed recovery rates. the recovery rates of o. volvulus larvae after developing in nsg mice with or without human cells was in the same order of magnitude as that reported for the recovery of adult filarial worms, where infections were initiated by larvae recovered directly from the insect vector. these infections included brugia pahangi in cats [ ] , brugia malayi in leaf-monkey [ ] , and onchocerca ochengi in cattle [ ] . in the final analysis, optimal parasite recovery was observed in mice humanized with huskmc (maximum of worms), hunsg (maximum of worms) and blt mice (maximum of worms). it was clear that worms increased in size during the infection period with individual worms achieving up to times the size of the original l . growth of worms within a single mouse was not consistent and suggests that there is significant variability within the infecting larval population. it does verify, however, that humanized mice have the potential to support extended development of o. volvulus. both male and female worms grew in length and resumed their sexual development. although no cast cuticles were observed, it was evident from organ development that the parasites had molted into fourth-stage larvae. urine and serum was collected from humanized mice infected for - -weeks with o. volvulus for the identification of biomarkers. infected huskmc mice or blt mice were selected for this analysis so the biomarkers identified would develop in the presence of human cells thereby potentially enhancing their specificity. several o. volvulus-specific peptides were identified in the serum and urine of blt and huskmc mice (s table) , however, no o. volvulusspecific proteins were found in both urine and serum from either mouse source. the most likely useful biomarkers were the proteins listed in fig b. though most of the proteins were identified by one or more unique peptide(s), among the proteins with unknown function (ovoc , ovoc , ovoc ), ovoc does not have orthologues in other filarial species and hence would likely be able to distinguish o. volvulus from other filarial infections. because of the expected low number and abundance of o. volvulus-specific protein identification in the serum and urine from any given mouse in the current system, mass spectrometry was carried out with pooled serum and urine samples from each group of mice. in conclusion, novel small-animal hosts, nsg mice, have been identified that support the survival and development of o. volvulus l into advanced l mammalian stages. humanized mice have also been shown to be effective at identifying biomarkers for early o. volvulus infections. it is anticipated that these small-animal hosts for o. volvulus will also be useful as part of the effort to identify new anthelminthic drugs. finally, the fact that o. volvulus survives and develops in nsg mice humanized with human immune cells may provide the opportunity to study the human immune response to early infection with o. volvulus in a small animal model. global, regional, and national comparative risk assessment of behavioural, environmental and occupational, and metabolic risks or clusters of risks in countries, - : a systematic analysis for the global burden of disease study detection of onchocerca volvulus in skin snips by microscopy and real-time 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mice non-obese diabetic-recombination activating gene- (nod-rag null) interleukin (il)- receptor common gamma chain (il r gamma null) null mice: a radioresistant model for human lymphohaematopoietic engraftment eosinophils and il- support nematode growth coincident with an innate response to tissue injury humoral immunity in humanized mice: a work in progress aml xenograft efficiency is significantly improved in nod/scid-il rg mice constitutively expressing human scf, gm-csf and il- blt humanized mice as a small animal model of hiv infection ivermectin resistance in onchocerca volvulus: toward a genetic basis genome-wide analysis of ivermectin response by onchocerca volvulus reveals that genetic drift and soft selective sweeps contribute to loss of drug sensitivity protective immunity to the larval stages of onchocerca volvulus is dependent on toll-like receptor immunoglobulin e and eosinophil-dependent protective immunity to larval onchocerca volvulus in mice immunized with irradiated larvae differential cytokine and antibody responses to adult and larval stages of onchocerca volvulus consistent with the development of concomitant immunity cryopreservation of infective larvae of onchocerca volvulus (filarioidea: onchocercidae) infection of tissue culture cells with bloodstream trypomastigotes of trypanosoma cruzi detection of onchocerca volvulus infection by o- polymerase chain reaction analysis of skin scratches polymerase chain reactionbased diagnosis of onchocerca volvulus infection: improved detection of patients with onchocerciasis dna-based detection of onchocerca volvulus effects of presensitization on the development of lymphatic lesions in brugia pahangi-infected jirds removal of wolbachia from brugia pahangi is closely linked to worm death and fecundity but does not result in altered lymphatic lesion formation in mongolian gerbils (meriones unguiculatus) universal sample preparation method for proteome analysis protocol for micro-purification, enrichment, pre-fractionation and storage of peptides for proteomics using stagetips a cross-platform toolkit for mass spectrometry and proteomics openms-an open-source software framework for mass spectrometry uniprot: a hub for protein information tandem: matching proteins with tandem mass spectra open mass spectrometry search algorithm masssieve: panning ms/ms peptide data for proteins the collaborative cross, a community resource for the genetic analysis of complex traits the utility of the new generation of humanized mice to study hiv- infection: transmission, prevention, pathogenesis, and treatment resistance and susceptibility to filarial infection with litomosoides sigmodontis are associated with early differences in parasite development and in localized immune reactions complement component c is required for protective innate and adaptive immunity to larval strongyloides stercoralis in mice role of eosinophils and neutrophils in innate and adaptive protective immunity to larval strongyloides stercoralis in mice strongyloides infection in rodents: immune response and immune regulation extracellular traps are associated with human and mouse neutrophil and macrophage mediated killing of larval strongyloides stercoralis human and mouse macrophages collaborate with neutrophils to kill larval strongyloides stercoralis innate and adaptive immunity to the nematode strongyloides stercoralis in a mouse model strongyloides stercoralis: protective immunity to third-stage larvae inbalb/cbyj mice immunity to onchocerca spp. in animal hosts morphology of onchocerca volvulus the use of cell-conditioned medium for the in vitro culture of onchocerca spp. larvae (nematoda: filarioidea) onchocerca volvulus: biochemical and morphological characteristics of the surface of third-and fourth-stage larvae in vitro cultivation of third-stage larvae of brugia malayi to the young adult stage sustained engraftment of cryopreserved human bone marrow cd (+) cells in young adult nsg mice long-term human cd + stem cell-engrafted nonobese diabetic/scid/il- r gamma(null) mice show impaired cd + t cell maintenance and a functional arrest of immature nk cells repeated infection of cats with brugia pahangi: parasitological observations experimental infection of the leaf-monkeys, presbytis cristata and presbytis melalophos with subperiodic brugia malayi onchocerca ochengi infections in cattle as a model for human onchocerciasis: recent developments we thank the consenting infected donors from the villages around kumba, cameroon (marumba i, marumba ii, boa bakundu, bombanda, and bombele) who participated in the study. we also thank dr. peter enyong and the staff at the tropical medicine research station for their technical support in the production and cryopreservation of the o. volvulus l s.we thank dr. timothy manser, thomas jefferson university, for his support and encouragement for using human-stem cell engrafted humanized mice; dr. judy sakanari, university of california san francisco for her gift of bovine embryo skeletal muscle cells and dr. fernando pardo manuel de villena, ms. darla r. miller, and dr. linda d. siracusa for guidance with collaborative cross strain import and husbandry. key: cord- -qw tusd authors: krishna, smriti m.; omer, safraz mohamed; li, jiaze; morton, susan k.; jose, roby j.; golledge, jonathan title: development of a two-stage limb ischemia model to better simulate human peripheral artery disease date: - - journal: sci rep doi: . /s - - - sha: doc_id: cord_uid: qw tusd peripheral arterial disease (pad) develops due to the narrowing or blockage of arteries supplying blood to the lower limbs. surgical and endovascular interventions are the main treatments for advanced pad but alternative and adjunctive medical therapies are needed. currently the main preclinical experimental model employed in pad research is based on induction of acute hind limb ischemia (hli) by a -stage procedure. since there are concerns regarding the ability to translate findings from this animal model to patients, we aimed to develop a novel clinically relevant animal model of pad. hli was induced in male apolipoprotein e (apoe(−/−)) deficient mice by a -stage procedure of initial gradual femoral artery occlusion by ameroid constrictors for days and subsequent excision of the femoral artery. this -stage hli model was compared to the classical -stage hli model and sham controls. ischemia severity was assessed using laser doppler perfusion imaging (ldpi). ambulatory ability was assessed using an open field test, a treadmill test and using established scoring scales. molecular markers of angiogenesis and shear stress were assessed within gastrocnemius muscle tissue samples using quantitative polymerase chain reaction. hli was more severe in mice receiving the -stage compared to the -stage ischemia induction procedure as assessed by ldpi (p = . ), and reflected in a higher ischemic score (p = . ) and lower average distance travelled on a treadmill test (p = . ). mice undergoing the -stage hli also had lower expression of angiogenesis markers (vascular endothelial growth factor, p = . ; vascular endothelial growth factor- receptor , p = . ) and shear stress response mechano-transducer transient receptor potential vanilloid (p = . ) within gastrocnemius muscle samples, compared to animals having the -stage hli procedure. mice subjected to the -stage hli receiving an exercise program showed significantly greater improvement in their ambulatory ability on a treadmill test than a sedentary control group. this study describes a novel model of hli which leads to more severe and sustained ischemia than the conventionally used model. exercise therapy, which has established efficacy in pad patients, was also effective in this new model. this new model maybe useful in the evaluation of potential novel pad therapies. major amputation, renal failure and death) and poor long-term durability [ ] [ ] [ ] [ ] . there is great interest in developing novel medical therapies for the leg symptoms of pad. recent efforts have focused on stimulating development of new blood vessels within the leg through angiogenesis or by encouraging the remodelling of existing small vessels into improved collateral channels (arteriogenesis). promising results for novel treatments, such as viral vectors carrying angiogenesis promoting agents and stem cells, in pre-clinical models of pad have not been consistently replicated in large clinical trials - . in patients that have pad, atherosclerosis-associated arterial narrowing develops gradually over many years allowing the legs to adjust to the gradual decrease in blood flow through compensatory mechanisms within the blood vessels and muscle fibres . in contrast, the most commonly used animal model for initial testing of novel therapies for pad is a model of acute blood supply interruption through ligation or excision of the femoral artery (referred to here as the -stage hind limb ischemia (hli) model) , . previous studies report that the ligation and excision of the femoral artery in the -stage model leads to increased fluid shear stress within the limb collateral arteries resulting in altered gene expression patterns through shear stress responsive elements which promote arterio-and angio-genesis [ ] [ ] [ ] . hind limb blood supply in this -stage model therefore usually naturally recovers over a period of approximately weeks . this model does not therefore simulate the clinical presentation of pad. patients typically present with a history of acute exacerbation of chronic symptoms of leg pain on walking and have ongoing ischemic symptoms. the -stage hli model may therefore not be an ideal model to study therapeutic angiogenesis and arteriogenesis , . another approach to inducing hli is the placement of an ameroid constrictor around the femoral artery to induce gradual occlusion , , . previous studies suggest that this approach leads to mild ischemia and that blood flow recovery occurs within - weeks , . furthermore, previous pre-clinical pad research has mainly focused on assessing hind limb blood supply with limited assessment of ambulatory ability , . on the other hand, the assessment of novel treatments in pad patients usually involves measures of walking ability using treadmill or corridor walking tests , . there is therefore a need for an increased focus on functional tests of the limb within clinically-relevant rodent models. we hypothesised that the limb ischemia produced by the current -stage hli model would be more severe and sustained if the model was modified to include an initial more slowly progressive arterial narrowing over days prior to the induction of acute ischemia (i.e. a -stage model). our overall aim was to develop a more clinically relevant rodent model that could incorporates stable on-going limb ischemia in order to test therapeutic interventions. mice. male apolipoprotein e deficient (apoe −/− ) mice (n = , obtained from animal resources centre, western australia) were used for the experiments. mice were housed in a temperature-controlled room ( ± °c) with an automatic : -h light/dark cycle ( : to : hours). mice were singly housed in a clear individually-ventilated, temperature and humidity-controlled cage system (aero ivc green line; tecniplast) with enrichment. all experiments were performed during the light phase ( : - : hours) and mice were fed with standard rodent chow and water ad libitum during the course of these experiments. approval for the animal studies was obtained from the institutional ethics committee (animal ethics committee, james cook university) and experimental work performed in accordance with the institutional and ethical guidelines of james cook university, australia, and conforming to the guide for the care and use of laboratory animals (national institutes of health, usa). hli models. the first phase of the study utilised two hli models: the most commonly used unilateral acute hli model ( -stage hli) , , and the newly developed -stage hli model. male apoe −/− mice aged months were randomly divided into groups as follows: group = -stage hli model (n = ), group = -stage sham (n = ), group = -stage hli model (n = ) and group = -stage sham (n = ). body weight and primary outcome measures were recorded at regular intervals as illustrated in fig. a . all functional assessments were performed in a subset of mice randomly selected from each experimental group (n = - ). the creation of the -stage hli model involved exposure of the left femoral artery through a vertical . - cm skin incision under a stereotactic microscope (leica). the femoral artery and its side branches were then ligated with - silk sutures (ethicon) immediately distal to the inguinal ligament and proximal to the popliteal bifurcation before being excised ( supplementary fig. s a,b) . femoral nerves were carefully preserved. the wound was irrigated with sterile saline and then the overlying skin was closed using - vicryl sutures (ethicon). post-operative pain was reduced using lignocaine (troy laboratories). a similar surgery without ligation or excision of the femoral artery was performed on the -stage sham controls. the -stage hli model was performed using a -stage surgical procedure. the left femoral artery was exposed as described above and custom made miniature ameroid constrictors of . mm internal diameter (research instruments sw) were positioned on the artery. one was placed on the femoral artery immediately distal to the inguinal ligament and one was positioned proximal to the sapheno-popliteal bifurcation ( supplementary fig. s c ). after days, a new incision was made and the femoral artery ligated and excised, as described for the -stage hli model. a similar two-stage surgery was performed without placement of ameroids, nor ligation and excision of the femoral artery for the -stage sham controls. assessment of the effect of exercise training in the -stage hli model. during the second phase of the study, the effect of an exercise program on male apoe −/− mice aged months undergoing the -stage hli model (male apoe −/− mice, n = ) was tested. mice subjected to -stage hli were randomly allocated to an exercise training or control group (n = per group). mice in the exercise group received to m (between - mins of running wheel access) of exercise each day on a running wheel ( station home cage running the movement of animals were monitored and functional scores of the various groups were assessed according to the scoring criteria detailed in the materials and methods section. the -stage hli model showed reduced function throughout the experimental period compared to the -stage hli model. data shown as mean ± sem and analysed by repeated measures -way anova, and p value significant at ≤ . . (e) graph showing modified ischemia scores. the animals were monitored and scored for signs of ischemia according to previously published criteria detailed in the materials and methods. the -stage hli model showed a higher level of ischemia compared to the -stage hli depicted by a lower scoring throughout the study period. data shown as median ±sem and analysed by repeated measures -way anova, and p value significance set at ≤ . . suggested that the hli typically resolved over the course of days, with hind limb blood supply reaching a plateau between and days after surgery . the ldpi measurements were therefore performed at the following time points for -stage hli model: day prior to surgery, immediately after surgery, days , , , and after surgery. for the -stage hli model, the ldpi measurements were performed at the following time points: day prior to the first operation (ameroid placement), immediately after the first operation, days , , and after the first operation, immediately after the second operation (femoral artery excision), and , , and days after the second operation (i.e. , , , and days after the first operation). a schematic illustration of the experimental design is shown in fig. a . body mass was also measured on the same day as the ldpi measurements. in clinical practice pad patients are treated to improve pain free walking capacity and resolve rest pain and tissue loss (critical limb ischemia, cli). in clinical trials, these are usually investigated by walking tests and assessment of pain. similar to clinical trials, in the current study ambulatory ability was assessed with a treadmill test, voluntary physical activity examined through an open field test and foot pain estimated through a mechanical allodynia test. all outcomes were assessed by an assessor blinded to mice group. semi-quantitative assessments of limb function and ischemia were performed at the same time points as the blood flow measurements ( fig. a ; supplementary tables s , s ). limb function was assessed using the clinical use score (tarlov scale) as: = no movement; = barely perceptible movement, no weight bearing; = frequent and vigorous movement, no weight bearing; = supports weight, may take or steps; = walks with only mild deficit; = normal but slow walking and = full and fast walking , . limb ischemia was scored using the ischemia scoring scale as previously reported: = auto-amputation of leg; = leg necrosis; = foot necrosis; = two or more toe discoloration; = one toe discoloration; = two or more nail discolorations; = one nail discoloration and = no necrosis . all scoring was performed by two independent observers and found to be identical. treadmill test. mice were run on a six lane excer / treadmill (columbus instruments) without incline. mice were acclimatised to the treadmill by ambulating on it at m/min for min once daily on three consecutive days prior to any testing. before each treadmill test, mice were fasted for h. the speed of the treadmill was controlled using the software and calibrated using an inbuilt speedometer mounted on the treadmill platform. a treadmill test involved an initial warm up at m/min for min followed by a progressive speed increase from to m/min, accelerated at m/min. following this the treadmill speed remained at m/min for up to a total running time of min. during the test a stimulus grid of hz was kept on until mouse exhaustion as previously reported . exhaustion of the mouse was defined if the mouse returned to the stimulus grid times despite a hz electrical stimulus to encourage walking on the belt. the treadmill software recorded the total distance walked by a mouse until exhaustion. a blinded observer supervised the experiment to assess outcomes. the treadmill belt and lanes were cleaned with water and % alcohol and dried with paper towel after each test to remove any body scent. treadmill testing was carried out before ameroid placement, days after ameroid placement, and and weeks after completion of the -stage hli (fig. a) . for the -stage hli model, treadmill testing was performed before ligation and excision of the femoral artery and and weeks after ischemia induction. voluntary physical activity test. the open field test is a common measure of voluntary physical activity in rodents suggested to be similar to a -min walk test used in humans . to ensure consistency prior to the test, mice were brought to the testing room in their home cages at least hr prior to the start of behavioural testing. the mice were fasted during the acclimatisation period and given free access to water under normal lighting. the open field box was made of opaque plastic ( × × cm), divided into an outer field (periphery) and a central field ( × cm) which was primarily used for analysis. mice were individually placed in the centre of the arena and movements of the mice were recorded using a video camera (logitech) supported with acquisition software (capture star ver. ; cleversys inc) and analysed by the topscan lite software (high throughput version . ; cleversys inc). the test protocol used was identical for each mouse assessed. after each test the open field box was cleaned with water and % alcohol and dried with a paper towel to remove the body scent, which could be a cue to movement of the mice. room lighting, temperature, and noise levels were kept consistent for all tests. the mouse movements were recorded for min, to mimic the short timed nature of the -min walk test. rest time was recorded as motion measure score < . in the software and average speed was calculated only for motion measure score > . . total distance travelled (m), frequency of movement, time spent in the arena (s) and average velocity in the arena (mm/s) were measured. mechanical allodynia test. the paw pressure transducer and the pressure application measurement device (pam; ugo basile) is a non-invasive tool for measuring mechanical allodynia threshold and hypersensitivity in rodents. the pam device allows an accurate measurement of primary mechanical hypersensitivity in rodents , . a gradually increasing squeeze force is applied across the joint at a rate of approximately gms/sec until a behavioural response (paw withdrawal, freezing of whisker movement, wriggling or vocalization) is observed with a cut-off of sec. the peak gram force (gf) applied immediately prior to limb withdrawal was recorded by the base unit, and this value was designated the limb withdrawal threshold (lwt). lwt was measured twice in both the ipsilateral and contralateral limbs by two independent observers. the measurements were averaged and presented as a ratio of operated left limb to the un-operated right limb. blood tests. blood was collected by cardiac puncture at the completion of the experiments. platelet poor plasma was separated as described previously , . the plasma concentrations of interleukin (il)- , interferon (ifn)-γ, monocyte chemoattractant protein- (mcp- ) and tumour necrosis factor (tnf)-α were determined scientific reports | ( ) : | https://doi.org/ . /s - - - www.nature.com/scientificreports www.nature.com/scientificreports/ using a cytometric bead array kit (cba, bd biosciences). the inflammatory markers were assessed in samples (n = /group) selected from each group using a random number generator. briefly, μl of mixed capture beads and μl of serially diluted standard or plasma sample and μl of phycoerythrin (pe) detection reagent, were incubated in the dark for h in sample assay tubes. samples were then washed twice with ml of the wash buffer, resuspended, and acquired on the cyan adp flow cytometer (beckman coulter). results were analysed and quantified by fcap array ™ software (v , bd biosciences). we previously reported this method to have good reproducibility with an inter-assay coefficient of variation of - % (n = - ) . total nitrate was measured in plasma samples by a nitrate/nitrite colorimetric assay kit following the manufacturer's protocol (inter-assay coefficient of variation . %; cayman chemicals) as reported previously . briefly, nitrate was converted to nitrite using nitrate reductase. subsequently, addition of the griess reagents converted nitrite into a deep purple azo compound and the absorbance was measured at nm using an omega plate reader. histological assessments. low capillary density has been reported in the gastrocnemius muscle of pad patients and animal hli models and associated with functional impairment , . hence at the end of experiments gastrocnemius muscle samples were collected from the mice and stored in optimal cutting compound (oct, proscitech) which was progressively frozen in isopentane (sigma) suspended in liquid nitrogen. sections ( µm-thick) were obtained on poly l-lysine coated slides (proscitech) from each sample with muscle fibres oriented in the transverse direction. all histological assessments were performed on sections that were examined in a blinded fashion at x magnification. muscle fibre structure. fixed cryostat sections were stained with hematoxylin and eosin (h&e, proscitech), examined at magnifications of x or x to assess the integrity of the tissues. degenerating muscle fibres were identified in the h&e stained sections by morphological assessment. assessors looked for the presence of mature skeletal muscle fibres (small peripheral nuclei) versus immature skeletal muscle myoblasts (large lobulated central nuclei) . muscle fibre number and size were examined in separate fields in distinct areas in each specimen. muscle fibrosis. the extent of skeletal muscle fibrosis was assessed by staining the cryostat sections ( µm-thick) with picrosirius (proscitech). briefly, tissue sections were stained and examined under x power light microscope and skeletal muscle fibrosis was analysed using the image analysis software (zeiss axio imager z ). quantification of fibrosis was expressed as the percentage of fibrotic tissue present within the section ( mm tissue area) using a previously published protocol . immunohistochemistry and morphometric analysis of capillary and arteriolar density. these were performed as previously reported , . the gastrocnemius muscles from ischaemic and non-ischaemic hind-limbs were collected and embedded in oct compound (proscitech), frozen, and cut into µm-thick sections. the slides were fixed at − °c in % ethanol for hr. slides were washed three times in cold pbs with % horse serum ( min/ wash) and blocked overnight with % horse serum in pbs at °c. immunohistochemistry was performed using primary antibodies against cd ( : dilution; abcam) and smooth muscle α-actin (α-sma, : dilution; abcam). bound primary antibodies were detected by using appropriate secondary antibodies (biotinylated anti-goat igg and biotinylated anti-rat igg, all at : dilutions, vector labs) using avidin-biotin-peroxidase (vector labs) as described previously . pictures from four random areas of each section and three sections per mouse were taken by using a digital camera (nikon eclipse sci epifluorescence microscope, nikon corporation) at × magnification. capillary density were quantified by measuring the percentage of cd and α-sma staining out of the total area as previously described. western blotting. gastrocnemius muscles were mainly harvested at the end of studies (i.e. weeks after full ischemia induction). gastrocnemius muscles were also harvested from a subset of mice (n = ) subjected to the -stage hli (n = /time-point) prior to and days and after ameroid placement. samples were frozen in liquid nitrogen, and stored in oct compound (proscitech) at − °c. tissues were pulverised in ripa buffer ( mm sodium chloride, . % np- or triton x- , . % sodium deoxycholate, . % sodium dodecyl sulfate, mm tris, ph . ) with protease inhibitors (roche diagnostics, australia) and phostop (roche diagnostics, australia) to extract proteins and quantitated using the bradford protein assay kit (biorad, usa). samples ( μg of protein/lane) were loaded onto a % sds-polyacrylamide electrophoresis gel. after electrophoresis ( v, min), the separated proteins were transferred ( ma, min) to a polyvinylidene difluoride membrane (biorad, usa). non-specific sites were blocked with % non-fat dry milk for min, and the blots were then incubated with following antibodies: anti-vascular endothelial growth factor (anti-vegf www.nature.com/scientificreports www.nature.com/scientificreports/ mrna analysis by quantitative real-time pcr. at the end of the study gastrocnemius muscle samples were harvested, placed in rna later (qiagen) and stored at − °c. samples (n = /group) were selected from each group using a random number generator and were processed for gene expression analysis. total rna was isolated using an rneasy mini kit (qiagen) according to manufacturer's instructions and quantified spectrophotometrically using nanodrop . rna samples ( ng) were subjected to quantitative real time pcr (qrt-pcr) analysis of genes of interest using the quantitect sybr green one-step rt-pcr assay (qiagen). qrt-pcr was performed using primers for mouse vegf-r (ppm f), vegf-r (ppm a), trpv (ppm a), klf (ppm b) and gapdh (qt ). the relative expression of these genes were calculated by using the concentration-ct-standard curve method and normalized using the average expression of mouse gapdh for each sample using the rotor-gene q operating software (version . . ) as previously reported , . statistical analyses. all data were tested for normality using the d' agostino-pearson normality test. data with normal distribution were expressed as mean ± standard error of mean (sem) and analysed using parametric tests. non-normally distributed data were expressed as median and interquartile ranges (iqr) and analysed using non-parametric tests. statistical significance was determined using the unpaired student t test for comparison between two groups or analysis of variance followed by student-newman-keuls post-hoc analysis for comparison between multiple groups. comparison of the time course of ldpi indices, clinical scores, open field tests and treadmill exercise tests were done by -way anova for repeated measures, followed by bonferroni post hoc analysis or by linear mixed effect method using r studio software. difference in the clinical ischemia score were determined by fisher's exact test. analyses were performed using prism (graphpad software, san diego, ca) or r software. a p value of ≤ . was considered to be statistically significant. mice undergoing -stage hli had more severe ischemia than those undergoing -stage hli. immediately after femoral artery excision, limb perfusion assessed by ldpi was similarly reduced in both hli models by approximately %. mice subjected to the -stage hli had more rapid recovery of hind limb perfusion than those subjected to the -stage procedure (p = . , fig. b,c, supplementary fig. s ). by days after ischemia induction limb perfusion was similar in mice subjected to the -stage procedure and sham controls (p = . ) but still reduced in mice subjected to the -stage procedure by comparison to sham controls (p < . ). there was no change in overall body mass after ischemia induction (supplementary fig. s ). mice subjected to -stage hli showed more severely impaired hind limb use than those undergoing -stage hli. after ischemia induction, mice subjected to both methods of hli developed limb oedema, paleness of skin and occasional muscle necrosis. mice in all experimental groups exhibited a severe functional deficit after surgery (fig. d) . functional score was significantly worse in mice subjected to the -stage hli than those subjected to the -stage hli (p = . ). both the hli models showed increased ischemia compared to the respective shams. there were no cases of auto-amputation or foot or limb necrosis (supplementary fig. s ). mice subjected to the -stage hli showed a significantly worse ischemic score compared to those subjected to the -stage hli (repeated measures way anova, p = . , fig. e ). mice subjected to -stage hli had reduced treadmill performance. mice subjected to the -stage hli showed no significant difference in total distance travelled during the study period on a treadmill test when compared to shams (repeated measures way anova, p = . ; fig. a ). after the first procedure of the -stage model (ameroid placement) the treadmill ambulatory performance of mice was not significantly affected ( supplementary fig. s a ). in contrast mice subjected to -stage hli had a significant reduction in total distance travelled on the treadmill compared to their sham controls (p = . ) and mice subjected to -stage hli (p = . ; fig. a ). supplementary fig. s b-d) . this reduction in physical activity was maintained after completing the -stage hli by comparison to sham controls and also mice subjected to -stage hli (fig. b) . the reduction in physical activity of mice subjected to -stage hli was reflected in less distance travelled, less total time in motion and lower velocity of the movement compared to sham controls (fig. c-e) . when compared to the -stage hli, the stage-hli model showed a reduction in the total distance travelled in the open field arena (linear mixed effect model, p = . ). mice subjected to hli had enhanced mechanical allodynia. mice subjected to both -stage and -stage hli showed significantly increased sensitivity to pressure compared their respective sham controls and there was no significant difference in pressure sensitivity between the two models (fig. f ). hli induces systemic inflammation. the plasma concentrations of the cytokines assessed were below the detectable ranges in both the sham control groups (table ) . mice subjected to hli, irrespective of model, had plasma cytokine concentration significantly higher than the sham controls although levels were not significantly different between models ( table ). the plasma concentrations of nitric oxide (no) metabolites were higher in mice undergoing -stage hli than the sham control group (p < . ) and mice undergoing -stage hli (p = . , table ). myofibers which are healthy and functionally active are characterised by peripheral nuclei, while myofibrils with central nuclei are immature and do not show optimal contraction . in gastrocnemius muscle samples removed from sham controls, myocytes were angular with peripheral nucleus (fig. a) . at day after ischemia induction, mice subjected to -stage hli showed microscopic changes such as cellular swelling, focal necrosis and interstitial oedema. there were also numerous infiltrating inflammatory cells. gastrocnemius muscle samples from mice subjected to -stage hli showed more homogenous appearance with all myocytes showing peripheral nuclei and limited inflammatory cell infiltration (fig. a) . histological evaluation revealed that tissues of mice subjected to -stage hli had fewer immature myofibers cells than the tissues from -stage hli model. furthermore, muscle samples from mice subjected to -stage had prominent oedema, myofibre separation and multifocal neutrophilic infiltration. neutrophils were observed throughout the tissue sections. necrotic muscle fibres were prominent and formed confluent areas (fig. a) . muscle fibrosis was assessed by picrosirius red staining which suggested that -stage hli led to increased skeletal muscle fibrosis compared to -stage hli (p = . ) or sham controls (p = . ; fig. b ,e). mice subjected to -stage hli had fewer hind limb collaterals. consistent with the reduced perfusion as assessed by ldpi, both arteriogenesis and angiogenesis was inhibited in the ischemic gastrocnemius muscles of the -stage hli model (fig. c,d) . measurement of angiogenesis by cd immunostaining showed that the presence of arterioles was significantly reduced in samples from the -stage hli compared to the -stage hli (p = . ) or sham controls (p = . ; fig. ). the arteriolar density was also significantly less in samples from the -stage hli model compared to the -stage hli (p = . ) or sham control (p = . ; fig. ). protein concentrations of angiogenesis and shear stress response markers were downregulated in the gastrocnemius muscles of mice undergoing -stage hli. the relative total vegf and vegfr- (but not vegfr- , p-enos/enos and hif-α) protein levels in gastrocnemius tissue collected from mice weeks after -stage hli were significantly less than in sham controls and mice undergoing -stage hli (fig. a-d, supplementary fig. s ). analysis of tissues from the -stage hli model prior to ameroid placement and day and day after ameroid placement suggested no significant changes in concentrations of trpv or vegf in response to ameroid constriction ( supplementary fig. s ). at the end of the experiment, protein concentrations of trpv and klf were significantly less in the gastrocnemius muscle samples from mice undergoing -stage hli compared to sham controls and mice undergoing -stage hli (fig. e,f) . qrt-pcr showed that the relative expressions of vegf-r , trpv and klf in gastrocnemius muscle of mice subjected to -stage hli were significantly lower than within the gastrocnemius muscle of mice undergoing -stage hli or in sham controls (fig. g-j) . exercise training improved functional capacity but not limb perfusion in mice subjected to -stage hli. supervised exercise training is an established method to improve functional capacity in pad patients , and previous studies show that mice respond positively to exercise training , . in order to examine whether an established clinically effective therapy was effective in the novel animal model, the effect of exercise training (using a running wheel) on functional capacity of mice subjected to -stage hli was assessed. exercise training was commenced days after ischemia induction. exercise training did not affect limb perfusion as shows the data from the ischemic limbs from the -stage and -stage hli models and the respective sham controls (n = /group, scale bars in all images = µm). (e-g) quantitative bar graphs showing the effect of hli on (e) skeletal muscle fibrosis by picrosirius red staining, (f) angiogenesis by immunohistochemical staining against cd and (g) arteriogenesis by immunohistochemical staining against α-sma. all values are median and interquartile ranges (n = /group) and p value significance set at ≤ . . ( ) : | https://doi.org/ . /s - - - www.nature.com/scientificreports www.nature.com/scientificreports/ www.nature.com/scientificreports www.nature.com/scientificreports/ assessed by ldpi (linear mixed effect test, p = . ; fig. b ,c). mice subjected to exercise training showed a significant increase in average treadmill walking capacity compared to sedentary controls (p = . ; fig. d ). exercise training upregulated gastrocnemius muscle vegf and trpv levels. since improvement in ambulatory performance as a result of exercise training could be due to enhanced angiogenesis, the expression of angiogenesis and shear stress responsive proteins vegf, vegf-r , vegf-r , trpv and klf were assessed in the gastrocnemius muscles (fig. ). vegf (p = . , fig. b ) and trpv (p = . , fig. e ) but not vegf-r , vegf-r and klf , were highly upregulated following exercise training (fig. c,d,f ). this report describes the development of a novel model of hli which results in more severe and prolonged ischemia than the traditional model. mice subjected to the -stage hli had functional and ambulatory impairment and a positive response to exercise training as has been reported for pad patients . previous rodent studies suggest that placing of ameroid constrictors alone without manipulating the femoral artery results in mild ischemia and blood flow recovers within weeks . hence, the novel hli model was based on placement of two ameroid constrictors on the femoral artery to promote gradual occlusion followed by excision of intervening segment after days to induce severe ischemia. a previous report suggests that recovery of hind limb blood flow is reduced in apoe −/− compared to c bl/ j mice due to their limited collateral arteries and hence apoe −/− mice were used in the current study . pad patients are generally older and exhibit metabolic derangements that limit angio-and arterio-genesis and previous studies suggest that apoe −/− mice have delayed skeletal muscle healing , reduced angiogenesis responses and impaired functional recovery after hli further supporting the rationale for choosing this mice species , , . mice subjected to -stage hli had rapid recovery of limb blood flow and reached a perfusion level similar to the sham controls within days as has been reported by other investigators , , . ligation and sudden excision of the femoral artery is believed to generate a pressure gradient between the proximal and distal ends of the occluded vessel, resulting in increased shear stress and a redirection of blood flow towards the collaterals and through numerous branches arising from the internal iliac artery, resulting in rapid improvement in blood flow , . ameroid constrictors have been shown to cause luminal occlusion within days, however, the blood flow slowly increases in the next - weeks , . hence, in the new model, we superimposed a secondary acute event by excising the intervening femoral artery segment along with the ameroid constrictors. in contrast to the -stage hli, mice subjected to -stage hli had on-going limb ischemia and a prolonged functional deficit on both forced and voluntary ambulation tests. these findings support the value of the novel model for the testing of interventions aimed at achieving clinical improvements in pad patients. since angiogenesis is an inflammation-driven process , the concentrations of circulating cytokines were measured. these markers of systemic inflammation increased in response to hli in both models examined. twenty eight days after hli induction, the concentrations of circulating cytokines were similar in the two models studied. gastrocnemius muscle samples obtained from the -stage hli model had marked neutrophilic infiltration. it has been previously reported that inflammatory cells accumulate in hypoxic tissues and promote angiogenesis . it is possible that the systemic concentrations of cytokines were not reflective of the level of inflammation within the hind limb. markers of angiogenesis and arteriogenesis in gastrocnemius tissue, such as cd and α-smc, were found to be less evident in the -stage than the -stage hli model. furthermore, gastrocnemius vegf and vegf-r protein levels and amount of total plasma no metabolites were significantly lower in the -stage than -stage hli model. vegf promotes angiogenesis through binding to vegf-r expressed on endothelial cells . vegf induces the release of no thereby promoting microvascular perfusion and endothelial progenitor cell mobilization [ ] [ ] [ ] . endothelial cell derived microrna, such as mir- , have also been implicated in controlling angiogenesis through inhibiting rho gdp dissociation inhibitor (rhogdi)-α, an important regulator of enos phosphorylation . it appears likely that the low levels of pro-angiogenic markers in the -stage hli model reflect less activation of endothelium-dependent pro-angiogenesis signalling pathways which were stimulated by collateral flow within the -stage model. shear stress promotes arteriogenesis by stimulating remodelling of collaterals , . endothelial cells transduce changes in shear stress into intracellular signals which promote expression of a distinct set of genes which can control the response to ischemia [ ] [ ] [ ] . previous studies suggest that increased shear stress promotes phosphorylation and upregulation of mechano-sensors, such as trpv [ ] [ ] [ ] [ ] . it was postulated that the distinct ways of inducing hli in the two models studied might be reflected in different trpv expression. mice subjected to -stage hli had lower expression of trpv compared to those undergoing -stage hli. furthermore, in the -stage hli model, there was no change in trpv protein levels after ameroid placement, suggesting that ameroid constriction is a gradual process that does not lead to shear stress changes capable of stimulating mechano-sensors like trpv . these findings also suggest that -stage hli results in more limited collateral flow than the -stage approach. the acute reduction in arterial pressure gradient following femoral artery excision in the -stage hli model it thought to be registered by endothelial shear stress response elements resulting in upregulation of angiogenesis and arteriogenesis promoting genes . simulation of trpv , for example by α-phorbol , of vegf-r (g), vegf-r (h), trpv (i) and klf (j) assessed in the gastrocnemius muscles of mice undergoing hli. quantitative real time pcr (qrt pcr) was performed on extracted total mrna using specific primers and normalised to glyceraldehyde phosphate dehydrogenase (gapdh) expression. data analysed by mann-whitney u test (n = samples/group). ( ) : | https://doi.org/ . /s - - - www.nature.com/scientificreports www.nature.com/scientificreports/ -didecanoate, has been reported to promote increase no release and increased hind limb blood flow . trpv deficient rodents have impaired vasodilatation [ ] [ ] [ ] [ ] . this supports the important role of trpv in promoting adaptation to acute limb ischemia. four weeks of exercise training led to an approximate -fold increase in treadmill ambulatory distance in the mice subjected to -stage hli, paralleling findings from pad patients [ ] [ ] [ ] [ ] . these findings suggest the novel -stage hli mouse model simulates the walking impairment experienced by patients. in support of the relevance of this model to patients, we found that exercise therapy improved treadmill performance without improving limb perfusion, a finding similar to that described in pad patients , , . since exercise training increases shear stress in pre-existing collaterals we examined the expression of trpv and angiogenesis markers . compared to sedentary controls, mice undergoing exercise training showed increased total protein levels of vegf and trpv , which was in accordance with previous reports showing enhanced expression of pro-angiogenesis markers after exercise training [ ] [ ] [ ] . overall these findings suggest flow-mediated upregulation of shear stress responsive genes is important in stimulating angiogenesis responses in the new model. this study have several strengths and weaknesses. the -stage hli model which is usually utilised for pad research has many limitations including its disparate pathophysiological mechanisms compared to patient presentations, the temporary nature of the ischemia and its relative responsiveness to a variety of therapies which are not effective in patients . this study suggests the novel -stage model has clear advantages over the -stage model since ischemia is more severe and prolonged and does not naturally recover making it suitable to access the 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arteriesendorsed by: the european stroke organization (eso)the task force for the diagnosis and treatment of peripheral arterial diseases of the european society of cardiology (esc) and of the european society for vascular surgery (esvs) cilostazol for intermittent claudication a systematic review of the uptake and adherence rates to supervised exercise programs in patients with intermittent claudication exercise for intermittent claudication a systematic review of treatment of intermittent claudication in the lower extremities cardiovascular effects of exercise: role of endothelial shear stress exercise-induced expression of angiogenesis-related transcription and growth factors in human skeletal muscle the influence of physical training on the angiopoietin and vegf-a systems in human skeletal muscle exercise linked to transient increase in expression and activity of cation channels in newly formed hind-limb collaterals this research was funded by a faculty administered grant and a research infrastructure block grant from james cook university and funding from the queensland government. jg holds a practitioner fellowship from the national health and medical research council, australia ( ) and a senior clinical research fellowship from the queensland government. smo was supported by funding from the graduate research school and college of medicine, james cook university. we would like to acknowledge with thanks the help of prof. zoltan sarnyai (james cook university) who provided access to open field test assessment facility, dr. joseph moxon (james cook university) who assisted with the lme used to analyse data from the exercise study and dr. pacific huynh (james cook university) who provided the mouse images in figs. a and a. s.m.k. lead the design of the research, undertaking of experiments, and interpretation of data and writing of the manuscript. s.m.o., j.l., s.m. and r.j.j. performed parts of the experiments, contributed to interpretation of the data and gave critical comments on the manuscript. j.g. contributed rationales for the studies, led funding applications, co-wrote the manuscript and contributed to project supervision and data interpretation. the authors declare no competing interests. supplementary information is available for this paper at https://doi.org/ . /s - - - .correspondence and requests for materials should be addressed to j.g.reprints and permissions information is available at www.nature.com/reprints.publisher's note springer nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. license, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the creative commons license, and indicate if changes were made. the images or other third party material in this article are included in the article's creative commons license, unless indicated otherwise in a credit line to the material. if material is not included in the article's creative commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. to view a copy of this license, visit http://creativecommons.org/licenses/by/ . /. key: cord- -iq e qp authors: otxoa-de-amezaga, amaia; miró-mur, francesc; pedragosa, jordi; gallizioli, mattia; justicia, carles; gaja-capdevila, núria; ruíz-jaen, francisca; salas-perdomo, angélica; bosch, anna; calvo, maria; márquez-kisinousky, leonardo; denes, adam; gunzer, matthias; planas, anna m. title: microglial cell loss after ischemic stroke favors brain neutrophil accumulation date: - - journal: acta neuropathol doi: . /s - - - sha: doc_id: cord_uid: iq e qp stroke attracts neutrophils to the injured brain tissue where they can damage the integrity of the blood–brain barrier and exacerbate the lesion. however, the mechanisms involved in neutrophil transmigration, location and accumulation in the ischemic brain are not fully elucidated. neutrophils can reach the perivascular spaces of brain vessels after crossing the endothelial cell layer and endothelial basal lamina of post-capillary venules, or migrating from the leptomeninges following pial vessel extravasation and/or a suggested translocation from the skull bone marrow. based on previous observations of microglia phagocytosing neutrophils recruited to the ischemic brain lesion, we hypothesized that microglial cells might control neutrophil accumulation in the injured brain. we studied a model of permanent occlusion of the middle cerebral artery in mice, including microglia- and neutrophil-reporter mice. using various in vitro and in vivo strategies to impair microglial function or to eliminate microglia by targeting colony stimulating factor receptor (csf r), this study demonstrates that microglial phagocytosis of neutrophils has fundamental consequences for the ischemic tissue. we found that reactive microglia engulf neutrophils at the periphery of the ischemic lesion, whereas local microglial cell loss and dystrophy occurring in the ischemic core are associated with the accumulation of neutrophils first in perivascular spaces and later in the parenchyma. accordingly, microglia depletion by long-term treatment with a csf r inhibitor increased the numbers of neutrophils and enlarged the ischemic lesion. hence, microglial phagocytic function sets a critical line of defense against the vascular and tissue damaging capacity of neutrophils in brain ischemia. electronic supplementary material: the online version of this article ( . /s - - - ) contains supplementary material, which is available to authorized users. neutrophil infiltration under conditions of sterile inflammation can contribute to tissue injury. neutrophils are transiently detected in the brain after stroke since they are rapidly attracted to the injured brain peaking between and days post-ischemia [ , , , ] . compelling evidence suggests that neutrophils are contributors to tissue damage after ischemic stroke [ , , , , ] , in spite of the fact that diverse experimental strategies inhibiting neutrophil activation or depleting neutrophils provided conflicting results [ , ] . likely, the differences between experimental studies depend on the efficacy and potential side effects of the diverse neutrophil depleting or inhibiting strategies, status of capillary reperfusion, lesion severity, and integrity of the blood-brain barrier (bbb). moreover, several aspects of neutrophil infiltration after acute ischemic brain damage remain controversial. neutrophils accumulate in perivascular spaces in murine and human strokes [ , ] . the presence of neutrophils in the brain parenchyma has been reported in rodent models of permanent ischemia [ , , ] , but it is more controversial in experimental models of transient ischemia [ , ] . several studies reported the presence of neutrophils in the brain parenchyma in postmortem samples of patients deceased between day and [ ] , or days after stroke onset but not at other time points [ , ] . in other studies, neutrophils were not detected in the brain parenchyma of stroke patients [ ] . therefore, the molecular determinants underlying perivascular neutrophil accumulation and the conditions facilitating the potential access of neutrophils to the brain parenchyma need further clarification. the observation that microglia phagocytose neutrophils in the ischemic brain [ ] [ ] [ ] led us to hypothesize that microglia function may be critical to explain neutrophil accumulation in the injured brain tissue. microglial cells react to brain ischemia in different ways depending on the regional location and temporal course of the lesion. microglial cells are vulnerable to ischemia and previous reports showed death of microglia after oxygen and glucose deprivation in tissue slices [ ] and cell cultures [ , ] . in addition, microglial reduction has been reported after transient mcao [ ] , and microglial dysfunction and loss was detected in classical neuropathological studies of brain ischemia in rodents and primates [ , ] . classical histopathological studies have shown long-lasting microgliosis surrounding the infarction several days after ischemic stroke onset. however, the progression of this reaction from the very acute phase of stroke is less precisely determined mainly due to the fact that microglia and infiltrating macrophages show many common features and markers leading to the frequent terminology of microglia/macrophages to describe the mononuclear myeloid cell reaction that follows stroke. microglia have a unique transcriptomic signature distinguishable from that of macrophages or monocytes [ , ] . therefore, reactive microglia and infiltrating macrophages likely play different functions in the injured brain tissue. current developments allow the distinction between these cells with antibodies against more specific microglia markers [ , ] , availability of fluorescent reporter mice [ ] , or transfer of fluorescent reporter leukocytes [ ] . by exploiting some of these novel experimental possibilities, we investigated the neutrophil-microglia crosstalk after brain ischemia. the results show that microglial cells effectively remove brain-infiltrating neutrophils, hence microglia dysfunction or death is associated with neutrophil accumulation into the injured brain tissue. we used adult male mice on the c bl/ background. mice expressing tamoxifen-inducible cre recombinase under the direction of the cx cr promoter in the mononuclear phagocyte system (cx cr cre/ert ) [ ] (# jax ® mice) were crossed with either ai mice harboring a loxp-flanked stop cassette that prevents transcription of the red fluorescent protein tdtomato (tdt) (b .cg-gt(rosa) sortm (cag-tdtomato)hze/j (# jax ® mice) [ ] , or colony stimulating factor receptor (csf r) +/flox mice (b .cg-csf r tm jwp /j, # jax ® mice). we used heterozygous catchup ivm mice expressing tdt in ly g +/− neutrophils [ ] . homozygous catchup ivm (ly g −/− ) mice were crossed with cx cr gfp/gfp mice to obtain double heterozygous mice with red fluorescent neutrophils and green fluorescent microglia [ , ] . we also obtained cells from dsred mice constitutively expressing the red fluorescent protein dsred under the control of the actin promoter [ ] . wildtype mice were obtained from a commercial source (janvier, france). mice were maintained in the animal house of the school of medicine of the university of barcelona under controlled spf conditions. animal work was conducted with the approval of the ethical committee of the university of barcelona (ceea) and the direcció general de polítiques ambientals i medi natural, departament de territori i sostenibilitat de la generalitat de catalunya. studies complied with the "principles of laboratory animal care" (nih publication no. - , revised ), and the spanish national law (real decreto / ). the brains of six patients suffering from acute ischemic stroke who died between and days after stroke onset at the stroke unit of the hospital clinic of barcelona were used after obtaining written consent from their relatives or legal representatives for tissue removal after death at the neurological tissue bank of the biobank-hospital clinic-institut d'investigacions biomèdiques august pi i sunyer (idibaps). the ethics committee of this hospital approved the study. online resource shows a summary of patient characteristics. the elapsed time from death to autopsy was - h. an expert neuropathologist dissected the ischemic core, periphery, and a portion of non-ischemic tissue (control) obtained from a region distant to infarction, as described [ ] . samples were embedded in oct and immediately frozen in liquid nitrogen for sectioning at µm in a cryostat. the bone marrow of transgenic dsred mice [ ] was used to generate chimeric mice, as reported [ ] . in brief, recipient adult ( -month old) wild-type mice received three intraperitoneal injections of the chemotherapeutic agent busulfan ( mg/g body weight) , and days prior to transfer via the tail vein of five million bone marrow cells from dsred donor mice. mice were used weeks after grafting and reconstitution was assessed by flow cytometry analysis. to impair microglial function, mice received a daily oral administration by gavage of the csf r inhibitor gw [ ] ( mg/kg body weight in a volume of . ml) (#s , selleckchem) for days, which is a dosing regimen that does not challenge microglial survival [ ] . treatment controls received the same volume of the vehicle ( . % hydroxypropylcellulose, . % tween- ). treatment started h prior to induction of ischemia, it was randomly allocated, and was administered in a blinded fashion. for microglia depletion, mice received the csf r inhibitor plx (plexxikon) following previously reported protocols [ , , ] . the inhibitor was mixed into ain- a standard chow at ppm (brogaarden, denmark). mice ( -week-old) received the diet ad libitum for weeks prior to induction of ischemia and the diet was maintained until the mice were killed. treatment controls received ain- a diet for the same period of time. both diets were given in parallel in groups of five animals per cage. surgery was carried out under isoflurane anaesthesia and mice received analgesia (buprenorphine, µl of a . mg/ml solution, via s.c.). permanent occlusion of the middle cerebral artery (mcao) was induced by coagulation of the distal portion of the right mca together with ligation of the ipsilateral common carotid artery. this experimental model induces a focal cortical lesion in the ipsilateral hemisphere. a subset of mice receiving the above diets (control or plx ) was used to study the volume of the lesion day after induction of ischemia by t w mri in a . t biospec / horizontal animal scanner (bruker biospin, ettlingen, germany), as reported [ ] . sample size was calculated using g*power . software (university of dusseldorf) with an alpha level of . , statistical power of . , and estimating a size effect of . based on sd of previous results from our laboratory and published data on the effect of microglia depletion on infarct volume in other stroke models [ ] . one mouse died (control diet), and one mouse was excluded (plx diet) due to surgical problems. bromodeoxyuridine (brdu) ( mg/ml) (# , bs pharmingen) was daily injected ( μl) via i.p. into mice starting day after mcao until day . one-hour after the last brdu administration mice were killed and processed for immunofluorescence. brdu was detected in brain tissue sections using a rat monoclonal fitc-anti-brdu antibody ( : , #ab , abcam, cambridge, uk) [ ] . mouse blood and brain tissue were processed for flow cytometry as described [ ] . fc receptors were blocked by previous incubation for min with cd /cd (clone . g , bd pharmingen) in facs buffer (pbs, mm edta, % fbs) at °c. live/dead aqua cell stain (molecular probe, invitrogen) was used to determine the viability of cells. cells were incubated with the following mix of microglia cells from adult mice ( - weeks old) were isolated and cultured using immunomagnetic separation (miltenyi biotec, germany). mice were perfused via the left ventricle with ml of cold saline and collected in hanks' balanced salt solution (hbss) buffer without calcium/magnesium (# - ; life technologies). the brain tissue was enzymatically dissociated using the neural tissue dissociation kit-p (# - - ; miltenyi biotec). the gentlemacs™ dissociator with heaters (# - - ; miltenyi biotec) was used for mechanical dissociation steps during min at °c. the digested tissue was filtered ( µm) with hbss buffer with calcium and magnesium (# - ; life technologies) and prepared for myelin removal process (myelin removal beads ii, # - - ; miltenyi biotec). then, cells were magnetically labeled with cd b microbeads (# - - ; miltenyi biotec) diluted in pbs supplemented with . % bsa for min in the dark in the refrigerator ( - °c) . cd b + cells were collected using magnetic field columns (miltenyi biotec). cell suspensions ( μl) were then plated in complete medium consisting of dmem medium (# ; gibco-brl) supplemented with % fetal bovine serum (fbs; gibco-brl) containing u/ml penicillin and μg/ml streptomycin (# ; gibco-brl) added as a drop in the middle of each well of a poly-l-lysine (#p ; sigma) pre-coated -well plate (µ-slide well, ibidi # ). cells were incubated for min at °c and then µl of complete medium were carefully added to each well. twenty-four hours later, we replaced % of complete medium, and we did a full medium change at day . the cells were maintained at °c in a humidified atmosphere of % co for div. we obtained human microglial cells from the ischemic tissue of one patient deceased days after fatal stroke. fresh brain tissue (about mg) was harvested at autopsy ( h after death) and was placed in a falcon tube with sterile cold rpmi medium (# - , gibco). visible meninges were removed, the tissue was cut in small pieces using a scalpel and incubated in a . % trypsin-edta solution in pbs at rt for min. then, dmem/f (# ; gibco-brl) with % fbs and dnase i ( units/ml) was added ( : ), the tissue was disaggregated, centrifuged for min at ×g and the pellet was re-suspended in ml dmem/f supplemented with % fbs, % l-cell conditioned medium obtained from the l cell line, and u/ml penicillin/ μg/ml streptomycin (# ; gibco-brl). cells were seeded in poly-l-lysine coated t flasks, incubated in % co at °c and allowed to adhere. culture medium was changed twice a week and at div the cells were scrapped and seeded in a -well plate (µ-slide well, ibidi # ) previously coated o/n with poly-l-lysine. a time-lapse microscopy study was initiated h later after addition of fresh bone marrow neutrophils. afterwards, we fixed the cells for an immunofluorescence study with antibodies against the purinergic receptor p y, g-protein coupled, (p ry ) ( : , #as a, anaspec). neutrophils were obtained from the bone marrow of adult ( - weeks old) mice. the bone marrow was flushed using a -gauge needle with rpmi (# - , gibco) supplemented with % fbs onto a ml falcon tube through a -μm cell strainer. cells were centrifuged at ×g for min. the supernatant was discarded and cells were then incubated for min with an erythrocyte lysis solution ( mm nh cl, mm khco , . mm edta). after washing with cold pbs supplemented with % fbs, cells were incubated at °c for min with a mix of fcblock ( / ; clone . g ; bd pharmingen; bd bioscience), and the antibody ly g (clone a , fitc; bd pharmingen) with µl/ cells. cells were washed with pbs- . % bsa, and were then incubated with anti-fitc microbeads (# - - , miltenyi biotec) for min at °c with µl microbeads/ cells. after washing, the fraction of positive ly g cells was magnetically collected and prepared for immediate use or cells were frozen in fbs serum with % of dmso until the day of the experiment. human neutrophils were isolated from the blood by density gradient centrifugation. human and mouse neutrophils were stained with celltracker™ green cmfda (#c ; ther-mofisher scientific). fig. localization of microglia and infiltrating leukocytes. we generated chimeric mice by administering dsred fluorescent bone marrow cells to -month old wild-type receptor mice (n = ). after months, we induced ischemia and days later we studied the brain by immunofluorescence (n = ) (a, b) and flow cytometry (n = ) (c, e). a cd hi cd b hi cells infiltrating the ipsilateral hemisphere are mostly dsred + whereas cd dim cd b dim microglial cells are dsred − . b flow cytometry shows an increase in infiltrating dsred leukocytes (cd b hi cd hi ) (mann-whitney test, **p = . ). c immunostaining of astrocytes (gfap, green) showed the presence of dsred cells at the border and core of the lesion separated from the peripheral area that shows a prominent astroglial reaction. d microglial cells were stained with an antibody against p ry (green), which did not co-localize with dsred + leukocytes. the morphology of the microglia in the different regions is illustrated with representative images. cell nuclei were stained with to-pro (blue). e p ry + microglial cell at the border of the lesion nearby dsred + infiltrating leukocytes. f schematic representation of the distribution of microglia (green) and infiltrating leukocytes (red) in the different regions of the ischemic hemisphere. scale bar c µm; d, e µm . c-f analysis of microglial morphology in the core and periphery of the ipsilateral cortex and the contralateral cortex (contral.) (n = - cells per region of different mice represented by the different colors) using imagej tools. g, h imaris analysis of d-reconstructions of the above cells (b). i counting the number of microglial cells per area showed an increased microglial density in the periphery and a decrease in the core (n = - fields in different mice). statistical analyses in c-i were carried out with the kruskal-wallis test followed by the dunn's test. **p < . and ***p < . vs. contralateral microglia; && p < . and &&& p < . vs. peripheral microglia. j flow cytometry after dissecting out the core and periphery regions of the ipsilateral hemisphere and mirror regions of the contralateral hemisphere and days after mcao in an independent group of mice (n = mice per time point). for comparative purposes the number of microglial cells (cd low cd b + ) is expressed by mg of brain tissue. data analysis was conducted with two-way anova by region (p < . ) and time point (p = . ) followed by the bonferroni test. the number of microglia was higher in the periphery than the core of infarction day ( && p < . ) and days ( &&& p < . ) after mcao. furthermore, the number of microglia decreased in the core of infarction versus the corresponding contralateral region day (**p < . ) and days (*p < . ) postischemia. in the periphery, the number of microglia cells increased in the ipsilateral versus the corresponding contralateral hemisphere at day ( # p < . ). scale bar μm isolated and stained neutrophils ( , cells/ml) were added to the adult microglia cultures at div. automated multiposition live cell imaging was carried out using a leica tcs sp confocal microscope (leica microsystems, heidelberg, germany) equipped with adaptive focus control to keep the specimen in focus and an incubation system with temperature and co control. cells were subjected to a timelapse study while maintained at °c in a humidified atmosphere of % co . all images ( - z sections) were acquired using a apo × (numerical aperture . ) glycerol immersion objective lens, pinhole set at . airy units. images of cmfda and dsred were acquired sequentially line by line using and laser lines and detection ranges at - and - , respectively. simultaneously, bright field images were acquired. multiposition confocal images were acquired every min during - h, with an image matrix of × pixel; hz; × line average and autofocus control. manual analysis was performed using fiji software (version . . -rc- / . d). we recorded - timelapse videos per well and analysed - frames in each video. in every frame, manual tracking of neutrophils was performed using the mtrackj plugin [ ] to identify phagocytosis of neutrophils by microglial cells. we studied in parallel four wells per genotype (csf r +/+ or csf r +/− microglial cells) in each independent experiment and conducted five independent experiments. the analysis was performed in a blinded fashion by assigning a code to each video that did not reveal the identity of the genotype. we used green fluorescent zymosan a bioparticles (#z- ; thermo fisher scientific) in the phagocytosis assay. at div, microglial cells were exposed to zymosan fluorescent beads ( , particles/ml) for h. following - washes to remove all the non-phagocyted particles, cells were fixed with cold % paraformaldehyde for min, permeabilized with . % triton x- (sigma) in pbs . m for min, blocked with % goat serum in pbs for h, and incubated overnight at °c with the primary rabbit antibody against the p ry receptor ( : , #as a, anaspec). the next day, cells were washed and incubated with red fluorescence alexa fluor ® dye-labelled goat anti-rabbit igg antibody (#a , life technologies) for h at room temperature. dapi (#d , life technologies) stained was performed to visualize the cell nuclei. cells were then covered using fluoromount-g ® (southern biotech, birmingham, al, usa). images were obtained with a fluorescence inverted microscope (leica ctr ). mice were perfused via the left heart ventricle with ml of cold saline ( . %) followed by ml of cold % paraformaldehyde (pfa) diluted in phosphate buffer (pb) ph . . the brain was removed, fixed overnight with the same fixative, and immersed in % sucrose in pb for cryoprotection for at least h until the brains were completely sunk to the bottom of the tube. after that, brains were frozen in isopentane at − °c. cryostat brain sections ( -μm thick) were fixed in ethanol %, blocked with % normal serum, and incubated overnight at °c with primary antibodies: rat monoclonal antibodies against ly g cell nuclei were stained with dapi or to-pro (invitrogen). cryostat sections from human brain tissue were processed for immunofluorescence as described above with a rabbit polyclonal antibody against p ry ( : , # a, anaspec) and a mouse monoclonal antibody against ki ( : , # , cell signaling tech). consecutive sections were stained with thionine for examination of the lesion at the light microscope. confocal images were obtained (tcs-spe-ii or sp microscopes from leica microsystems; or a zeiss lsm microscope) and were not further processed except for enhancing global signal intensity in the entire images for image presentation purposes using las software (leica), imagej, or adobe photoshop. for estimation of the density of p ry + cells and ki + cells in human brain sections, images were obtained ( × objective), the number of immunostained cells and cell nuclei per image were counted in ten different fields per brain region of each subject, and average values per region and time group were calculated. for cell counting in mouse brain sections, we obtained - confocal images of the immunostaining ( × objective) in three different brain sections per mouse. microglia morphology was assessed using fiji software (version . . -rc- / . d) and imaris software (ima-ris bitplane v. . ). basic shape descriptors such as the circularity index (ci) or the area were performed with the plugin shape descriptors [ ] ; other parameters, such us the ramification index (ri), were obtained using the sholl analysis plugin [ ] . parameters such as volume or sphericity index were measured using imaris software after creating a d surface in the maximum intensity projection image. then, microglial cells were thresholded by the huang method [ ] to generate a binary mask (with a . mean filter). the ci parameter was calculated by the shape descriptors plugin ( p[area]/[perimeter] ). the highest count of intersections (max inters) reflects the highest number of processes in the cell. two-group comparisons were carried out with the mann-whitney u test. for multiple group comparisons we used the kruskal-wallis test followed by the dunn's test. comparisons were two-sided. comparisons of groups by brain region and time were carried out with two-way anova followed by the bonferroni post-hoc analysis. twoway anova by genotype and experiment, with an experiment-matched design, was used to analyze quantification of in vitro studies. statistical analyses were performed with graphpad software. the specific test used in each experiment and n values are reported in the figure legends. to unequivocally distinguish microglia from infiltrating leukocytes we generated chimeric mice with the hematopoietic system derived from fluorescent (dsred) donor mice where microglia remained non-fluorescent, whereas a high proportion of peripheral myeloid cells were dsred + (fig. a; online resource ). most myeloid cells infiltrating the ipsilateral brain hemisphere were dsred + days after mcao, as assessed by flow cytometry (fig. a, b) , and they were preferentially located in the lesion core where the expression of gfap is lost (fig. c) . we stained microglia with anti-p ry antibodies [ , , ] and verified that the infiltrating dsred + cells were not p ry + . microglia and infiltrating dsred + leukocytes co-existed at the border of infarction, whereas microglia were abundant at the infarct periphery but scarce in the core of the lesion (fig. d-f ). microglia acquired a reactive phenotype at the periphery and border of infarction with thicker ramifications compared to microglia of the contralateral hemisphere. in contrast, microglial cells in the infarcted core showed a dystrophic morphology since the cell body became smaller and there were only a few long ramifications showing an appearance of discontinuity as if they were broken or beaded, and the density appeared to be reduced (fig. d) . to ensure that in wild-type mice we did not miss microglial cells in the infarcted core due to downregulation of the markers used to label microglia, i.e. iba and p ry , we studied the cx cr cre/ert mice [ ] crossed with floxed rosa :tdt reporter mice [ ] , which express the red fluorescent protein in microglia (fig. a, b; online resource ) obtaining the same findings as in wild-type mice. next, we analysed microglia morphology (online resource ) in the contralateral hemisphere, and in different zones of the ipsilateral hemisphere, i.e. periphery and infarcted core, days after mcao (fig. c-h) . shape descriptors showed increased circularity and reduced area of microglia in the ipsilateral hemisphere that was more marked in cells located in the core region (fig. c, d) . a sholl analysis showed that ischemia reduced the number of ramifications, and maximal intersections per microglial cell, and again the changes were greater in the core (fig. e, f) . analysis of d-reconstructions of the cells showed a reduced volume and higher sphericity index after ischemia, particularly in the core (fig. g, h) . furthermore, the quantification of cells per area showed that while microglial cell density increased in the periphery, it was reduced in the core of the lesion (fig. i) . this result was confirmed by flow cytometry after excising the core and periphery of the ipsilateral hemisphere and mirror regions of the contralateral hemisphere and days after mcao. microglia cell number was severely reduced in the core of the lesion at and days post-ischemia (fig. j) . altogether, these findings show that microglial cells are sensitive to persistent ischemic conditions and are lost in the infarcted core. fig. microglial proliferation after ischemic stroke in mouse and human brain. immunofluorescence in mouse (a-c) and human (d-g) brain tissue. a-c brdu incorporation (green) in dsred − ramified microglial cells expressing p ry (blue). d human tissue of stroke patients deceased at different time points after stroke onset. the brains were grouped according to the day of death after stroke in ' - days' (n = ) and ' - days' (n = ) groups. the number of p ry + cells per area tended to decrease in the core of the lesion in both groups and to increase at the periphery of infarction in the ' - days' group. **p < . vs. periphery. the percentage of ki + cells among the p ry + cell population increased at the periphery of infarction in the ' - days' group (***p < . vs. control and vs. core). e-g representative images of double-immunopositive p ry (green) and ki (red) microglial cells (arrowheads) at the periphery of infarction from different stroke patients deceased (e-f) or (g) days after stroke. nuclei are stained with to-pro (blue). scale bar µm in contrast to the lesion core, the microglial cell number increased at the periphery of infarction days post-ischemia (fig. i, j) . this effect was attributable to microglial proliferation as shown in dsred chimeric mice that received injections of the cell proliferation marker brdu after mcao (fig. a-c) . by cell counting, we calculated that . ± . % (mean ± sd, n = mice) of the microglial cells at the periphery of infarction incorporated brdu suggesting microglial proliferation, in agreement with previous reports [ , ] . in contrast, microglial cells were brdu − in the contralateral non-ischemic hemisphere. notably, brdu was found in ramified microglial cells suggesting that microglia could undergo cell division without regression of their differentiation status. we extended the results to the human brain by showing an increased number of microglial cells and proliferating ki + microglia at the periphery of infarction in post-mortem human brain tissue of stroke patients (fig. d-g) . we also found reduced microglial cell numbers in the lesion core of stroked human brains (fig. d) thus supporting that the findings in mice might be relevant to human stroke. our data identified the edge of the lesion as a site for possible interactions between microglia and leukocytes since both cell types were abundant in this zone. indeed, we observed numerous microglial cell processes surrounding the blood vessels and getting into contact with infiltrating dsred + leukocytes by sampling the dsred + cells adjacent to the vascular endothelium (online resource ). furthermore, we detected microglial processes surrounding dsred + cells suggestive of engulfment of leukocytes (fig. a-c; online resource ). d-reconstructions of confocal images showed phagosomes completely wrapping dsred + leukocytes (fig. b, c) . the csf r signaling pathway is critical for survival of microglia and maintenance of their functions [ ] , including endocytic processes [ ] . consequently, by interfering with microglial function after oral administration of the csf r inhibitor gw [ ] for days, we found more dsred + cells at the periphery of infarction not surrounded by microglia or in apparent contact with microglia, suggesting that microglia dysfunction impaired the process of phagocytosis of leukocytes (fig. d) . neutrophils showed bright dsred fluorescence in the dsred chimeric mice, as assessed by flow cytometry and immunofluorescence days post-ischemia (fig. a) . we detected ly g + dsred + neutrophils shrouded by microglia at the periphery of infarction (fig. b, c) . furthermore, processes of microglial cells located nearby the surface of the cortex seemed to traverse the external cortical basement membrane and surround neutrophils located in the subpial space (fig. d) . catchup ivm mice crossed with transgenic cx cr gfp/gfp mice allowed obtaining heterozygous double reporter mice with red fluorescent neutrophils and green fluorescent microglia [ , ] . in these mice, we observed microglia (green) adjacent to the basal lamina of blood vessels and surrounding extravasated neutrophils (red) after mcao (fig. e- to further investigate the phagocytosis of neutrophils by microglia, we carried out an in vitro study using time-lapse confocal microscopy. we isolated microglia from adult mouse brains, cultured the cells in vitro for days, and exposed them to freshly isolated bone marrow neutrophils (stained with cmfda) to study phagocytosis. microglial cells phagocytosed neutrophils in vitro (fig. a, b , and timelapse microscopy movie in online resource ). by following neutrophil trajectories along time (time-lapse microscopy movie in online resource ), we counted the number of neutrophils phagocytosed by microglia. we validated that allogenicity in the phagocytosis experimental design was not interfering with the assay by comparing phagocytosis of neutrophils obtained from different mice with the phagocytosis of neutrophils from the same mouse. we found no differences, ruling out prime effects of allogenicity in the fig. microglia cells phagocytose infiltrating dsred leukocytes. a-c chimeric mice were generated by bone marrow transfer from donor dsred mice to recipient wild type mice and were subjected to ischemia (n = ). immunofluorescence showing iba + dsred − microglial cells engulfing dsred leukocytes at the periphery of infarction at day after mcao. a confocal images of an iba + (green) dsred − microglial cell engulfing a dsred leukocyte. the images correspond to different z planes. b d-reconstructions of iba + dsred − microglial cells (blue) engulfing dsred + leukocytes (red). c microglial cell (iba + , blue) with engulfed red cells in several prolongations. nuclei are stained with dapi (white). magnified details of engulfed dsred cells are shown on the right hand side. f dsred chimeric mice received oral administration of either the csf r inhibitor gw or the vehicle (n = per group) starting h prior to mcao and then daily for days. the brain was studied days post-ischemia by immunofluorescence using anti-p ry antibody to label microglia (green), dsred for infiltrating leukocytes, and to-pro- for staining the cell nuclei (blue). the image shows a microglial cell at the periphery of infarction engulfing dsred leukocytes. schematic representation of this cell illustrating: (a) a dsred cell completely surrounded by a microglial process; (b) a microglial process making apparent contact with a dsred leukocyte (touching); and (c) a dsred leukocyte separated from microglia (free). counting the number of dsred cells in the above status (a-c) in relation to microglia showed that the csf r inhibitor increased (***p < . ) the number of free dsred cells. two-way anova by treatment and condition followed by the bonferroni test. scale bar corresponds to a, b µm; c µm for left image and µm for the magnifications on the right; d µm ◂ phagocytosis of neutrophils by microglia (online resource ). given that we observed signs of impaired phagocytosis of neutrophils in vivo after ischemia in mice after shortterm treatment with a csf r inhibitor (fig. d) , we investigated in vitro the role of csf r in this process. to this end, we obtained microglia from adult mice with heterozygous csf r +/− microglia (obtained by crossing cx cr cre/ ert with csf r flox/+ mice). less neutrophils were phagocytosed by csf r +/− microglia compared to csf r +/+ microglia, as assessed by time-lapse microscopy where we counted the neutrophils phagocytosed by microglia during the -h duration of the experiment (fig. c ). in addition, csf r +/− microglia showed reduced phagocytic activity in a phagocytosis assay with fluorescent beads (fig. d-f ). we then studied the potential relevance of these findings for human cells by obtaining human microglia from the post-mortem brain of an ischemic stroke patient deceased days after stroke onset. after maintaining the human cells in culture for days, we exposed the cells to neutrophils obtained from blood of a donor control subject. we observed very active phagocytosis of neutrophils (fig. g, h and timelapse microscopy movie in online resource ). by immunofluorescence after the ex vivo assay, we detected p ry expression in the cells and observed that they contained material from neutrophils (fig. i) . neutrophil numbers were higher in the core of infarction than the periphery and days after mcao, as assessed by flow cytometry after dissection of these brain regions (fig. a) . neutrophils were seen in perivascular spaces of venules (fig. b) but also in the parenchyma outside the basement membrane in the core of the lesion (fig. c, d) . strikingly, neutrophils were found in the brain parenchyma in zones of the core where microglia was absent or showed signs of dystrophy, as assessed in immunostained brain sections of wild-type mice and reporter mice, including the cx cr cre/ert -rosa :tdt mice (fig. e ) and the catchup ivm -cx cr +/− double reporter mice (fig. f-h) . at the periphery of infarction neutrophils were surrounded by reactive microglia, suggesting that microglia phagocytosed neutrophils thereby preventing their accumulation in this region. in contrast, in the core of infarction, dysfunction or loss of microglia might facilitate the accumulation of neutrophils. to obtain further evidence that microglia remove neutrophils after ischemia, we depleted microglia by feeding the mice for weeks with a diet containing a csf r antagonist (plx ) [ , , ] . plx diet caused a strong reduction ( %) of the microglia population (fig. a ) but did not affect blood leukocyte counts (online resource shows the gating strategy and cell quantifications are shown in online resource ), in agreement with previous reports [ , ] . however, we detected a reduction of a minor subset of blood ly c − monocytes (online resource ), which is dependent on csf r [ ] . in brain tissue, plx diet reduced the numbers of infiltrating monocytes ( %) and f / + macrophages ( %) versus the control diet days post-ischemia (online resource ), in agreement with previous findings suggesting a role for microglia in the recruitment of monocytes into the brain [ ] . in contrast, the plx diet increased the numbers of neutrophils in the brain tissue after ischemia, as assessed by flow cytometry at day (fig. b) . immunofluorescence in cx cr cre/ert :r -tdt mice showed extravasated neutrophils that seemed more abundant in the absence of microglia (fig. c, d) . by counting the number of neutrophils located either in the parenchyma or associated with blood vessels (hence not crossing the parenchymal basal lamina) we found an increase in the percentage of parenchymal neutrophils in the absence of microglia and days post-ischemia (fig. e) . of note, neutrophils were often observed on the fig. microglia engulf neutrophils. a-c chimeric mice generated by transfer of dsred bone marrow cells to wild type recipients. a flow cytometry shows cd b + ly g + dsred neutrophils in the ipsilateral but not the contralateral hemisphere (mann-whitney test, **p = . , n = ) days post-ischemia. infiltrating neutrophils (nimp-r + , ly g + ) are dsred + . b, c p ry + microglial cells (blue) engulf neutrophils at the periphery of infarction. images obtained days after mcao representative of n = chimeric mice. d image of a cx cr cre/ert :rosa -tdt mouse days after mcao showing a microglial cell (red) sending a process across the external basal lamina of the cortex (α -laminin, blue) to trap a neutrophil (ly g + , green) in the subpial space. e-i images obtained from cx cr gfp/+ /catchup mice, which have gfp + microglia (green) and tdt + neutrophils (red) day after mcao. sequence of confocal z-images showing the basal lamina (pan-laminin, blue) of a capillary with a neutrophil in the lumen and an extravasated neutrophil, surrounded by a microglial cell (e). z projections of one plane and confocal projection illustrating interaction of microglia with basal lamina and neutrophils (f-g). d-reconstructions showing the microglial cell (green) attached to the capillary (blue) and intraluminal (h) and extravasated (i) neutrophils (red). nuclei are stained with dapi (white). images were obtained from superficial cortical layers (a-c, e-i) and the brain surface (d) in zones corresponding to the core of the lesion (a), border of the lesion (d-i), and periphery (b, c). scale bar μm ◂ basement membrane of capillaries (fig. d) and venules (fig. f) suggesting a possible interaction of these cells with basal lamina components. in line with this, microglia depletion increased the size of the ischemic lesion (fig. g) , further supporting a beneficial effect of microglia at the periphery of the infarction. this study supports the concept that microglia phagocytose and remove neutrophils after brain ischemia [ , [ ] [ ] [ ] and demonstrates that neutrophil accumulation in the brain parenchyma is associated with reduced microglial phagocytic activity, attributable to ischemia-induced microglial cell dysfunction due to loss or dystrophy. morphometric analysis of microglia showed changes in the periphery of the lesion compatible with microglial reactivity and similar to those reported [ ] . overall, morphological changes of microglia within the lesion core were larger than in the periphery, for instance regarding the notable loss of ramifications and reduced cell size. such profound morphological changes of microglia in the lesion core might indicate a further process of transformation from reactive microglia to dystrophic microglia, potentially associated with cell dysfunction. furthermore, we found reduced microglial cell numbers in the core of infarction. while our results support microglial degeneration in the infarcted core, microglial cells proliferated and accumulated at the periphery of infarction in mouse and human brain, in agreement with previous findings in the mouse brain [ , ] . these reactive microglial cells at the periphery of infarction phagocytosed neutrophils, suggesting that the phagocytic activity of microglia prevented neutrophil accumulation in this region. accordingly, the numbers of neutrophils were higher in the core than the periphery of the lesion. microglial activity and survival are critically dependent on csf r [ ] . consequently, drug-induced inhibition of csf r or genetic reduction of csf r expression in microglia impaired their phagocytic capacity in vivo and in vitro. previous studies reported that csf- promotes phagocytosis of ab - peptide by primary human microglia in vitro [ ] , and it regulates cell motility in macrophages [ ] . csf r is a tyrosine kinase that upon activation shows phosphorylation of several intracellular tyrosine residues [ ] . upon activation, csf r associates with several signaling molecules, notably phosphoinositide -kinase (pi k) [ ] . csf r also activates akt [ ] , and it induces erk / -mediated signaling in microglia [ ] . akt [ , ] and erk / [ ] are involved in the phagocytic process. however, the specific signaling molecules downstream of csf r participating in phagocytosis in microglia after brain ischemia, and the precise step(s) of the phagocytic process affected by csfr remain to be identified. microglia depletion induced by long-term inhibition of csf r in vivo [ , , , ] increased the numbers of neutrophils in the ischemic brain tissue, further supporting the view that microglial cells contribute to neutrophil removal. neutrophils are attracted to the injured brain after acute stroke [ , , , , , ] . thereby, neutrophils adhere to venules and migrate through the vessel wall to reach perivascular spaces [ ] . in addition, neutrophils access perivascular spaces of penetrating cortical vessels from the leptomeninges [ ] . accumulation of neutrophils in the leptomeninges might be due to extravasation from pial vessels. in addition, neutrophil migration from the skull bone marrow through direct anatomic connections [ ] might explain the presence of neutrophils in the subarachnoid space, although migration of neutrophils from there to perivascular spaces of cortical vessels still needs further investigation. subpial neutrophils are separated from the brain parenchyma by the basement membrane and glia limitans. likewise, the parenchymal basal lamina and surrounding astrocyte end-feet separate perivascular cells from the brain parenchyma. interestingly, we observed ramifications of microglial cells apparently crossing the basal lamina suggesting the possibility that reactive microglia might sample the perivascular space and also the subpial space after brain ischemia. using intravital fig. microglia phagocytose neutrophils in vitro under the control of microglial csf r expression. microglial cells were obtained from adult mice (a-f) or a human stroke patient deceased days after ischemic stroke (g-i). after days in culture, the cells were exposed to corresponding control mouse or human neutrophils and studied by time-lapse confocal microscopy for h. a, b microglia were obtained from dsred mice (red) and neutrophils were stained with cmfda (green). d-reconstructions of image sequences ( ) ( ) ( ) ( ) ( ) of the time-lapse video (see supplementary video and ) illustrating the phagocytosis of neutrophils by mouse microglia (a). the time point of each image is indicated (hours:minutes). an original confocal image is shown b for illustrative purposes. c microglia cultures were obtained from csf r +/+ (wt) and csf r +/− littermate mice (n = mice per genotype) and the cell cultures were exposed to neutrophils and studied by time-lapse microscopy, where microglial cells were seen by phase contrast and neutrophils were stained with cmfda and detected by green fluorescence. we studied four wells per mouse in each independent experiment (n = ), recorded - videos of different fields per well, and analysed - frames per time-lapse video. quantification of the number of neutrophils phagocytosed by microglia (normalized by the number of microglia in each well) shows that heterozygous csf r +/− microglia phagocytose less neutrophils than wt microglia. two-way anova by genotype and experiment, with an experiment-matched design, show a genotype effect ***p < . . d-f cultures of wt and csf r +/− microglia were exposed to green fluorescent zymosan beads (n = independent experiments). at the end of the experiment cells were fixed and immunostained with anti-p ry antibodies (red) and the number of cells containing fluorescent beads was counted. compared to wt microglia (d), csf r +/− microglia (e) also shows a reduced capacity to phagocytose zymosan beads (green) (f). two-way anova by genotype and experiment, as above, shows a significant genotype effect **p < . . g sequential snapshot images ( - ) of human microglia obtained during the h time-lapse microscopy study in which frames were studied. the images illustrate neutrophil phagocytosis by human microglia at the indicated times (hours:minutes). h magnification of the indicated part of sequence in g is shown to illustrate the engulfment of a neutrophil by a human microglial cell. i after the time lapse-experiment, human cells were fixed and stained with anti-p ry antibodies (red). nuclei are shown in blue (dapi). the microglial cells contain material (green fluorescence) derived from digested neutrophils. scale bar μm ◂ microscopy, we previously found evidence that microglia phagocytosed neutrophils before they extravasated to the brain parenchyma [ , ] . however, further studies are required to demonstrate whether microglia can really cross the external cortical basement membrane after brain ischemia. although we detected engulfment of complete cells by microglia, some of the images suggest that microglia may take portions of the neutrophils while they are located in the perivascular or subpial spaces, potentially through a process of trogocytosis [ ] . the blood vessel glycocalyx and basement membrane composition varies between organs and inflammatory conditions suggesting that leukocytes may have to use diverse strategies to access different inflamed tissues [ ] . in the brain, neutrophils cross the endothelial cell layer and the endothelial basal lamina of venules to reach the perivascular spaces after ischemia [ ] . then, they accumulate in the perivascular spaces because they do not seem to readily cross the parenchymal basal lamina [ ] , at least not at the same pace as they transmigrate through the former layers. however, the precise molecular determinants of this process remain to be identified. the different molecular composition of the two layers of basal lamina surrounding the perivascular spaces, local molecular diversity, and the finding that certain basal lamina components inhibit leukocyte transmigration [ ] , might explain why neutrophils have more difficulty to cross the parenchymal than the endothelial basal lamina after brain ischemia. in a model of transient ischemia, there is evidence suggesting that neutrophils are kept in the perivascular spaces without infiltrating the brain parenchyma [ ] , whereas other studies suggested that neutrophils reach the brain parenchyma [ ] . it is plausible that stroke severity, status of microglia function, and time point of the study are critical determinants of the presence of neutrophils in the brain parenchyma. neutrophils located in the perivascular spaces might damage the basement membrane by releasing proteolytic enzymes and/or undergoing netosis [ ] . however, at this stage we cannot exclude the possibility that neutrophils gained access to the brain parenchyma in a passive fashion after loss of vessel integrity in the ischemic core. several lines of evidence support that after brain ischemia neutrophils release proteolytic enzymes, promote matrix metalloproteinase (mmp) activation, and cause bbb breakdown [ , , , , , ] . accordingly, blocking neutrophils or neutrophil-derived mmp- is markedly protective in models of systemic inflammation and stroke, e.g. [ , ] . furthermore, pharmacological inhibition of neutrophil elastase or genetic deficiency of this enzyme reduced bbb disruption and vasogenic edema after transient mcao [ ] suggesting that neutrophils contributed to vascular damage following stroke. in this study we showed that, after permanent ischemia, neutrophils gained access to the brain parenchyma of the lesion core when it was already severely damaged and microglia was lost due to persistent ischemia. under these conditions, parenchymal neutrophils might be bystanders of severe tissue damage. therefore, it is likely that preventing the access of neutrophils to the brain parenchyma in this model would not have a major impact on the size of the brain lesion since the damage is already established by the time the cells reach the parenchyma and the core of infarction will not recover. this possibility agrees with the finding that inhibition or deficiency of neutrophil elastase was not protective in models of permanent mcao [ ] . in contrast, inhibiting microglial phagocytic activity in this model might bear negative effects by favoring neutrophil accumulation in the ischemic periphery. accordingly, detrimental effects of neutrophils became apparent in our study after microglia depletion causing an abnormal increase in neutrophils and larger ischemic lesions. a limitation of our study is that we did not assess stroke outcome in the long term. future work should investigate how microglia depletion affects the progression of the ischemic brain lesion and the neurological deficits. the results highlight an aspect of microglia phagocytic function that may be beneficial for the ischemic tissue. nonetheless, several mechanisms can contribute to the detrimental effect of microglia depletion and csf r deficiency. for instance, pioneer studies demonstrated increased ischemic lesions related to reduced production of neurotrophic factors after depleting proliferating microglia [ ] , and neuroprotective functions mediated by csf r [ ] . moreover, we previously identified that absence of microglia significantly augmented infarct size in a model of transient ischemia, in part mediated by dysregulation of fig. the presence of neutrophils in the brain parenchyma is associated with dystrophy and loss of microglia. a flow cytometry analysis of cd b + ly g + neutrophils in the core and periphery of infarction and in mirror regions of the contralateral hemisphere and days after mcao (n = mice per time point) shows that ischemia increases the number of neutrophils in the core of infarction more than the periphery (two-way anova, bonferroni test, ***p < . ). b-d brain confocal images day after mcao (n = ) show ly g + neutrophils (green) in the perivascular space of a venule (b) and the parenchymal side of capillaries (c, d). the basal lamina is stained with pan-laminin (red) and nuclei are stained with to-pro (blue). e neutrophil (ly g + , green) accumulation is higher at the border (dotted line) of the infarcted core than the periphery, whereas microglia (red cells, cx cr cre/ert :rosa -tdt mice) accumulate in the infarct periphery and are scarce in the core. the vascular basal lamina is shown in blue (pan-laminin). f-h images obtained from catchup mice crossed with cx cr gfp/gfp mice at day (f, g) and day (h) postischemia. extravasated neutrophils (red) away from the vascular basal lamina (pan-laminin, blue) are seen in the core of the lesion where microglia (green) is absent or dystrophic, whereas neutrophils are surrounded by reactive microglial cells in the periphery (f). g examples ( - ) of microglial cells sending prolongations towards neutrophils day after pmcao. neutrophils located in perivascular spaces extend protuberances crossing the basal lamina ( ). extravasated neutrophils are seen near vessels with discontinuous basal lamina ( ). they are surrounded by reactive microglia at the border of the lesion ( - ), but dystrophic microglia seem to be unable to fully reach the extravasated neutrophils ( ) . h at day , microglial cells sending prolongations towards neutrophils are seen at the border of the lesion ( ). extravasated neutrophils are seen in zones where microglia is dystrophic ( - ) or absent ( ) ( ) ( ) . the vascular basal lamina is hardly detected at places where the neutrophils are located ( ) . arrowheads indicate neutrophils, whereas arrows indicate microglia. the cell nuclei (dapi, white) are shown in g ( ) ( ) and h ( - ). scale bar μm ◂ neuronal activity [ ] . the latter model caused moderate leukocyte infiltration and we failed to observe a significant impact of microglia depletion on bbb injury and leukocyte recruitment, at least at the times examined [ ] . in contrast to the findings suggesting beneficial effects of microglia in brain ischemia, several lines of evidence support that the phagocytic activity of microglia could exert negative effects by removing viable neurons through phagoptosis [ , , , ] . it is possible that any negative consequences of phagoptosis of neurons might predominate under mild ischemic conditions where the inflammatory response is low, vascular integrity is preserved, and neutrophil attraction to the brain is negligible. collectively, our results support a model where microglia removes neutrophils from the parenchyma and perivascular and subpial spaces after brain ischemia. severe ischemic conditions induce local microglia loss/dystrophy facilitating the presence of neutrophils in perivascular spaces first and in the brain parenchyma later. overall, this study shows that reactive microglial cells phagocytose and remove neutrophils, whereas microglial loss or dysfunction enhances neutrophil accumulation in the ischemic lesion. our results, hence, suggest that microglia function is critical to prevent neutrophil infiltration to the brain parenchyma and to minimize the negative impact of neutrophils in the vascular bed after ischemic stroke. fig. microglia depletion increases the number of neutrophils in the brain parenchyma. a schematic representation of the experimental design. eight-week old mice received a control or plx -containing diet for days. then mcao was induced and the animals continued with the corresponding diet one or four more days until the end of the study. b flow cytometry (n = mice per group) showed the microglia (cd low cd b + cells) depleting effect of the plx diet, and an increased number of neutrophils (cd b + ly g + ) in the ipsilateral hemisphere of mice with depleted microglia. two-way anova by treatment and brain hemisphere, and bonferroni posthoc test, **p < . . c control or plx -containing diet was given to cx cr cre/ert :rosa -tdt mice with the same dosing regimen. microglia is shown in red, neutrophils in green (ly g + ), the vascular basal lamina is stained with pan-laminin (blue), and nuclei (dapi) are shown in white. the absence of microglia is associated with an increased presence of extravasated neutrophils (arrowheads). d is a magnified image showing extravasated neutrophils after a plx containing diet. e, f distribution of neutrophils in parenchymal versus perivascular or intravascular locations, as assessed by cell counting in brain sections immunostained with ly g, pan-laminin and to-pro . mice treated with the plx diet show a higher (mann-whitney test) percentage of parenchymal neutrophils day (**p = . ) and days (**p = . ) post-ischemia (n = - mice per group). f illustrates the previous staining after plx diet. g brain lesion volume was measured with t w mri h post-ischemia in both diet groups (n = per group). the brain lesion was larger in mice depleted of microglia (mann-whitney test, *p = . ). scale bar μm (c); μm (e, f) ◂ new tools for studying microglia in 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was performed at the centre de recerca biomèdica cellex, barcelona. the cerca programme of generalitat de catalunya supports the institut d'investigacions biomèdiques august pi i sunyer (idibaps). plx was provided by plexxikon under materials transfer agreement. we acknowledge the cytomics and image platforms of idibaps for access to equipment. we would like to thank elisenda coll (advanced optical microscopy-ccitub) for excellent technical assistance. we thank the neurological tissue bank of the biobank-hospital clinic-idibaps for sample and data procurement, and to patient's relatives for giving consent to sample use for research purposes. key: cord- -a pkh q authors: tardieu, m.; goffinet, a.; harmant-van rijckevorsel, g.; lyon, g. title: ependymitis, leukoencephalitis, hydrocephalus, and thrombotic vasculitis following chronic infection by mouse hepatitis virus (mhv ) date: journal: acta neuropathol doi: . /bf sha: doc_id: cord_uid: a pkh q mouse hepatitis virus (mhv ) is either avirulent (resistant mice), hepatotropic (susceptible mice). or neurotropic (semisusceptible mice), depending on the strain of mice infected. in semisusceptible mice, infection led first to a transient meningitis, ependymitis, and leukoencephalitis, followed by a permanent communicating hydrocephalus and, later on, to a chronic thrombotic vasculitis affecting meningeal and parenchymal vessels at the brain stem level. small foci of ischemic necrosis related to vascular occlusions were seen in the dorsal brain stem. cyclophosphamide treatment of semisusceptible mice significantly reduced the meningeal infiltrates but did not prevent the development of hydrocephalus and other neuropathologic changes. identical lesions occurred in fully susceptible mice infected with a low dose of virus, but no neurologic disorder could be induced in genetically resistant mice even following immunosuppression or intracranial inoculation. the leukoencephalitis differed from the demyelinating lesions observed with mhv . vascular lesions were of particular interest. more attention should be given to the possibifity of virus induced chronic cerebral vasculitis in man. differences in susceptibility to virus infection depend on characteristics of injected virus (weiner et al. wolinsky and stroop ) , the route of infection (johnson ) , and on host genetic factors and immune function (allison ; hirsch et al. ; levy-leblond et al. ). mouse hepatitis virus (mhv ), a member of the corona virus group, is either avirulent, hepatotropic, or neurotropic, depending on the strain of mice infected. adult a/j mice are fully resistant to the virus. susceptible strains (e.g., dba/ or balb/c) develop an acute hepatic necrosis leading to death within a few days. some mouse strains (e.g., c h/he) as well as f hybrids between resistant and susceptible strains exhibit a "semisusceptibility" resulting either in early death or, in surviving animals, in the development of a chronic disease with neurologic manifestations and virus persistence (dupuy et al. ; le prevost et al. a, b) . ependymitis and vasculitis have been reported . susceptibility or resistance to mhv infection has been shown to be under the influence of at least two major gene complexes, one for the acute disease and the other, h- linked, for the chronic disease (levy-leblond et al. ). in addition to genetic factors, one of us has observed that host defense against mhv infection requires at least three types of immunocompetent cells: t-lymphocytes, splenic macrophages, and nk-like lymphoid cells (tardieu et al. ) . the aim of the present neuropathologic study was to better delineate the interaction of mhv with the different cells of the central nervous system (cns), as influenced by the genetic background and immunologic status of the host. of particular interest were an early transient leukoencephalitis and a chronic thrombotic vasculitis in the later stage of the disease. x a/j) fi hybrids (thereafter designed as baf mice) were bred in our mouse colony as previously described (le prevost et al. a) . passage, assay, and recovery of mhv were performed in susceptible dba/ mice as reported previously (le prevost et al. a) . virus titer was expressed in ld /g of tissue. the virus was injected intraperitoneally (i.p.) at a dose of ld in . ml of saline buffer unless otherwise specified. in a group of a/j strain mice, ld of viral suspension were injected intracerebrally through a burhole in the parietal bone (total injected volume: i gl). a total of mice were injected. ninety-one survived and were available for study. at various times after infection [on days , , , , , , , , , , , , , and post infection (p.i.) ], mice were anesthetized with ether and perfused through the left ventricle with either formaldehyde ( % w/v in phosphate buffer) for opto-microscopic studies, or formaldehyde ( % w/v in phosphate buffer) plus glutaraldehyde ( . % v/v) for electron-microscopic studies. the whole cranium was fixed overnight. the brain was then removed, embedded in paraffin, and sliced coronally on a serial basis for the preparation of paraffin sections which were processed by conventional techniques. in a series of mice prepared for electron-microscopic studies, selected fragments of ependyma, white matter, cortex and brain stem were obtained, postfixed in % oso , and embedded in epoxy resin. semithin sections were stained with toluidine blue or with the pas method. thin sections were stained with uranyl acetate and lead citrate and examined using a philips em electron microscope. cyclophosphamide treatment. cyclophosphamide was reconstituted with saline buffer and a freshly prepared solution was injected i.p. at a dose of mg/kg. cyclophosphamide treatment, in semisusceptible baf mice, given either before or just after mhv infection, leads to % mortality (willenborg et al. ) . to avoid acute mortality, cyclophosphamide was injected on days , , p.i. or and p.i. in some experiments, a/j strain mice were injected with cyclophosphamide , , and/or days before infection. a strontium treatment. cu of strontium ( sr) were injected i.p. in baf mice on two separate occasions, weeks apart. six weeks after the last injection, animals were considered " rtreated", as described previously (tardieu et al. ) . mhv was injected weeks after the second injection. after infection, ( %) of the semisusceptible mice (baf , ch ) survived and developed a progressive neurologic disease characterized by incoordination, paresis of the hind limbs, enlargement of the head, and progressive neurologic deterioration leading to death within - months. in this group of animals, no neuropathologic changes could be detected when examined on days and p.i. the first abnormalities, at days p.i., consisted of an important meningeal in-filtration of polymorphonuclear and mononuclear cells. at days p.i., the infiltrate consisted of small lymphocytes, plasmocytes, and macrophages. after days p.i., the diffuse meningeal infiltrate diminished progressively and was minimal after days p.i. during the same period inflammatory cuffing of meningeal vessels became progressively more marked. perivascular inflammatory cells consisted of small lymphocytes, plasmocytes, and macrophages. between and days p.i. perivascular infiltrations of mononuclear cells and microglial nodules appeared in the hemispheric white matter (fig. l a) . in rare instances, a microglial nodule was observed in the adjacent cortex. at days the inflammatory lesions in the white matter had disappeared, leaving widespread destruction and cavitation (fig. i b) . at days p.i., the first signs of an ependymitis appeared. between and days p.i. the granular ependymitis was particularly marked. inflammatory lesions predominated in the fourth ventricle and aqueduct ( fig. a) . focal aggregates of inflammatory cells consisting of mononuclear cells were formed beneath the ependyma and the ependymal cell line was focally disrupted. some of these granulomas bulged into the ventricular lumen and became even detached to form rosettes which were found free in the csf or were attached to the cilia of the ependymal cells. under the electron microscope, these granulomatous buds were seen to consist of lymphocytes and histio-monocytes together with ependymocytes. no viral particles could be seen within the affected ependymal cells. the cells of the subependymal aggregates did not stain with an antiserum against gfap, suggesting that they did not contain proliferating astrocytes. no changes were detected in the chroid plexus. after days p.i., the ependymal lesions became progressively less active and demonstrated residual scarring. the ependymal cell line was focally disrupted, and in the posterior part of the fourth ventricle it was completely destroyed. proliferation of subependymal atrocytes was not conspicuous (fig. b) . the first evidence of ventricle enlargement was noted at days p.i. hydrocephalus progressed thoughout the life span of the animals. on serial sectioning of the aqueduct no stenosis was observed at and days p.i. in mice killed after days p.i. vascular lesions were observed. numerous meningeal arterioles showed severe alterations : hyaline necrosis of the media, fragmentation of the elastic lamina and intimal proliferation (fig. ) . some arterioles and capillaries were occluded by an inflammatory thrombus (figs. , ) consisting of plasmocytes, a few polymorphonuclear leukocytes, and necrotic cells of uncertain origin (fig. ) . between - days p.i. vasculitis and thrombosis were seen to affect intraparenchymal yes- fig. a , b. inflammatory nodules in hemispheric white matter. neocortex is situated below and subiculum above the central white matter. fragments of ependyma are seen amidst the inflammatory cells. a days p.i. nissl, x . b widespread destruction of cerebral white matter, no inflammation; days p.i. he, x sels beneath the iv ventricle and in the dorsolateral part of the brain stem (fig. ) . a t some points, the nervous tissue surrounding these vessels showed distinct signs of ischemic necrosis, characterized by the presence of macrophages and proliferating astrocytes. aggregates of inflammatory cells were seen around vessels and in the surrounding parenchyma. n o microglial nodules and no intranuclear inclusions were observed. the infected semisusceptible mice which died acutely during week showed lesions similar to those observed in fully susceptible mice, i.e., acute hepatitis with a normal appearance of the cns. cyclophosphamide treatment. a group of baf mice were injected i.p. with mhv ( ld ). two died acutely and the others were treated with cyclophosphamide as described in material and methods. among the infected and cyclophosphamide-treated mice, survived and two died at and days p.i. pathologically, the ependymal lesions and ventricular dilatation were identical to non-treated mice. hyaline necrosis of the walls of meningeal arteries and thrombosis existed as in controls. in contrast, there was a marked diminution of the meningeal and perivascular inflammatory cell infiltration as compared to control mice which were infected by mhv but were not treated with cyclophosphamide. there was no evidence of leukoencephalitis. strontium treatment. treatment with sr resulted in acute liver necrosis with death between day and p.i. in the five semisusceptible mice tested. these mice showed a pattern of lesions similar to that observed in susceptible mice. when six susceptible balb/c mice were injected i.p. with mhv ( ld ), they died of an acute hepatic necrosis - d a y s after m h v infection, and no neuropatholigic lesion was observed except a slight degree of meningeal infiltration. a group of balb/c mice was then infected with a low dose of virus ( ld ). eight of these animals died acutely with in - days, the other two survived. the neuropathologic lesions were identical to those observed in semisusceptible mice, i.e., meningitis, leukoencephalitis, ependymitis, ventricular dilatation, and vasculitis. if the dose of inoculated virus was further lowered ( ld ), neither acute nor chronic lesions developed in five injected animals. to determine whether resistant mice could develop a chronic disease, three experiments were performed. first, three resistant a/j mice were injected in the same way as the semisusceptible animals. no clinical manifestations or neuropathologic abnormalities were observed. secondly, a/j strain mice were immunosuppressed with cyclophosphamide. after infection with mhv , the most profoundly immunosuppressed animals (two or three cyclophosphamide injections before mhv infection) died acutely as previously shown (willenborg et al. ) ; in the two surviving animals a slight meningeal infiltration and a perivascular infiltrate were observed on day p.i. without any ependymal damage, in a third experimental group mhv was injected directly into the brain of nine mice. only minimal neuropathologic lesions were observed (a light microglial infiltration at the point of injection) without any ependymal or vascular change. systemic infection of semisusceptible strains of mice with mhv leads to a remarkable sequence of brain lesions, such as meningitis and leukoencephalitis to mention those appearing first. the diffuse meningeal infiltrate tends to disappear progressively within a few weeks without fibrotic changes. however, perivascular infiltrates remain, especially at the level of the brain stem. the acute leukoencephalitis (fig. a) , which is more marked in c h, is restricted to the central white matter of the cerebral hemisphere and is visible only during a limited period of time between days and p.i., leaving behind severe destructive lesions (fig. b) . this type of leukoencephalitis is different from white matter lesions produced by mhv , which consist of noninflammatory patchy demyelination (waksman and adams ; lampert et al. ; weiner ; herndon et al. ; haspel et al. ; weiner and stohlman ; stohlman and weiner ) . the presence of glial nodules in the white matter and occasionally in the adjacent cortex, may be considered as an indication of a direct action of the virus on glial cells. inflammatory changes in the ependyma appeared approximately at day and persisted for about month (fig. a) . they resulted in widespread destruction of the ependymal lining (fig. b) . viral particles were not detected with the electron microscope in the ependymal cells, in contrast with the findings in other viral ependymitis (nielsen and baringer ; wolinsky ) . progressive hydrocephalus starting at about weeks p.i. was probably a major factor in the death of the animals. virus-induced experimental hydrocephalus has been attributed either to stenosis of the aqueduct produced by an ependymitis (johnson et al. ; johnson and johnson ; johnson ) or to a post infectious fibrosis of the meninges (masters et al. ) . in our animals aqueductal stenosis was not observed (at least until the th day p.i.), and there was no meningeal fibrosis (arachnoid villi were not examined). immunosuppression of semisusceptible animals with cyclophosphamide did not prevent the appearance of hydrocephalus; its most remarkable effect was the nearly complete suppression of the meningeal infiltrate. fibrosis of the meninges can, therefore, probably be discounted as the cause of intraventricutar hypertension and the mechanism of hydrocephalus remains unsettled. however, the parallelism between the intensity of ependymitis and hydrocephalus should be noted: both abnormalities were more important in baf mice than in c h mice. in contrast to the early, self-limiting, inflammatory lesions observed in the cerebral white matter and ependyma, vasculitis appeared late, after ependymitis had subsided, and increased progressively thoughout the life of the animals. these remarkable lesions consisted in hyaline necrosis of vessel walls and thromboses (figs. , ) . plasmocytes were remarkably numerous in the inflammatory thrombi (fig. ). perivascular cuffings with lymphocytes and plasmocytes were even more abundant than in the early phases of the disease. arterioles, capillaries, and venules were affected, essentially in the meninges surrounding the pons and medulla, deep in the subependymal region of the ivth ventricle, and within the dorsolateral parts of the brain stem, where small loci of ischemic necrosis related to vascular occlusions were observed (fig. ) . it is not impossible that some of the parenchymal lesions could be ascribed to an encephalitic process; however, the presence of vascular occlusions and ischemic necrosis in these areas is unquestionable. in man, particularly in the fetus, the possibility for a chronic viral infection to induce ischemic brain lesions after a long delay, through a slowly progressive thrombotic vasculitis, has not been sufficiently considered. such a sequence of events is known, however, in congenital rubella, where degeneration of vessel walls leads to multifocal ischemic necrosis of the brain (rorke and spiro ; singer et al. ; rorke ) and similar lesions have been shown in experimental animals (rorke et al. ) . a rare condition, granulomatous angiitis has been related to varicella-zoster infection (kolodny et al. ; rosenblum and hodfield ; linnemann and alvira ) and to other viral infections (reyes et al. ) in man. also, it is known that inflammatory perivascular infiltrates perist for many months in human poliomyelitis (esiri ) . at the time vascular lesions develop, a low titer of virus can still be detected in the brain, as late as months p.i. (le prevost et al. b), and dupuy et al. ( ) have demonstrated at that stage a severe non specific immunodepression (dupuy et al. ) . to investigate possible immune mediation in the generation of vascular lesions, we studied the effects of two immunomodulating regimen in semisusceptible mice: cyclophosphamide, which depresses t-and b-cell activities (stockman et al. ) and s sr, which abolishes selectively nk cell activity (kumar et al. ; tardieu et al. ). cyclophosphamide did not prevent necrosis of vessel walls and thrombosis. sr treatment changed the pattern from semisusceptible to susceptible mice, dying of acute hepatic necrosis. to study further the effect of r, preliminary experiments were performed in which mice were injected with mhv day after the second injection of sr, to avoid acute hepatic necrosis. the intensity of vasculitis in these mice and in controls was identical. these experiments suggest that t, b, and nk-cells do not play a prominent role in the induction of vascular lesions. however, there is as yet no clear evidence in favor of a direct action of the virus on the vessels, and further research is needed into the pathogenesis of the thrombotic vasculitis following mhv infection. the same neurologic disease can occur in fully susceptible mice infected with a low dose of virus, but attempts to induce this disease in genetically resistant mice have been unsuccessful, even following immunosuppression or intracranial inoculation. these findings suggest that host cells in the brain from fully susceptible and semisusceptible strains are equally able to support viral replication and are equally susceptible to give rise to destructive lesions. the absence of disease in resistant mice may be related to an inability of host cells to either bind or replicate mhv . it is also possible that other means of immunosuppression may alter this genetic resistance. genetic factors in resistance against virus infection persistent virus infection with neurological involvement in mice infected with mhv c ( ) 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virus in mice. i. role of sr-sensitive effector cells responsible for rejection of bone marrow allografts mechanism of demyelination in jhm virus encephalomyelitis. electronmicroscopic studies immunopathology of mouse hepatitis virus type infection role of humoral and cell-mediated immunity in resistance mechanisms b) immunopathology of mouse hepatitis virus type infection. iii. clinical and virologic observations of a !aeristent viral infection genetic study of mouse sensitivity to hmv infection: influence of the h- complex pathogenesis of varicella-zoster angiitis in the cns pathogenesis ofreovirus type i hydrocephalus in mice. significance of aqueductal change reovirus-induced aqueductal stenosis in hamsters. phase contrast and electron-microscopic studies virus-like particles in granulomatous angiitis of the central nervous system cerebral lesions in congenital rubella syndrome experimental cerebrovascular lesions in congenital and neonatal rubella-virus infections of ferrets nervous system lesions in the congenital rubella syndrome granulomatous angiitis of the nervous system in cases of herpes zoster and lymphosarcoma pathology of the congenital rubella syndrome differential effects of cyclophosphamide on the b-and t-cell compartments of adult mice chronic central nervous system demyelination in mice after jhm virus infection neonatal susceptibility to mhv infection in mice. ii. role of natural effector marrow cells in transfer of resistance neuropathological effects of persistent infection of mice by mouse hepatitis virus infectious leukoencephalitis. a critical comparison of certain experimental and naturallyoccuring viral leukoencephalitis with experimental allergic encephalomyelitis pathogenesis of demyelination induced by a mouse hepatitis virus (jhm virus) molecular basis of reovirus virulence: role of the s gene viral models of demyelination effect of cyclophosphamide on the genetic resistance of c h mice to mouse hepatitis virus mumps virus-induced hydrocephalus in hamsters. ultrastructure of the chronic infection virulence and persistence of three prototype strains of mumps virus in newborn hamster key: cord- -fvf jn authors: kjeldsberg, elisabeth; hem, annelise title: detection of astroviruses in gut contents of nude and normal mice date: journal: arch virol doi: . /bf sha: doc_id: cord_uid: fvf jn gut contents of nude and normal mice were examined by electron microscopy in association with an outbreak of diarrhea in a colony of nude mice. virus-like particles with a morphology consistent with previous descriptions of astroviruses of other species were demonstrated in a high percentage of the animals. gut contents of nude and normal mice were examined by electron microscopy in association with an outbreak of diarrhea in a colony of nude mice. virus-like particles with a morphology consistent with previous descriptions of astroviruses of other species were demonstrated in a high percentage of the animals. various viruses have been detected in recent years by electron microscopy (em) of stools and contents of the intestinal tract from both man and animals ( ) . the relationship of some of these viruses to gastroenteritis has been established or postulated. different viruses are causative agents of diarrhea in mice. the epizootic diarrhea of infant mice (edi~[) virus was demonstrated in by cheeve~ and muell~ ( ) . the morphology of this virus was described in by muck and zajac ( ) and it was later classified as a rotavirus. lethal intestinal virus of infant mice (livim) was first described by k~aft in ( ) . this virus could be distinguished from edim by its pathology and clinical signs, and by serological tests ( ) and it was later shown to belong to the coronavirus group ( , ). recently another coronavirus was isolated from an infant mouse in association with diarrhea and designated as diarrhea virus of infant mice (dvim) ( ) . astroviruses were first detected in human faeces in association wit, h gastroenteritis ( ) , and morphologically indistinguishable particles have been reported in diarrheal faeces of lambs ( ) , calves ( ) , birds ( ) and cats ( ) . astrovirus has not been demonstrated in mice so far. in this note we report the detection of astrovirus-like partieles in gut contents from nude mice, with and without clinical signs of illness, and from normal symptomless mice in association with an outbreak of diarrhea. gut contents of mice from different sources and of different strains and stocks were examined: . han:nmri nu/nu bred in isolators in the animal unit. . balb/e/nu/nu bom. . nih:bg/nu/nu bred in isolators in the animal unit. . nih:nihs/nu/nu bred in isolators in the animal unit. . bom:nml~i (normal controls). all the animals were caesarean derived and barrier maintained and of specified pathogen free quality when delivered from the breeder. the nude and thymus deficient mice were kept in a barrier unit. they were given irradiated altromin pelleted diet ad libitum. the water was acidified to ph . with hydrochloric acid. autoclaved woodshavings (hahnflock ) were used as bedding. the diarrhea episode started during a heat wave in the summer when the temperature in the anim m room varied between -- ° c and the relative humidity between -- per cent. the duration of the disease in the individual animal was generally protracted. when it was obvious that 'the animal was ill with diarrhea or wasting it was killed. the mice with normal haircoat were kept in a conventional animal room for -- days after arrival from the breeder before they were submitted to examination. only animals received from the same breeder were kept in this room. the age of the animals varied between weeks and months. both sexes were represented about evenly in nude and normal animals. the gut contents of the mice were scraped off and suspended to per cent v/v in phosphate buffered saline (pbs) ph . the suspension was shaken with a vortex mixer for one minute to disperse the material, left on the bench for minutes at room temperature and shaken by hand from time to time. the extract was centrifuged at g for five minutes and the supernatant was kept at -- ° c until required for use. in a few experiments gut contents were suspended to per cent v/v in pbs containing per cent w/v triton x- (pbs/tx- ) and disrupted with ten strokes of a glass homogenizer. the mixture was cleared at i × g for minutes, the pellet washed with a small volume of pbs/tx-i and the supernatants pooled. for electron microscopy the extracts from gut contents were treated as earlier described ( ). . ml extract was centrifuged for minutes at r.p.m, and the supernatant reeentrifuged for minutes at , r.p.m. in a sorvall rc -b centrifuge ss- rotor. the deposit was suspended in a few drops of distilled water and treated in a branson ultrasonic bath for minutes to disperse the virus particles. negative staining was performed by mixing equal volumes of virus suspension and per cent potassium phosphotungstate pit and layering the mixture on a formvar carbon coated mesh copper grid. after one minute excess fluid was removed with filtering paper, and the grid was air-dried. the specimen was examined in a jem b electron microscope at a magnification of , x using kv accelerating voltage. the magnification had been calibrated with a diffraction grating specimen. a sample was considered negative if no virus particles were observed within minutes examination. intestinal scrapings from nude mice with and without clinical signs of illnes and from normal symptomless mice were treated and examined symptomless or with symptoms other than diarrhea in the electron microscope as described above. particles resembling astrovirus were demonstrated in of the nude mice. the particles were roughly spherical in outline and had a diameter of about nm. the -- pointed star configuration, characteristic of astroviruses, was seen on some of the particles, which mostly appeared in aggregates (fig. a--c) . on some of the micrographs the virus particles showed a smooth outer edge (fig. a) . often, however, fiber-like structures which seemed to form bridges between the virus particles were seen (fig. b) . electron microscopy of pbs/tx- extracts of gut contents occasionally showed astrovirus particles penetrated with stain revealing an inner core structure -- nm in diameter (fig. c) . virus particles were demonstrated in both apparently healthy and diseased animals. the results of the examination of nude and normal mice are summarized in table . seventeen of the nude mice examined suffered from diarrhea while animals were killed for various reasons; i.e. abcesses, bite wounds, termination of experiments. astrovirus was demonstrated in ( per cent) of the animals with diarrhea and in ( per cent) from the control group. no attempt was made to quantify the amount of virus in the samples, but there appeared to be a higher number of virus particles in the samples from animals with diarrhea than from those without. small amounts of astrovirns-like particles were also demonstrated in of l normal mice showing no sign of illness. the morphology of the virus-like particles detected in gut contents of nude and normal mice corresponds to the previous description of astroviruses. the occurrence of the virus in association with diarrhea is consistent with the demonstration of astrovirnses in humans and other animal species in association with gastroenteritis. the failure to demonstrate virus in one of the animals with diarrhea may be due to low sensitivity of the technique. as the majority of astrovirns particles are usually aggregated ( ) a great deal is probably lost in the low speed centrifugation. demonstration of aggregates of virus-like structures in deposits after low speed centrifugation confirms this assumption. the presence of large aggregates of virus-like particles in the intestinal scraping suggests a multiplication of the astrovirus in epithelial cells of the intestinm tract, which would be in agreement with earlier findings in infected lambs ( ). demonstration of astrovirus in a high percentage of nude and normal mice without diarrheal symptoms might suggest that the animals are symptomless carriers of the virus and that the pathogenicity in the nude mice is enhanced by break-down of the climatic control or heavy experimental stress. this hypothesis needs further support. studies on the pathogenicity and characteristics of the mouse astrovirus and the relationship of the virus to diarrhea in these animals are in progress. lethal enteritis in infant mice caused by mouse hepatitis virus lethal intestinal virus of infant mice is mouse hepatitis virus epidemic diarrheal disease of suckling mice. i. manifestations, epidemiology and attempts to transmit the disease ultrastructure of the small intestine in astrovirusdnfeeted lambs purification and characterization of ovine astrovirus detection of astroviruses in feces of a eat with diarrhea comparison of solid-phase (immune electron microscopy, direct electron microscopy and enzyme-linked immunosorbent assay for detection of rotavirus in faecal samples an apparently new lethal virus disease of infant, mice epizootic diarrhea of infant mice and lethal intestinal virus infection of infant mice viruses in infantile gastroenteritis detection of astroviruses in turkey faeces by direct electron microcopy purification and characterization of epizootic diarrhea of infant mice virus detection and transmission of nm virus particles (astroviruses) in faeces of lambs with diarrhea morphnogicat and biological properties of a new eoronavirus associated with diarrhea in infant miee virus infections of the gastrointestinal tract isolation of small viruses resembling astroviruses and caliciviruses from acute enteritis of calves authors' address : dr. elisabeth kjeldsberg, national institute of public health key: cord- -aavpj r authors: schwarte, l.a.; zuurbier, c.j.; ince, c. title: mechanical ventilation of mice date: journal: basic res cardiol doi: . /s sha: doc_id: cord_uid: aavpj r due to growing interest in murine functional genomics research, there is an increasing need for physiological stable in vivo murine models. of special importance is support and control of ventilation by artificial respiration, which is difficult to execute as a consequence of the small size of the animal and the technically demanding breathing pattern. in addition, numerous genetically altered mice show depressed spontaneous ventilation or impaired respiratory responses. after an introduction in murine respiratory physiology we describe options for ventilatory support, its monitoring and the potential side effects. this review will provide an overview on current possibilities in the field of airway support in mouse research. rate (rr) of min Ð , a ventilatory tidal volume (vt) of µl, an inspiratory fraction (inspiratory to total time of the respiratory cycle, ti/tt) of . and a resulting ventilatory minute volume (ve) of . mlámin Ð was found. similar values are found for wild type and endothelin- knock-out mice (et (Ð/Ð) ) when birth was achieved by cesarean section ( ) . rather low respiratory values were found in a study comparing wild type neonates with littermates deÞcient for the ret-protooncogene: rr ranged from Ð min Ð , vt from Ð µl and ve from . Ð . mlámin Ð , with no significant differences between the groups. the authors suggest that a reduced body temperature in their setting contributed to their Þndings ( ) . with respect to control of breathing, newborn wild type mice ( g bodyweight) show similar ventilatory responses to hypercapnia compared to other newborn mammals ( ) . neonates deÞcient in endothelin- ( sv/j x icr, et- (Ð/Ð) ) have an attenuated ventilatory response to hypoxia and hypercapnia, compared to their wild type littermates ( ) . a signiÞcantly reduced ventilatory response to hypercapnia was also found in neonate mice deÞcient in the ret-protooncogene, compared to wild type littermates, whereas no consistent differences were obtained during hypoxic challenge ( ) . parameters for the spontaneous ventilation of adult mice are given in table , where the following characteristics of mice ventilation are given: rr = Ð mlámin Ð , vt = . Ð . ml and ti/tt = . Ð . . little information is currently available on the lung mechanics of mice ( ) . murine lung-thorax compliance was measured in pancuronium-relaxed, mechanically ventilated mice (balb/c, no weight stated) in the range of Ð µl (cmh o) Ð under control conditions, and µl (cmh o) Ð after experimental surfactant inactivation ( ) . respiratory system resistance was measured in age matched a/j-and c h/hejmice, revealing signiÞcant strain differences under baseline conditions ( vs. cmh oám/ Ð ás Ð ) and especially after i.v. acetylcholine treatment ( vs. cmh oám/ Ð ás Ð ) ( ) . in the same study, signiÞcant differences were also found for the respiratory system elastance under both conditions ( vs. cm h oáml Ð at baseline and vs. cm h oáml Ð after i.v. acetylcholine). again, one has to realize that marked differences exist between mouse strains in respect to respiratory physiology and pathophysiology. divergent data is available on physiologic values for murine arterial blood gasses, regarded as the gold standard for the evaluation of adequacy of ventilation. information on tissue pco of the mouse indicates that it Þts within the normal mammalian range ( ) . later it was suggested that mice have considerably lower alveolar and arterial pco than other mammals, as low as mmhg (at ph . ) ( ) . indeed, recent data support these lower pco ( mmhg in chronically instrumented sv/j x icr mice ( ) , mmhg in chronically instrumented c bl/ mice ( )). although effects of ( , ) or restrainment cannot completely be excluded in these studies, the data does indicate a lower paco for the mouse, e.g., compared to mammals ranging from rats to humans (paco Ð and Ð mmhg respectively). mechanical mouse ventilation is indicated unter the following circumstances. first, the ÒanesthesiologicalÓ indication: one of the major goals of anesthesia is achievement of more ( , ) , mice lacking the brain derived neurotropic factor bdnf ( ), ret-protooncogene deÞcient mice with depressed ventilatory response ( ), and endothelin- deficient mice with altered blood gas-values (e.g., signiÞcantly lower po than wild type littermates) and impaired respiratory response to hypoxia and hypercapnia ( ) . however, it is often unknown when during development and under which conditions alterations occur in the respiratory system or the control of breathing ( ) . also among inbred wild type strains the control of respiration differs substantially, e.g., the c bl/ -strain was classiÞed as highly responsive to hypercapnia, whereas the dba/ -strain was highly responsive to hypoxia ( ) . therefore, in these animals mechanical ventilation offers the possibility to study effect of differences in genetic background independent of changes in ventilation. second, the ÒsurgicalÓ indication: certain surgical procedures have an improved outcome or can only be performed with support of mechanical ventilation. examples are the bilateral ligation of the carotid artery ( ) , where non-ventilated mice often die from respiratory disturbances, or the growing Þeld of cardiac research that needs an open-chest murine model ( , , , ) . hereby opening of the thorax and the adherent interpleural space induces lung collapse with respiratory insufficiency, whereas with support of a mechanical respirator the lungs can be inßated and ventilated. there are several possibilities of accessing and maintaining the airway in mice. in early studies using a mechanical ventilator with active in-and expiration for mice ( ) , the airway was accessed by advancing a tube through the mouth into the pharynx, but not further into the trachea. although technically less demanding than endotracheal intubation, this attempt risked gastric gas-insufflation (including aspiration of stomach content) and did not provide peep capability. a different, nontraumatizing mode to access the airways is performed with the brady-newsom apparatus ( ): it consists of a gas-chamber around the murine head, sealed at the thorax by a tight neoprenecollar. elevating the pressure in this chamber leads to increased airway pressures, with respect to ambient air. thus this concept provides continuous positive airway pressure (cpap) if the mouse ventilates spontaneously, or mechanical ventilation, if periodic pressure changes in the chamber are generated. although this apparatus has advantages, e.g., the technically less demanding airway access, it is also hampered with the disadvantage of gastic gas insufflation and aspiration of gastric content. to circumvent this problem, mechanical ventilation of mice today is usually performed after securing the airways by orotracheal intubation or via tracheotomy and consecutive endotracheal intubation. tracheotomy has been performed in preterm neonate mice ( . g bodyweight) with insertion of polyethylene tubes (sp , natsume, tokyo, japan; tapered . mm outer diameter (od)) ( ), whereas for adult mice the od of the endotracheal tube ranges from . mm ( Ð g mice) ( ) to . mm ( Ð g mice) ( ) . for experiments requiring recovery after surgery, temporary orotracheal intubation is performed, ideally via direct laryngoscopy with a purpose-made laryngoscope ( ) . the visualization of relevant airway structures requires a strong small-focus light-source, allowing transillumination of the laryngeal cavity (with vocal cords and tracheal oriÞce), when put on the ventral cervical region from the outside ( ). orotracheal intubation is performed with or without visual conÞrmation of the tubeÕs tip-position (tube position judged by respiratory excursions). visualization of the trachea (after surgical access to the deeper cervical structures) and controlled advancement of the endotracheal tube allows more accurate positioning of the tube, but is more invasive and has therefore an increased morbidity and mortality. for animals sacriÞced at the end of the experiment, direct surgical access to the airways is an alternative option. since most of our mouse surgeries require preparation of deeper cervical structures (e.g., catherization of a carotid artery and jugular vein) performing tracheotomies is convenient, with the additional advantage of minimized dead space (vd). a reliable surgical procedure for this airway access is brießy described: after induction of anesthesia the mouse is put into the supine position and the head is reclined (silk or rubber band around the upper incision teeth and attached to the operating surface) to allow easy access to the ventral neck. a median cerival skin incision (upper thorax aperture to lower jaw) is performed and layerwise skin, fascia, fat and connective tissue covering the thyroid gland are removed. the thyroid lobes are divided bluntly at their isthmus, pulled aside and kept retracted by bulldogclamps. the pretracheal muscles are spread bluntly and pulled aside to allow access to larynx and trachea. tracheotomy is performed by a transversal cut between two tracheal rings, usually in the lower third of the trachea. for the endotracheal intubation vascular pe-catheters (abbocath-t¨, abbott-venisystems) are used, cut to a length of about mm with an angled tip ( ¡) to allow smooth introduction. the correct position of the endotracheal tube is conÞrmed by judging chest excursions, e.g., if respiration is still visible and symmetric. the tube is secured by ligation (silk - , davis & geck¨) around the trachea. if maintenance of spontaneous ventilation is desired, the endotracheal tube is shortened to minimize vd and airway resistance. for mechanical ventilation, initially applied rr and/or vt should be sufficiently higher than spontaneous rr and vt of the anesthetized mouse to decrease respiratory drive (e.g., Òbreathing against the ven-tilatorÓ) by moderate hyperventilation. after connecting the endotracheal tube, anesthesia can be safely deepened for an additional depression of ventilatory drive and facilitation of mechanical ventilation. alternatively, this goal can be achieved (avoiding additional cardiocirculatory depression) by a non-depolarizing muscle relaxant (vecuronium-bromid . mgákg Ð bodyweight i.p., norcuron¨, organon). using this option it should be realized however that anesthesia depth cannot be judged from parameters like spontaneous movement or limb-withdrawal to paw pinch, but instead on changes in hemodynamics. a side aspect of murine airway access is the preparation of a ventilated (and perfused) isolated lung. this model has been described for the investigation of cytokines released from a hyperventilated mouse lung ( ) . the physiological lung variables obtained from this murine model (female balb/c, Ð g body weight) after min of npv (negative pressure ventilation) are a vt = µl, dynamic compliance (cdyn) of . ml/cmh o and an airway resistance of . cm h oás/ml. there are two basic modes of respiration, spontaneous ventilation and controlled mechanical ventilation (cmv), where work of breathing is taken over by the ventilator. between these there are a variety of mixed forms, like respiratory assistance, augmenting inspiration if shallow or labored (rsp , kent-scientiÞc¨, us) or supported spontaneous ventilation with continuous positive airway pressure (cpap), adopted for mice by brady and colleagues ( ) . however, these mixed modes are not largely established for mice yet, and will therefore not discussed in detail. although mechanical ventilation of mice has major advantages, it is confounded by difficulties: obviously, the small size of the animals makes airway access more challenging than in other laboratory animals. for example, in Ð g mice, the trachea has an accessible length of only Ð mm and a circumference of about . mm ( ) . appropriate endotracheal tubes have an outher diameter ranging from . mm for neonate mice ( ) to . mm for adult mice ( ) . the actual mechanical ventilation of the mouse is complicated by the technically demanding respiratory pattern of this species, e.g., the high rr, the low ti/tt ratio and the small vt, with the latter also demanding a minimized deadspace (vd) to prevent rebreathing. in commercially available rodent ventilators, the relatively large system-vd allows substantial gas compression, thereby minimizing the vt delivered to the mouse. ewart et al. ( ) reported that ml of added vd (compliancẽ . ml/cmh o) and a peak inspiratory pressure of cm h o reduce the delivered vt by about %. thus, mouse ventilators (see table ) should have a range of technical modalities to enable proper murine ventilation. since some authors did not report on the type of ventilator used (see table ) the list might be incomplete. the most obvious difference between spontaneous respiration and usual modes of mechanical ventilation (mv) are inverted pressure relations, with respect to ambient pressure, during the respiratory cycle: during spontaneous inspiration the expansion of the intrathoracic volume (mainly caused by contraction of the diaphragm and extension of the rib cage) generates a negative intrathoracic pressure and allows gas ßow into the lungs. during expiration mainly passive elastic forces of lung and rib cage generate a positive intrathoracic pressure, leading to exhalation of air. applying usual mv, the air is pushed during inspiration into the miceÕs lungs, leading to a positive intrathoracic pressure. during expiration intrathoracic pressure equilibrates with ambient pressure (intermittent positive pressure ventilation, ippv) or remains positive (continuous positive pressure ventilation, cppv). therefore it is important to notice that mean airway pressure during mechanical ventilation is higher than during spontaneous ventilation. these higher pressures contribute to side effects induced by mechanical ventilation. mechanical ventilators are classified according to their method of cycling between the inspiratory and expiratory phases. small animal ventilators are usually time-cycled: the ventilator switches between the respiratory phases after a certain time has elapsed, depending on the preset respiratory rate. although other methods of cycling might be favorable under certain experimental conditions (e.g., volume-cycled to prevent pulmonary volutrauma in murine open chest preparations), they are not established yet. however, although the method of cycling is classiÞed according to a single parameter (e.g., time), some mouse respirators allow a more sophisticated control of the ventilation by limiting relevant parameters: to prevent high inspiratory peak airway pressures, for example, most mouse ventilators allow the limitation of the ventilatory system pressure. most commercial mouse ventilators are time cycled and pressure limited. the primary goal of mechanical ventilation is delivery of an adequate respiratory minute-volume (ve) to the murine basic research in cardiology, vol. , no. ( ) © steinkopff verlag lung. to achieve this, the rr and vt have to be adjusted to supply the actual ventilatory requirements. rr in most mouse ventilators is the preset cycling parameter, but vt-lung may vary, depending on the compliance of lungs and tubing and whether respiration is pressure limited. a decrease in compliance of the respiratory system, for example in murine models of interstitial pulmonary diseases (ards, pneumonia), increases the airway pressure for a given vt ventilator . if ventilation is pressure limited, then vt lung will be considerably less than vt ventilator . in contrast, if higher peak pressures are accepted to maintain vt lung , the risk to traumatize the delicate murine lung will increase ( ) . to prevent the occurrence of these high pressures, inspiration time relative to expiration can be increased for a given vt (up to inverse ratio ventilation (irv), with inspiration longer than expiration). disadvantages of a higher inspiratory fraction during mechanical ventilation are possibly insufficient times for complete exhalation (Òair trappingÓ) and the prolonged phases of elevated intrathoracic pressure, which may cause a decreased cardiac preload and consequently lowered blood pressures ( ). a feature provided by some mouse-ventilators is the possible application of external positive end-expiratory airway pressure (peep): during expiration, airway pressure is not allowed to equilibrate with ambient pressure ( cmh o), but kept at a higher level (usually Ð cmh o). mechanical ventilation with peep prevents the endexpiratory collapse of small airways and possibly recruits atelectatic pulmonary areas for gas exchange by increase of functional residual capacity (frc). since pulmonary compliance increases (up to a certain degree) with increased frc, ventilation with peep supports pulmonary inßation. whether this holds true for mice has not been shown yet. additionally, ventilation with peep might mimic the physiologic end-expiratory tonus of inspiratory muscles and glottis of spontaneous ventilating mice ( ) . typical side effects, demonstrated in a murine model of peep, are discussed below. a list of ventilator settings is given in table . most experiments have mechanical ventilation set at rr = Ð ámin Ð , vt = . Ð . ml, ti/tt . Ð . . when these values are compared to values of spontaneous ventilating mice (table ) , it becomes obvious that lower rr and higher vt are commonly used to mechanically ventilate mice. a more rare feature provided by some mouse ventilators is the intermittent sigh-ventilation. here an inspiration with higher tidal volume (hyperinßation-or sigh-cycle) is administered after a certain number of respiratory cycles (for example every ventilatory cycles) or triggered manually (rsp- , kent-scientific¨corporation, litchfield, ct, usa or Ð / , harvard instruments¨, us). although not proven, this imitation of physiological sighing is thought to result in recruitment of atelectatic pulmonary areas, without the need for a continuous peep, circumventing constant elevation of airway pressures. intermittent positive pressure ventilation (ippv) and continuous positive pressure ventilation (cppv) are the two common modes in murine mechanical ventilation, as provided by commercial ventilators. however, for the ventilation of newborn mice ( . Ð . g bodyweight, vt Ð µl) the concept of the Òiron lungÓ, based on the principle of body surface negative pressure ventilation has been adopted ( ) to prolong survival time of nmda-receptor mutant mice ( ) , usually dying within h after birth. only a few studies using mechanical ventilation in mice report on additional ventilatory parameters, like inspiratory gas ßow or pressures in the ventilatory system. using a rr of ámin Ð , a vt of . ml and an inspiratory time of . s (resulting in a inspiratory fraction (ti/tt) of . , table data are also available on ventilation regimen for murine open-chest preparations: guo et al. ( ) compared respiratory rates of , and ámin Ð (harvard rodent ventilator, room air with oxygen ( ámin Ð ), vt = . ml with endotracheal tube loosely connected) in male icr mice ( Ð weeks old, mean body weight . g) with respect to the resulting arterial blood gases. adequate ventilation was obtained with a rr of ámin Ð , resulting in an arterial pao of mmhg ( and mmhg for ámin Ð and ámin Ð respectively), an arterial paco of mmhg ( and mmhg for ámin Ð and ámin Ð respectively) and an arterial ph of . ( . and . for ámin Ð and ámin Ð respectively). other regimens for the ventilation of open chest mice are listed in table . during controlled mechanical ventilation (cmv), the most frequent applied mode of artiÞcial respiration in mice, the work of breathing is taken over by the respirator. to facilitate this controlled mechanical ventilation (e.g., prevention of Òbreathing against the ventilatorÓ) it is usually performed under deep anesthesia. this ensures that relevant compensatory mechanisms (e.g., onset of spontaneous ventilation induced by hypercapnia or hypoxia) are impaired and underline the importance of monitoring mechanical ventilation. attempts to monitor mechanical mouse ventilation are complicated by the fact that even standard variables for ventilation are not established yet or show conßicting results (see table ). several possibilities are applicable to monitor adequacy of ventilation. a highly subjective way, requiring experience, is to observe the thorax-excursions with respect to rate, amplitude, symmetry and regularity as indicators of ventilatory rate, tidal volume, endotracheal tube position and attempt to spontaneous ventilatory effort. dalkara et al. ( ) suggest for a physiological mouse ventilation (mean paco = mmhg) keeping Òthe volume at a level at which thoracic movements Þrst become noticeably observedÓ. information on the oxygenation can be obtained from the ear and tailskin color, e.g., with cyanosis indicating poor oxygenation (desoxy-hemoglobin gá ml Ð ). these measures might serve as a Þrst orientation in the evaluation of the adequacy of mechanical ventilation. more objective and in-depth measures are gas ßows, airway pressures and partial pressures (see below). the measurement of respiratory gas ßow in mice has been a technical challenge, mainly because pneumotachographs attached to the endotracheal tube increase the ventilatory dead space (vd). recently pneumotachographs have been developed for mice that allow both direct airway gas ßow measurement and plethysmography (kent-scientiÞc¨small animal pneumotachs, trn , kent scientiÞc corporation). but even modern devices in this setting are suspected to increase dead space to a crucial extent, leading to partial rebreathing and consequently to hypercapnia and eventually hypoxia. the direct, non-invasive measurement of murine airway pressures is technically difficult; therefore, substitutes have been established to obtain estimates. in commercially available mouse ventilators, the airway pressures are measured inside the ventilator. the advantage of this construction is that it circumvents the need for an additional pressure transducing line, ideally originating from the endotracheal tube itself, to a pressure transducer. a major disadvantage however is that pressures measured in the ventilator need to be extrapolated to airway pressures within the endotracheal tube. this extrapolation is determined by the compliance of the respiratory gases and the tubing system (Òsignal dampingÓ). it is therefore desirable to measure airway pressures as close as possible to the endotracheal tube. with respect to this, we have developed an integrated endotracheal tube within a small aluminum frame ( x x mm, g), consisting of temperature controlled adapters for in-and expiratory tubing, an inline-capnography cell (vd = µl) and a liquid-filled airway-pressure transducer. although airway pressures are usually monitored to maintain safe values for mean-and peak-airway pressure, this measure can also serve to titrate damage in murine models of respirator-induced lung impairment, such as baro-or volutrauma ( ) , where tidal volumes (vt) have been adjusted to achieve traumatizing target airway pressures. fresh-gas inßow composition to the mechanical ventilator can be monitored with respect to the concentrations of the different respiratory gases, e.g., oxygen (o ), nitrogen (n ), nitrous oxide (n o) and volatile anesthetics. when rebreathing of exhaled air is excluded in the ventilatory circuit, analysis of fresh gas streaming to the respirator should accurately reßect the composition of inspiratory gases. this attempt is advantageous, compared to sample lines attached to the inspiratory tubing-limb of the system, because it circumvents the need for gas extraction from the inspiratory tubing with the consequence of decreased inspiratory airways-pressures and ventilatory tidal volumes. the actual measurement can be performed online with commercially available multi-gas analyzers (datex¨, hp¨). it has been argued that ventilation with room air may not be ideal in mice ( ) , based on observed high murine p values (po corresponding to % hemoglobin saturation) of mmhg ( ) or even mmhg ( ) . however, most studies have found a p ~ mmhg for the mouse, when measured under standard conditions (ph = . , pco = mmhg, ¡c) ( , , , , ) . a p of ~ mmhg is still rightshifted, when compared to humans (p = mmhg). nevertheless, although even with a high p ~ mmhg blood is virtually % saturated at room air ( ) , increased fio may be helpful in the mouse when uncertainty exists whether mechanical ventilation optimally expands the lungs. if volatile anesthetics (halothane, enßurane, isoßurane or more recent ones such as sevoßurane and desßurane) are used, additional considerations have to be taken into account: clinically used vaporizers for volatile anesthetics (draeger¨, series ) are usually precalibrated for gas ßows higher than that required for mice and will therefore give unreliable results when used with low gas ßows. although recalibration of the vaporizer for low air-ßow is the best option, a more common approach is to use an appropriate high gasßow (several hundred mlámin Ð ) with the abundant air released via a t-type adapter or valve. disadvantages of the latter approach are higher costs and the generation of relatively large amounts of waste gas giving environmental contamination and increased toxicity for exposed personnel. in contrast to maintenance of sufficient arterial oxygenation, which even under conditions of poor ventilatory support can be achieved by an increased fraction of inspiratory oxygen (fio ), adequate pulmonary elimination of co is the more challenging aspect of mechanical ventilation. although the arterial blood gas analysis is regarded as the gold standard for evaluation of proper ventilation, the drawbacks are that it is a discontinuous and invasive method requiring a substantial vol-ume of arterial blood ( . Ð . ml for a single measurement, Ð % of the total blood volume of a g mouse ( )), the latter aspect adding new sources of instability to the model. though often neglected, measurement of respiratory carbon dioxide concentration (capnography) is therefore recommended in mouse research. especially the determination of the end-tidal co (etco ), as a measure for alveolar co -concentration, is described as essential to maintain stable physiological parameters during mechanical mouse ventilation ( ) . however, capnography has rarely been performed in mice due to technical difficulties, like gas dilution artifacts occurring in side stream systems, which prevent accurate detection of endtidal co -peaks or-plateaus. therefore, to use the potential of capnography to its full extent, fast responding mainstreamcapnography is required. to this end we have developed an integrated mouse endotracheal tube with an implemented capnography-cell with minimal gas-mixing artifacts. since this cell is located in the endotracheal tube it allows real-time in-and expiratory mainstream breath-by-breath capnography. a typical capnography curve using this device is shown in fig. , showing several single breath capnography curves (inner section with high chart speed, rr ~ min Ð ). capnography is not only a measure for the adequacy of mechanical ventilation, but can also serve to detect changes in hemodynamics. an example for this is given in fig. : during steady-state anesthesia . ml blood was withdrawn from an arterial line (black arrow). the end-tidal carbon dioxide concentration drops immediately, likely due to a decrease in pulmonary perfusion (decreased cardiac output). resuscitation is performed by rapid infusion of . ml albumin solution (white arrow), which increased capnography values back to baseline, probably by restoring pulmonary perfusion. since time resolution is enhanced by our breath-by-breath capnography, the relation between expiratory co and speciÞc events can be described precisely. additionally, the capnography curves can be analyzed with respect to irregularity (e.g., due to intermittent spontaneous breathing) and shape alterations (e.g., airway obstruction). a few mouse capnographs are commercially available, mostly using side stream sampling (e.g., kent scientiÞc corporation sc- respiratory co monitor). the only main stream capnograph commercially available for mice to our knowledge is the sc- (kent-scientiÞc corporation) with an external co -probe to be placed in the ventilation tubing. however, we were unable to Þnd studies reporting on this device. a disadvantage of this device, as reported by the manufacturer, is that rr is limited to min Ð , which might not meet the demands of all experimental designs (table ) . the enhanced stability of the murine homeostasis is a major goal of mechanical ventilation, but typical side effects have to be considered, possibly adding new sources of instability to the murine model. these side effects can be classiÞed as regional (airways and lungs affected) or systemic (distant organs affected). a typical example for a ventilator-induced regional side effect is the mechanical hyperinßation of the murine lung, e.g., when large tidal volumes or high airway pressures are applied. this induces histological damage of the delicate murine pulmonary structures. this volutrauma has been shown in mice to trigger the onset of inßammation, including expression of cytokines ( ) . the systemic side effects of mechanical ventilation are (at least partly) due to a compromised hemodynamic situation. mechanical ventilation per se results in larger intrapulmonary pressures as compared to spontaneous ventilation, possibly inhibiting venous return to the heart. in addition, prolonged phases of positive airway pressures, e.g., when the inspiratory fraction (ti/tt) is increased or when external peep is applied, depresses the circulation by several mechanisms, also via an impaired venous return to the heart. as an example for a global hemodynamic variable, arterial blood pressure decreases immediately after application of higher levels of peep: fig. shows a typical blood pressure trace of a deeply anesthetized mouse (c bl/ , g bodyweight, anesthesia with ketamine ( mgákg Ð áh Ð ) and medetomidine ( µgákg Ð áh Ð ) indicating the immediate hypotensive reaction after application of cmh o peep. the extent of hypotension induced by mechanical ventilation is further related to the respiratory phase, as demonstrated in fig. , a simultaneous recording of capnography and arterial blood pressure in a c bl/ mouse (anesthetized with fentanyl ( . mgákgá Ð áh Ð ), ßuanison ( mgákgá Ð áh Ð ) and midazlam ( mgákgá Ð áh Ð ), a more hypotensive anesthesia than used in fig. , explaining the different baseline blood pressures). at end-expiration (white arrow), where intrathoracic pressure is minimal, arterial blood pressure reaches its peak value and vice versa (black arrow). a second example for side effects of the mechanical ventilation with peep distant to the lung is the impairment of the intestinal microcirculation. in anesthetized c bl/ -mice (terminal ileum exposed) we were able to visualize a marked reduction of perfused capillaries and a decrease in capillary blood flow velocity, using orthogonal polarized spectral (ops-) imaging ( ) . figure a/b shows a typical example for peep-induced microcirculatory impairment. both images show the same intestinal region, before ( a) and minutes after ( b) onset of cmh o external peep, with white arrowheads marking corresponding capillaries (black) in both images. in contrast to fig. a the capillaries in b are markedly less numerous and appear dashed, indicating erythrocyte aggregations formed at low capillary blood flow velocities. respiratory control of mice is a field of growing interest. although spontaneous ventilation is the more physiological mode of breathing, only mechanical ventilation maintains physiological values (blood gases, acid-base status) in situations with impaired spontaneous breathing, as occurring during anesthesia, surgery or constitutively in murine strains with impaired spontaneous ventilation. there are currently several commercially available small rodent ventilators feasible for use in mice. if mechanical ventilation is performed, then monitoring of this intervention is required, ideally by means of capnography. research still has to be performed on how the most physiological ventilation can be achieved in mice, which ventilatory patterns are appropriate and how ventilation related side effects can be limited. basic research in cardiology, vol. , no. 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respiration in curarized mice end-systolic pressure-dimension relationship of in situ mouse left ventricle impaired ventilatory responses to hypoxia and hypercapnia in mutant mice deÞcient in endothelin- blood oxygen affinity and alveolar ventilation in relation to body weight in mammals whisker-related neuronal patterns fail to develop in the trigeminal brainstem nuclei of nmdar knockout mice cardiovascular physiology in mice the ventilatory and metabolic response to hypercapnia in newborn mammalian species stable rightward shifts of the oxyhemoglobin dissociation curve induced by encapsulation of inositol hexaphosphate in red blood cells using electrophoration the development of a new mouse model of global ischemia lung tissue behavior in the mouse during constriction induced by methacholine and endothelin- ventilation, co -production, and co -exposure effects in conscious, restrained cf- mice leptin prevents respiratory depression in obesity determination of ventilatory volume in mice by whole body plethysmography cardiovascular reßexes in mice regulation of oxygen affinity in blood of fetal, newborn and adult mouse a computer-controlled research ventilator for small animals: design and evaluation reperfusion arrhythmias in the murine heart: their characteristics and alteration after ischemic preconditioning scaling: why is animal size so important oxygen dissociation curves of mammalian blood in relation to body size temporal change of plasma erythropoetin level in hypobaric hypoxic mice and the influence of an altered blood oxygen affinity near simultaneous hemoglobin saturation and oxygen tension maps in the mouse cortex during amphetamine stimulation mouse smooth muscle studies using gene-altered mouse models lung protein leakage in respiratory failure induced by a hybridoma making monoclonal antibody to the hydrophobic surfactant-associated polypeptide sp-b differential control of ventilation among inbred strains of mice leptin attenuates respiratory complications associated with the obese phenotype tissue gas tension in small wild mammals comparative quantitative morphology of the mammalian lung: diffusing area depressed heart rate variability and arterial baroreßex in conscious transgenic mice with overexpression of cardiac gs-alpha dynamic mechanisms determine functional residual capacity in mice, mus musculus hyperventilation induces release of cytokines from perfused mouse lung direct determination of plasma, cell, and organ blood volumes in normal and hypervolemic mice comparison of sensitization to scrude and purified house dust mite allergens key: cord- -ur sz s authors: mahabir, esther; bauer, beth; schmidt, jörg title: rodent and germplasm trafficking: risks of microbial contamination in a high-tech biomedical world date: - - journal: ilar j doi: . /ilar. . . sha: doc_id: cord_uid: ur sz s high-tech biomedical advances have led to increases both in the number of mice used for research and in exchanges of mice and/or their tissues between institutions. the latter are associated with the risk of dissemination of infectious agents. because of the lack of international standardization of health surveillance programs, health certificates for imported rodents may be informative but may not address the needs of the importing facility. preservation of mouse germ-plasm is achieved by cryopreservation of spermatozoa, embryos, or ovaries, and embryonic stem cells are used for the production of genetically engineered mice. after embryo transfer, recipients and rederived pups that test negative in microbiological screening for relevant microorganisms are released into full barrier holding areas. however, current research shows that embryos may also transmit microorganisms, especially viruses, to the recipient mice. in this article, we discuss regulations and practical issues in the shipping of live mice and mouse tissues, including spermatozoa, embryos, ovaries, and embryonic stem cells, and review work on microbial contamination of these biological materials. in addition, we present ways to reduce the risk of transmission of pathogens to mice under routine conditions. k nowledge of the prevalence, replication, and persistence of pathogens in a mouse facility aids both in assessments of the risk of transmission to other mice and mouse facilities and in the development of suitable management strategies to eliminate such risks. but there is a lack of current, comprehensive information on the prevalence of bacteria and parasites in mice in europe (for detailed information on us prevalence of these and murine viruses see carty ) . with respect to murine viruses, a summary of data from the past decade shows that the most prevalent in the united states (carty ; livingston and riley ) and europe (schoondermark-van de ven et al. ) are mouse hepatitis virus (mhv ), parvoviruses, mouse rotavirus, theiler's murine encephalomyelitis virus (tmev ), reovirus type (reo ), sendai virus, and mouse adenovirus (madv) (fl + k ). the report on european prevalence (schoondermark-van de ven et al. ) showed that the main viruses of concern there are mhv ( %), parvoviruses ( . %), mouse rotavirus ( . %), tmev ( . %), reo ( . %), pneumonia virus of mice (pvm, . %), sendai virus ( . %), and polyoma ( . %). the same report noted that viruses such as lymphocytic choriomeningitis virus (lcmv), mouse k virus, ectromelia virus, madv, and mouse thymic virus (mtv) have not been detected in europe in the last decade. these data are based on serological analysis of % of samples obtained between and from more than different institutions including universities, research centers, breeding companies, and industry in the netherlands ( %), france ( %), belgium ( %), and other european countries ( %, mainly germany and switzerland). since the discovery of murine norovirus (mnv ) in (karst et al. ) , its prevalence is reported to be . % from , mouse serum samples collected in the united states and canada in (hsu et al. ) . perdue and colleagues ( ) reported a prevalence ranging from % to % in sentinel mice from five us mouse facilities. in some german mouse facilities, mnv had a prevalence of % (nicklas et al. ) , . % (müller et al. ) , and % to %, depending on the type of mouse holding area (mahabir et al. b) . some viruses, such as mhv, mouse rotavirus, and sendai virus, are shed for only a short period of time, whereas ectromelia virus and pvm are shed for a moderate length of time, and other viruses such as lcmv, lactate dehydroge-nase-elevating virus (ldhv), murine cytomegalovirus (mcmv), minute virus of mice (mvm ), mouse parvovirus (mpv ), tmev, and mtv persist for longer periods of time (compton and riley ) . a comprehensive list of viruses and their target tissues is available in compton and riley ( ) . transportation of live mice and mouse cells and tissues from one institution to another is crucial to biomedical research in the international community. for the benefit of the mice, it is important to thoroughly plan such transportation before making shipping decisions. major proactive points of consideration include the observance of national legislation of all aspects of genetic technology and biosafety, international shipping regulations, packaging requirements, and consultations with and requirements of the exporting and importing institutions. us guidelines have recently been published for the transportation of laboratory animals (nrc ) , and european guidelines are summarized in appendix a of the european convention for the protection of vertebrate animals used for experimental and other scientific purposes (ets no. ; http://conventions.coe.int). the uk laboratory animal science association (lasa) also has published guidance on the transport of laboratory animals (swallow et al. ) . for shipments of live mice, specialized courier companies provide professional and comprehensive services. they are experienced in global logistics as well as country-and species-specific requirements and regulatory documents and concerns. in addition to importing/exporting country requirements, the international air transport association (iata) regulations should be followed when packing and preparing live animals for air transport (iata ) . packages for any kind of animal transport should be designed to prevent the animals' escape, exclude the entry of microorganisms, allow visual inspection of the animals without compromising their microbiological status, and allow external disinfection of the package on arrival at the receiving facility (lee et al. ). in addition, the following measures are indispensable to ensure minimal transit time and facilitate the animals' arrival in good health at their final destination: • a recent health report by a veterinarian of the exporting institution's animal colony including a ⁄ -year history of the colony's health status, • packaging in adequate transport boxes, with bedding, food, and water, • safety and stress reduction measures for the animals, and • early contact with the shipping corporation or carrier. for regional shipping, ground transport may pose the least stress as it entails minimal handling of the shipping container and a single environment during transportation. ground transportation should be carried out by licensed personnel in climate-controlled vehicles using the shortest routes. regional shipments by ground transportation normally involve one licensed carrier, whereas long distance or transcontinental shipping generally requires coordination of both ground transport and air freight and may be performed by multiple subcontractors, resulting in longer transit times and more handling, both of which may be more stressful for the mice (nrc ) . for the animals' comfort, it is particularly important to ensure suitable environmental conditions throughout the shipping. further to the stress involved in any shipment, longer journeys (particularly international or transcontinental journeys) also affect their diurnal rhythm. mice that experience shifts in light/dark cycles require up to weeks to normalize (weinert et al. ) and thus require a longer period of overall adaptation and restoration, ranging from to days to several weeks or even months, depending on the stress to which they were exposed during shipment (obernier and baldwin ) . the us department of agriculture (usda) guidelines for the importation of live laboratory animals set forth regulations on international transport of laboratory mice and their tissue to the united states (http://www.aphis.usda.gov/ vs/ncie/ilive-mam.html). other us regulatory agencies that may have oversight of research animal importation or shipment are the centers for disease control and prevention (cdc), the department of transportation (dot), and the us fish and wildlife service. in general, research mice are exempt from these regulations provided that they are not carrying infectious diseases and are from the genus mus musculus. imports to countries of the european union (eu) require the permission of the local government. to ensure us customs clearance, the following documentation should accompany the shipment: a pro forma invoice stating that the shipment contains "live laboratory mice" and listing the species (mus musculus), number, gender, age, type of package, and names and addresses of the exporting and importing institutions. the invoice should also include a statement that the animals do not meet the criteria for an endangered species nor pose a risk to human health. in addition, a health certificate is required with, if appropriate, a veterinarian's statement that "animals are healthy and have not been exposed to or inoculated with any livestock or poultry disease agents exotic to the united states" and that "the animals have not originated from a facility where work with exotic disease agents affecting livestock or poultry is conducted." some countries may have additional exportation documents that must be completed before the animals leave the country of origin, and commercial airlines also may ask for additional documents, which should be applied for and prepared well ahead of the time of shipment. for live mice and the cells and tissues derived from them some institutions require material transfer agreements (mtas) or, if the material is transferred on a collaborative basis, a short plan of the research project before shipment. exportation of live mice from the united states or the european union is not regulated but the shipment must conform to iata regulations and the destination country's regulations. because each country has its own regulations and requirements it is highly advisable to use a customs broker and/or a courier company knowledgeable in live animal shipping for international shipments of live mice. cryopreservation of embryos (glenister et al. ; shaw and nagakata ) and spermatozoa has become a routine mechanism to preserve mouse models and to transfer single mice or colonies without the welfare concerns that arise in the shipping of live animals. additional advantages to shipping cryopreserved germplasm (spermatozoa, oocytes, and resulting embryos) are the suitability of cryopreserved materials for storage and use when needed and for preliminary testing of sample aliquots to determine microbiological status before use. many institutions (including both of ours) have established transgenic animal cores that can assist in the recovery of cryopreserved materials. but if this expertise is not available at an investigator's institution there are established regional repositories in countries around the world that can assist in the recovery of cryopreserved materials; a number of these repositories have joined together to form the federation of international mouse resources (fimre; table ). many members are working together to assist the transfer of models across continents from one repository to another to facilitate their use by individual investigators (davisson ). these cooperative agreements will enable investigators to obtain recovered live mouse models from their local regional repository even if the model is cryopreserved and held in another country. cryopreserved oocytes, embryos, spermatozoa, and ovaries are typically shipped in a "dry shipper" in which the liquid nitrogen is absorbed in the shipper liner. these containers usually maintain an ultralow temperature for to days, depending on the model of shipper. in compliance with iata regulations, documentation of an inversion test should be included to demonstrate that no free liquid nitrogen is present in the shipper. cell lines, including murine embryonic stem (es ) cells, and tissues are usually shipped on dry ice, which is considered a hazardous material and has special packaging and labeling requirements (set forth in the iata regulations). alternatively, for short-term (less than hours) shipping, embryos can be transported in holding medium in cryopreservation straws at room temperature. likewise, murine es cells can be sent directly in the culture flask at room temperature. the importation paperwork for cryopreserved laboratory mouse tissues and cell lines is similar to that required for live animal importation to the united states (i.e., a pro forma invoice and declaration statements). in addition, any cells or tissues grown in vitro before shipment must be declared free of animal cell culture-derived products of livestock origin, particularly fetal or adult bovine serum. shipments of cell lines or tissues that contain a material of livestock origin such as fetal bovine serum require a usda importation permit. above all, proactive communication between the exporting institution, carrier, veterinary and legal authorities, regulatory agencies, and importing institution is of paramount importance for safe and successful deliveries. the oocyte and preimplantation embryo are surrounded by a zona pellucida (zp ), essentially a sulphated glycoprotein gel of the order of % to % (weight/volume) (green ) that protects the embryo from its environment (epifano and dean ; wasserman et al. ) . after removal of the surrounding cumulus cells, the zp is composed of a complex fibrous network interspersed with numerous pores that are largest at the outer surface and decrease in size centripetally. in viremic mice the reproductive tract may be susceptible to infectious pathogens either locally or systemically and viruses can spread from there to various tissues and organs. in mouse germplasm cells, pathogens may ( ) be present in the oocyte at fertilization and replicate in the embryo, fetus, or pups; ( ) be present in or attached to the spermatozoa and carried into the oocyte at fertilization; ( ) traverse, become embedded in, or adhere to the zp; or ( ) be present in the embryo after damage to the zp during handling or manipulation such as assisted reproductive technologies (arts). oocytes and embryos with an intact zp subjected to vigorous pipetting may rupture, and are further at risk when the zp is partially disrupted from arts such as intracytoplasmic sperm injection (icsi), subzonal injection (suzi), microinjection of oocytes, and blastocyst injection. there are typically four main experimental designs to determine the risk of pathogen transmission by in vivoderived embryos (hare ): • in vitro-in vitro: embryos from clean donors are exposed to the pathogen in vitro and assayed in vitro • in vitro-in vivo: embryos from clean donors are exposed to the pathogen in vitro and transferred to seronegative recipients, which are screened for the development of antibodies to the pathogen • in vivo-in vitro: embryos are collected from infected and/or seropositive donors and assayed in vitro • in vivo-in vivo: embryos are collected from infected and/or seropositive donors and transferred to seronegative recipients, which are screened for the development of antibodies to the pathogen. in efforts to gain more knowledge about the epidemiological potential of current and emerging arts, the main difficulty of working with an in vivo system is the selection of mice that are carrying the virus as they may be seropositive but not necessarily virus positive. many of the wellknown murine pathogens are shed for a short period of time and diagnosis of virus-positive mice depends heavily on environmental monitoring. in some cases, fecal samples are adequate for antemortem determination of the microbiological status (e.g., for parvoviruses, mnv, mhv, mouse rotavirus, reo , and tmev). in order to gain as much information as possible about the biological interaction of the germplasm with pathogens it is generally speedier to perform experimental work that more or less simulates in vivo conditions. however, experimental designs often include infections with high viral doses to demonstrate the "worst case" scenario. in the in vitro system, pathogens may be present either in the collecting media or in or on the gametes or embryos themselves. in vitro fertilization (ivf ) with infected spermatozoa and/or oocytes is an effective method to determine the risks posed by gametes or in vitro-derived embryos. the resulting embryos are analyzed in vitro by polymerase chain reaction (pcr) and/or are transferred to seronegative recipients that are monitored for seroconversion. it is also useful to screen their pups for the presence of the virus by pcr or serological analysis. a further step in determining the epidemiological potential of such germplasm is to monitor the collecting and washing fluids for the presence of the infectious agent, usually by pcr and virus isolation in cell culture. embryos are usually kept in short-term culture (e.g., for day) to prevent low levels of viruses from replicating to such an extent that they pose a real threat. ivf with fresh samples of mouse spermatozoa resulted in live offspring as early as (mukherjee and cohen ) , and cryopreservation of sperm with subsequent ivf and recovery of live mice started in the early s (yokoyama et al. ). advances in cryopreservation of spermatozoa, ivf, icsi, and embryo culture techniques make sperm cryopreservation a reliable means for preserving mouse strains and lines. few studies have examined the possibility of transmission of murine pathogens by spermatozoa. dutko and oldstone ( ) found that murine cytomegalovirus (mcmv) replicated in germ cells of the testes. baskar and colleagues ( ) confirmed this observation and found viral particles in spermatids; however, they did not detect any decreased fertility in these male mice and embryos developed normally to the blastocyst stage. tebourbi and colleagues ( ) examined whether mcmv microinjected directly into zygote-stage embryos (simulating icsi conditions) would result in infected live pups; they were able to infect the embryos, and the virus was present up until the blastocyst stage but disappeared in fetuses and pups. retroviruses have been demonstrated to replicate in epididymal sperm epithelium and associate with spermatozoa as they move through the epididymis, suggesting that venereal transmission is possible (kiessling et al. ) . recent studies have focused on murine pathogens that are prevalent in mouse colonies. raspa ( , ) examined testes and epididymis for the presence of helicobacter typhlonius and mhv, both of which were present transiently. in these two studies, spermatozoa collected from males with testes that tested positive for either h. typhlonius or mhv failed to produce positive live pups after ivf and embryo transfer (et ). peters and colleagues ( ) demonstrated that standard washing procedures in the ivf and embryo culture system are sufficient to eliminate mhv transmission when spermatozoa and oocytes are incubated with high levels of virus. mpv was recently found in spermatozoal samples (agca et al. ), but it remains to be determined if embryos generated using mpvcontaminated sperm result in infected offspring. in a recent study (mahabir et al. a) we demonstrated that mvmexposed in vivo-derived embryos washed ten times are still capable of transmitting the virus to recipient female mice. however, we also demonstrated that the ivf-et procedure with mvm-contaminated spermatozoa resulted in the production of virus-free seronegative pups (mahabir et al. ) . additional studies are needed to determine whether other prevalent viruses such as mnv, rotavirus, or tmev can be transmitted by spermatozoa. methods to remove pathogens from mouse spermatozoa have not been widely explored but one study did demonstrate that percoll separation of spermatozoa was not sufficient to remove mpv (agca et al. ). pathogens can be transmitted by et to recipients by contaminated personnel, instruments, or equipment, and transport or wash medium, as well as in or on the embryo itself, although an intact zp is usually regarded as a mechanism for preventing pathogen transmission during et. agents that infect embryos could be viruses, bacteria, fungi, mycoplasmas, or parasites, but because of their size viruses are the most likely pathogens to be transmitted during et. oocytes are typically collected and immediately used in icsi or ivf with cryopreserved sperm, although cryopreservation of oocytes is possible and becoming more common (endoh et al. ) . females are superovulated and the cumulus oocyte complexes (cocs) can either be used as intact clutches for ivf or treated with hyaluronidase to remove the cumulus cells for icsi. wild-type oocytes are usually collected from female donors held in known pathogen-free colonies and are coincubated with spermatozoa containing the mutation or gene of interest. however, in rare instances, oocytes or ovarian tissue (gunasena et al. ; hani et al. ) may be used as the primary means to recover mutant or transgenic mouse lines and the risk posed by pathogens may be higher in these cases. ovarian tissue cryopreservation is particularly useful for mouse models in which male infertility occurs (such as the x-autosome translocation mouse lines) or for rescue of lines in which only female animals are available (disteche et al. ; takahashi et al. ) . ovarian tissue transplantation carries an increased risk compared to gametes and embryos because it is a complex organ with multiple cell types, and tissue from viremic donors is likely to transfer infectious organisms. retroviral contamination of donor tissue by a recipient female has occurred with transmission to recovered offspring (lock et al. ) , demonstrating that genetic alteration via retroviruses can occur in offspring as a consequence of either the donor or recipient female. ovarian tissue from mice naturally infected with mhv has been shown to transmit mhv to the recipient females and offspring (scavizzi and raspa ) . in contrast, h. typhlonius-infected ovarian tissue transplantation did not result in infection of the recipient female or offspring (scavizzi and raspa ) . researchers have found mpv in both ovarian tissue and oocytes (agca et al. ), but it is unknown whether transplantation of infected ovarian tissue results in infection of recipient females and their offspring. very small viruses belonging to the picornaviridae family-for example, mengo virus, which is to nm (gwatkin (gwatkin , (gwatkin , , and the coxsackie b- virus, which is nm (heggie and gaddis )-have been shown to traverse the zp of murine embryos. investigators have documented lcmv in mouse oocytes and embryos, providing evidence of transmission via the oocyte (mims ) , and sendai virus ( to nm) in the murine zp (lavilla-apelo et al. , tuffrey et al. ) . one study reported infection with polyoma in the trophectoderm but not in the inner cell mass of murine embryos (abramczuck et al. ). we include es cells in this overview as they are fundamental to the production of genetically engineered mice. during blastocyst injection, besides feeder cells and the blastocysts themselves, the es cells may harbor infectious pathogens. the exchange of es cells between laboratories worldwide may increase the risk of transmitting mouse infectious agents as es cells are often not screened for viruses, and viral contamination and infection are not readily detectable by cell morphology. although a survey of es cell lines did not show the presence of murine infectious agents (nicklas and weiss ) , two studies showed that murine es cells infected with mhv- (kyuwa ; okumura et al. ) and mhv-a (kyuwa ) grew in vitro without showing either cytopathic effects or signs of differentiation okumura et al. ) . in addition to mhv, parvovirus and mycoplasma contamination has been found in es cells submitted to diagnostic laboratories for pcr testing (bb personal communication with lela riley, university of kansas, august ). the risk of es cell contamination by feeder cells and embryos can be reduced by obtaining them from mice that are free of relevant pathogens. washing protocols for embryos remove the viruses from the germplasm to a level below an infectious and/or immunogenic dose. although there are well-established washing protocols for the embryos of some domestic animals such as cattle and pigs (stringfellow and seidel ), none exist for murine embryos. some major contributing factors to reducing the risk of pathogen transmission during washing of the embryos include working under sterile conditions, repeated testing and use of pathogen-free reagents, use of a new pipette between washing drops, dilution of the washing fluids in a : range, and removal of zp-less or damaged embryos before transfer to suitable recipient mice. because of the zp's porous nature and depending on the virus size, even after washing there may be a risk of viruses nesting in the zp micropores. for example, reports show that trysin treatment of embryos has not been successful in removing sendai virus even after washings (lavilla-apelo et al. ) . experimental infection with mvm and washing of embryos times with medium revealed transmission of the virus by in vivo-derived embryos (mahabir et al. a) but not by embryos produced by ivf of oocytes with mvm-coincubated spermatozoa (mahabir et al. ) . this was an unexpected result that may be due to differences in the characteristics of the embryos themselves. with respect to in vitro-derived embryos, the cumulus cells surrounding the oocytes may have adsorbed some of the virus thereby reducing the quantity left for entrapment in the micropores. furthermore, the cumulus cells block entry of the virus as micropores are present only after removal of these cells. removal of the cumulus cells and washing of oocytes have been shown to eliminate mpv contamination in mouse oocytes (agca et al. ) , and this approach should be sufficient to remove the majority of viral contaminants when they are not present in the oocyte itself. embryo transfer recipients in rederivation programs should be held in individually ventilated cages (ivcs ) until testing shows that they are free of all unwanted microorganisms, including those listed in appendix of the federation of laboratory animal science associations (felasa) recommendations (nicklas et al. ) . there should be a minimum of weeks between the et and microbiological examination of the recipients, coinciding with weaning of the offspring at or weeks of age (wild-type littermate pups should not undergo health monitoring until they are at least weeks old). some mouse facilities screen recipients before releasing pups into full barrier areas and, for subsequent screening of the pups themselves, use sentinel mice or random samples from the colony. other mouse facilities screen the recipient mother and at least one pup from each litter (usually a wild-type pup) before releasing rederived pups into full barrier areas. if wild-type pups are not available for screening, it may be preferable to use cohoused wild-type sentinels placed at the time of weaning rather than relying on test results of genetically altered mice whose immune status is usually unknown. a number of reports have shown that in vitro-derived -cell embryos (peters et al. ) and in vivo-derived -cell (van keuren and saunders ) and -cell embryos (carthew et al. (carthew et al. , mahabir et al. a; reetz et al. ; suzuki et al. ) did not pose a risk of transferring mhv during embryo transfer. in addition, embryos from mice from holding areas that were positive for madv, mouse rotavirus, mpv, or tmev led to rederivation of the mouse lines (van keuren and saunders ) . the efficacy of embryo transfer for rederiving mice is reported to be high. due to short periods of virus shedding, donor mice may be seropositive but may not be virus carriers, thus leading to the production of virus-free seronegative pups. laboratories that deal with frequent imports of mice and biological materials should establish and implement effective measures to reduce the risk of transmitting infectious agents to staff or existing animal colonies at the importing institution. even collection of germplasm under sterile conditions does not prevent dissemination of infectious agents from colonies where they are prevalent. although health certificates that precede or accompany an import colony provide information on the animals' health status and a -to ⁄ -year history of health data, because of the interval between collection and analysis of the samples and preparation of the health report, both mice and biological materials should be considered carriers of microorganisms unless analyses prove the absence of contaminants. imported mice should therefore be kept in quarantine pending reevaluation of their health status and biological materials should be carefully screened before use. to enable facility management to obtain sound information on imported animals' current health status at any given time, each facility should design and implement health monitoring programs based on its needs. these programs use randomly sampled mice, contact sentinels, or sentinels exposed to soiled bedding. some protocols also include monitoring of exhaust air for pathogens not transferred by soiled bedding (brielmeier et al. ; compton et al. ) . in recent years, there has been an increase in the use of ivc rack systems in laboratory rodent facilities. recent data (brielmeier et al. ) show that ivcs provide complete biocontainment when infected and noninfected mice are kept in separate cages in the same ivc rack provided that cage bedding is changed in class ii laminar flow hoods or cage changing cabinets (cccs) and appropriate standard operating procedures (sops) are strictly observed. in a typical ivc rack, each cage receives high-efficiency particulate air (hepa)-filtered air. mice are kept under positive pressure to protect them from airborne infectious or other noxious particulate agents in the environment (clough et al. ; cunliffe-beamer and les ; lipman et al. ; lipman ) . similarly, the exhaust air from the cages is hepa-filtered before being returned to the room environment or to the heating, ventilation, and air conditioning (hvac) system. maintaining mice under negative pressure prevents dissemination of pathogens into the environment and minimizes (gordon et al. ; lipman ) or prevents transfer of infectious agents from cage to cage in an ivc rack or room, depending on the ivc rack model. for biocontainment purposes, ivcs are optimal for holding imported mouse colonies under quarantine pending the completion of adequate microbiological analyses. irrespective of the health report from the exporting institution, some facilities conduct routine prophylactic treatments of all imported and quarantined mice for pinworm and ectoparasites. others refuse import applications for mice infected with parasites and authorize such imports only if the mice have been successfully treated at the exporting institution before shipment. once the health status of an imported mouse colony is found compatible with that of the importing institution mice may be transferred from the quarantine area to an experimental unit and released for investigators' use. although ivcs meet a number of requirements for breeding and holding mice under specific pathogen-free (spf) conditions in experimental units, filter-top cages are an economical and suitable alternative. for core breeding units and long-term holding of laboratory mice under spf conditions, full barrier areas with a wet entry system or air shower and the use of ivcs have become an international standard. in general, these units do not allow access to investigators and mice are imported into the barrier only by et. trafficking of biological materials, including germplasm and es cells, should meet the same hygienic standards as those required for importing laboratory mice. care should be taken to ensure that collection and/or processing of cells and tissues of the germplasm are performed under sterile conditions. to determine microbiological status-for example, if investigators suspect the presence of a particular agent or wish to screen for a limited number of agents-it may be useful to test aliquots of biological materials, collection media, or washing drops by molecular biological analysis. well-established sensitive pcr techniques are available for determining the microbiological status of murine biological materials in-house or by commercial laboratories. in addition, the mouse antibody production (map) test blank et al. ; bootz et al. ; livingston et al. ; mahabir et al. ) is also performed as antibodies to several viruses are detectable by standard serological analyses. for such tests, mice should be free of all felasa-listed microorganisms (as well as mnv) and held under conditions that prevent dissemination of infectious agents. taken together, health monitoring, evaluation of the risk of pathogen transmission by mouse and germplasm trafficking, and appropriate managerial strategies are fundamental components of a facility's quality assurance program. last but not least, the establishment and implementation of suitable quality assurance programs are based on the expertise of the facility's supervisory staff, who must have sufficient knowledge of and experience in laboratory animal science (nevalainen et al. ) . infection of mouse preimplantation embryos with simian virus and polyoma virus detection of mouse parvovirus in mus musculus gametes, embryos, and ovarian tissues by polymerase chain reaction assay murine cytomegalovirus infection of mouse testes comparison of the mouse antibody production (map) assay and polymerase chain reaction (pcr) assays for the detection of viral contaminants virus pcr assay panels: an alternative to the mouse antibody production test comparison of the sensitivity of in vivo antibody production tests with in vitro pcr-based methods to detect infectious contamination of biological materials microbiological monitoring of laboratory mice and biocontainment in individually ventilated cages: a field study elimination of sendai (parainfluenza type ) virus infection from mice by embryo transfer pathogenicity of mouse hepatitis virus for preimplantation mouse embryos opportunistic infections of mice and rats: jacoby and lindsey revisited a positive, individually ventilated caging system: a local barrier system to protect both animals and personnel detection of infectious agents in laboratory rodents: traditional and molecular techniques efficacy of three microbiological monitoring methods in a ventilated cage rack effectiveness of pressurized individually ventilated (piv) cages in reducing transmission of pneumonia virus of mice (pvm) (abstr) federation of international mouse resources: global networking of resource centers late replication in an xautosome translocation in the mouse: correlation with genetic inactivation and evidence for selective effects during embryogenesis murine cytomegalovirus infects spermatogenic cells the developmental ability of vitrified oocytes from different mouse strains assessed by parthenogenetic activation and intracytoplasmic sperm injection biology and structure of the zona pellucida: a target for immunocontraception genome cryopreservation: a valuable contribution to mammalian genetic research elimination of mouse allergens in the working environment: assessment of individually ventilated cage systems and ventilated cabinets in the containment of mouse allergens three-dimensional structure of the zona pellucida live births after autologous transplant of cryopreserved mouse ovaries effect of viruses on early mammalian development. i. action of mengo encephalitis virus on mouse ova cultivated in vitro effect of viruses on early mammalian development. iii. further studies concerning the interaction of mengo encephalitis virus with mouse ova passage of mengovirus through the zona pellucida of the mouse morula fertility of mice receiving vitrified adult mouse ovaries design and analysis of research on infectious disease transmission by embryos effects of viral exposure of the two-cell mouse embryo on cleavage and blastocyst formation in vitro development of a microsphere-based serologic multiplexed fluorescent immunoassay and a reverse transcriptase pcr assay to detect murine norovirus infection in mice live animal regulations stat -dependent innate immunity to a norwalk-like virus epididymis is a principal site of retrovirus expression in the mouse replication of murine coronaviruses in mouse embryonic stem cell lines in vitro characterization of embryonic stem-like cell lines derived from embryoid bodies the effectiveness of trypsin treatment to remove sendai virus adhering to the zona pellucida of mouse preimplantation embryos the effect of experimental infection of mouse preimplantation embryos with paramyxovirus sendai efficacy of disinfectants against mvm-and mnv-contaminated surfaces isolator rodent caging systems (state of the art): a critical view evaluation of isolator caging systems for protection of mice against challenge with mouse hepatitis virus diagnostic testing of mouse and rat colonies for infectious agents polymerase chain reaction (pcr) testing of biological materials for rodent pathogens as an alternative to the mouse antibody production (map) test. (abstract) th felasa symposium studies of the mechanism of spontaneous germline ecotropic provirus acquisition in mice mouse antibody production test: can we do without it? transmission of mouse minute virus (mvm) but not mouse hepatitis virus (mhv) following embryo transfer with experimentally exposed in vivo-derived embryos prevalence of mouse norovirus (mnv) in a large breeding and experimental mouse facility. (abstract) th felasa symposium production of virus-free seronegative pups from murine embryos arising from in vitro fertilization with mice minute virus-exposed spermatozoa immunofluorescence study of the carrier state and mechanism of vertical transmission in lymphocytic choriomeningitis virus infection in mice development of normal mice by in vitro fertilization genetic diversity and recombination of murine noroviruses in immunocompromised mice felasa guidelines for education of specialists in laboratory animal science (category d): report of the federation of laboratory animal science association's working group on education of specialists (category d) accepted by the felasa board of management survey of embryonic stem cells for murine infective agents recommendations for the health monitoring of rodent and rabbit colonies in breeding and experimental units mouse norovirus (mnv): erste untersuchungsergebnisse (abstract) . gv-solas annual meeting guidelines for the humane transportation of research animals establishing an appropriate period of acclimatization following transportation of laboratory animals maintenance of pluripotency in mouse embryonic stem cells persistently infected with murine coronavirus naturally occurring murine norovirus infection in a large research institution risk assessment of mouse hepatitis virus infection via in vitro fertilization and embryo transfer by the use of zona-intact and laser-microdissected oocytes rederivation of inbred strains of mice by means of embryo transfer tissue distribution and duration of mouse hepatitis virus in naturally infected immunocompetent icr (cd- ) and immunodeficient athymic nude-nu mouse strains used for ovarian transplantation and in vitro fertilization helicobacter typhlonius was detected in the sex organs of three mouse strains but did not transmit vertically prevalence of naturally occurring viral infections, mycoplasma pulmonis and clostridium piliforme in laboratory rodents in western europe screened from cryopreservation of transgenic mouse lines manual of the international embryo transfer society rederivation of mice by means of in vitro fertilization and embryo transfer guidance on the transport of laboratory animals rescue of a transgenic mouse line by transplantation of a frozen-thawed ovary obtained postmortem failure to infect embryos after virus injection in mouse zygotes sendai (parainfluenza ) infection of mouse eggs rederivation of transgenic and genetargeted mice by embryo transfer constructing the mammalian egg zona pellucida: some new pieces of an old puzzle resynchronization of the circadian corticosterone rhythm after a light/dark shift in juvenile and adult mice production of normal young following transfer of mouse embryos obtained by in vitro fertilization using cryopreserved spermatozoa key: cord- -bqlf fe authors: rydell-törmänen, kristina; johnson, jill r. title: the applicability of mouse models to the study of human disease date: - - journal: mouse cell culture doi: . / - - - - _ sha: doc_id: cord_uid: bqlf fe the laboratory mouse mus musculus has long been used as a model organism to test hypotheses and treatments related to understanding the mechanisms of disease in humans; however, for these experiments to be relevant, it is important to know the complex ways in which mice are similar to humans and, crucially, the ways in which they differ. in this chapter, an in-depth analysis of these similarities and differences is provided to allow researchers to use mouse models of human disease and primary cells derived from these animal models under the most appropriate and meaningful conditions. although there are considerable differences between mice and humans, particularly regarding genetics, physiology, and immunology, a more thorough understanding of these differences and their effects on the function of the whole organism will provide deeper insights into relevant disease mechanisms and potential drug targets for further clinical investigation. using specific examples of mouse models of human lung disease, i.e., asthma, chronic obstructive pulmonary disease, and pulmonary fibrosis, this chapter explores the most salient features of mouse models of human disease and provides a full assessment of the advantages and limitations of these models, focusing on the relevance of disease induction and their ability to replicate critical features of human disease pathophysiology and response to treatment. the chapter concludes with a discussion on the future of using mice in medical research with regard to ethical and technological considerations. although the genetic lineages of mice and humans diverged around million years ago, these two species have evolved to live together, particularly since the development of agriculture. for millennia, mice (mus musculus) were considered to be pests due to their propensity to ravenously consume stored foodstuff (mush in ancient sanskrit means "to steal" [ ] ) and their ability to adapt to a wide range of environmental conditions. since the s, domesticated mice have been bred and kept as companion animals, and in victorian england, "fancy" mice were prized for their variations in coat color and comportment; these mouse strains were the forerunners to the strains used in the laboratory today. robert hooke performed the first recorded inquiry-driven experiments on mice in , when he investigated the effects of changes in air pressure on respiratory function [ ] . more recently, with data from the human genome project and sequencing of the mus musculus genome showing remarkable genetic homology between these species, as well as the advent of biotechnology and the development of myriad knockout and transgenic mouse strains, it is clear why the mouse has become the most ubiquitous model organism used to study human disease. in addition, their small size, rapid breeding, and ease of handling are all important advantages to scientists for practical and financial reasons. however, keeping in mind that mice are fellow vertebrates and mammals, there are ethical issues inherent to using these animals in medical research. this chapter will provide an overview of the important similarities and differences between mus musculus and homo sapiens and their relevance to the use of the mouse as a model organism and provide specific examples of the quality of mouse models used to investigate the mechanisms, pathology, and treatment of human lung diseases. we will then conclude with an assessment of the future of mice in medical research considering ethical and technological advances. as a model organism used to test hypotheses and treatments related to human disease, it is important to understand the complex ways in which mice are similar to humans, and crucially, the ways in which they differ. a clear understanding of these aspects will allow researchers to use mouse models of human disease and primary cells derived from mice under the most appropriate and meaningful conditions. in , the encyclopedia of dna elements (encode) program published a comparative analysis of the genomes of homo sapiens and mus musculus [ ] , as well as an in-depth analysis of the differences in the regulatory landscape of the genomes of these species [ ] . encode, a follow-up to the human genome project, was implemented by the national human genome research institute (nhgri) at the national institutes of health in order to develop a comprehensive catalog of protein-encoding and nonproteincoding genes and the regulatory elements that control gene expression in a number of species. this was achieved using a number of genomic approaches (e.g., rna-seq, dnase-seq, and chip-seq) to assess gene expression in over mouse cell types and tissues; the data were then compared with the human genome. overall, these studies showed that although gene expression is fairly similar between mice and humans, considerable differences were observed in the regulatory networks controlling the activity of the immune system, metabolic functions, and responses to stress, all of which have important implications when using mice to model human disease. in essence, mice and humans demonstrate genetic similarity with regulatory divergence. specifically, there is a high degree of similarity in transcription factor networks but a great deal of divergence in the cis-regulatory elements that control gene transcription in the mouse and human genomes. moreover, the chromatin landscape in cell types of similar lineages in mouse and human is both developmentally stable and evolutionarily conserved [ ] . of particular relevance regarding modeling human diseases involving the immune system, in its assessment of transcription factor networks, the mouse encode consortium revealed potentially important differences in the activity of ets in the mouse and human genome. although conserved between the two species, divergence in ets regulation may be responsible for discrepancies in the function of the immune system in mouse and human [ ] . certainly, the biological consequences of these differences in gene expression and regulation between human and mouse invite further investigation. the anatomical and physiological differences between model organisms and humans can have profound impacts on interpreting experimental results. virtually every biological process under investigation in experimental studies involves at least one anatomical structure. to aid in interpretation, many anatomy compendia have been developed for model organisms; the most useful organize anatomical entities into hierarchies representing the structure of the human body, e.g., the foundational model of anatomy developed by the structural informatics group at the university of washington [ ] . although an analysis of the myriad differences between mouse and human anatomy is beyond the scope of this chapter, a few of the most critical issues that have an impact on the interpretation of data from mouse experiments should be mentioned. the most obvious difference between mice and humans is size; the human body is about times larger than that of the mouse. size influences many aspects of biology, particularly the metabolic rate, which is correlated to body size in placental mammals through the relationship bmr ¼  mass ( . ), where bmr is the basal metabolic rate (in kcal/day). thus, the mouse bmr is roughly seven times faster than that of an average-sized human [ ] . this higher bmr has effects on thermoregulation, nutrient demand, and nutrient supply. as such, mice have greater amounts of metabolically active tissues (e.g., liver and kidney) and more extensive deposits of brown fat [ ] . furthermore, mice more readily produce reactive oxygen species than do humans, which is an important consideration when modeling human diseases involving the induction of oxidative stress (i.e., aging, inflammation, and neurodegeneration) [ ] . the lung provides an excellent example of the similarities and differences between human and mouse anatomy. similar to the human organ, the mouse lung is subdivided into lobes of lung parenchyma containing a branching bronchial tree and is vascularized by the pulmonary circulation originating from the right ventricle. there are a number of subtle variations in this general structure between species, i.e., the number of lobes on the right and left, the branching pattern, and the distribution of cartilage rings around the large airways, but the most important differences between the mouse and human lung are related to the organism's size (airway diameter and alveolar size are naturally much smaller in the mouse) and respiratory rate. moreover, there are important differences in the blood supply of the large airways in humans versus mice [ ] . specifically, the bronchial circulation (a branch of the high-pressure systemic circulation that arises from the aorta and intercostal arteries) supplies a miniscule proportion of the pulmonary tissue in mice (the trachea and bronchi) compared to humans; the majority of the lung parenchyma is supplied by the low-pressure, high-flow pulmonary circulation. in the mouse, these systemic blood vessels do not penetrate into the intraparenchymal airways, as they do in larger species [ ] . this difference, although subtle, has important ramifications regarding the vascular supply of lung tumors which, in humans, is primarily derived from the systemic circulation [ ] . these differences may also have profound consequences when modeling human diseases involving the lung vasculature. the adaptive immune system evolved in jawed fish about million years ago, well before the evolution of mammals and the divergence of mouse and human ancestral species [ ] . many features of the adaptive immune system, including antigen recognition, clonal selection, antibody production, and immunological tolerance, have been maintained since they first arose in early vertebrates. however, the finer details of the mouse and human immune systems differ considerably, which is not surprising since these species diverged million years ago [ ] . while some have claimed that these differences mean that research into immunological phenomena in mice is not transferable to humans, as long as these differences are understood and acknowledged, the study of mouse immune responses can continue to be relevant. research on mice has been vital to the discovery of key features of both innate and adaptive immune responses; for example, the first descriptions of the major histocompatibility complex, the t cell receptor, and antibody synthesis were derived from experiments performed on mice [ ] . the general structure of the immune system is similar in mice and humans, with similar mediators and cell types involved in rapid, innate immune responses (complement, macrophages, neutrophils, and natural killer cells) as well as adaptive immune responses informed by antigen-presenting dendritic cells and executed by b and t cells. however, due to the anatomical and physiological differences between these species as described above, divergence in key features of the immune system, such as the maintenance of memory t cells (related to the life span of the organism) and the commensal microbiota (related to the lifestyle of the organism), has arisen [ ] . similar to what has been discovered regarding the genetics of mice and humans, i.e., broad similarities in structure but considerable differences in regulation, there are a number of known discrepancies in the regulation of innate and adaptive immunity in mouse models of human disease mice versus humans, including the balance of leukocyte subsets, t cell activation and costimulation, antibody subtypes and cellular responses to antibody, th /th differentiation, and responses to pathogens (described in detail in table ). in addition to these differences in immune cell functions, the expression of specific genes involved in immune responses also differs, particularly those for toll-like receptors, defensins, nk inhibitory receptors, thy- , and many components of chemokine and cytokine signaling; additionally, differences between mouse strains are known to exist for many of these mediators [ ] . another important consideration when using mice to perform immunological research (with a view to translating these findings to human medicine) is the availability of hundreds of strains of genetically modified mice that have enabled exquisitely detailed studies on immune cell function, regulation, and trafficking. many of these strains involve the expression of inducible cre or cas that allow for targeted knockdown or overexpression of key immune function-related genes in specific cell types at specific moments in time. however, it is important to note that drift between mouse colonies has long been known to occur. in fact, a recent report described the fortuitous discovery of a point mutation in the natural cytotoxicity receptor (ncr ) gene in the c /bl cd . mouse strain, resulting in absent ncr expression. this mutation was found to have profound effects on the response of mice to viral infection, i.e., the mice were resistant to cytomegalovirus infection but more susceptible to influenza virus [ ] . this cautionary tale highlights the importance of understanding the genetic evolution of laboratory strains of mice, the effect of these genetic and immunological changes on mouse biology, and the impact on the translation of these results to human medicine. in addition to the differences between mouse and human genetics, physiology, and immunology highlighted above, several factors must also be taken into account when performing in vitro assays using isolated mouse cells and applying these findings to our understanding of human disease. particularly with regard to stem cell research, it should be noted that the telomeres of mouse cells are five-to tenfold longer than human telomeres, resulting in greater replicative capacity [ ] . there are also important differences in the regulation of pluripotency and stem cell differentiation pathways in humans and mice [ ] . moreover, there are considerable species differences in the longevity of cultured cells; for example, mouse fibroblasts are capable of spontaneous immortalization in vitro, whereas human fibroblasts become senescent and ultimately fail to thrive in culture [ ] . in summary, although there are considerable differences between mice and humans, constant improvement in the analytical techniques used to delineate these differences and their effects on whole organism and cell function have provided vital information and contributed to our understanding of both murine and human biology. experimentation employing mouse models of human disease will continue to provide key insights into relevant disease mechanisms and potential drug targets for further clinical investigation. however, several important considerations must be taken into account when selecting a mouse model of human disease, as described in the following section, using mouse models of human lung disease to illustrate this point. the two most salient features of a mouse model of human disease are the accuracy of its etiology (it employs a physiologically relevant method of disease induction) and its presentation (its ability to recapitulate the features of human disease). the relevance of any given mouse model can be judged on the basis of these two criteria, and there is considerable variation within mouse models of human disease in this regard. as a full assessment of the advantages and limitations of all currently available mouse models of human disease would be prohibitively long and complex, here we have elected to assess the accuracy of currently available models of human lung diseases, i.e., asthma, chronic obstructive pulmonary disease, and pulmonary fibrosis, focusing on the relevance of disease induction in these models and their ability to replicate critical features of human disease pathophysiology and response to treatment. the first and foremost notion when modeling human disease in mice is to acknowledge the species differences, which are significant [ ] . as described above, genetics, anatomy, physiology, and immunology differ between mice and humans, but despite these differences, mouse models of human disease are useful and necessary, as long as data interpretation is performed appropriately. an elegant example of differences between mice and humans that must be considered when designing a mouse model of human inflammatory lung disease is the key effector cell type in human asthma, i.e., mast cells. these leukocytes differ in granule composition as well as localization in the mouse and human airways [ ] . mice mostly lack mast cells in the peripheral lung [ ] , whereas humans have numerous mast cells of multiple subpopulations in the alveolar parenchyma [ ] . another example is anatomy: in contrast to humans, mice lack an extensive pulmonary circulation, which may have significant effects on leukocyte adhesion and migration, and subsequently inflammation [ ] . still, as long as these differences are taken into consideration, mouse models can be powerful tools in the discovery and exploitation of new targets for the treatment of human disease. the world health organization (who) defines asthma as a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which may vary in severity and frequency from person to person. the disease is characterized by airway hyperresponsiveness, airway smooth muscle thickening, increased mucus secretion and collagen deposition, as well as prominent inflammation affecting both large and small airways [ ] . nowadays, it is recognized that asthma is not a single homogenous disease but rather several different phenotypes united by similar clinical symptoms [ , ] . only a few animal species develop asthma naturally, including cats and horses [ , ] , whereas mice do not [ ] . however, mice can be manipulated to develop a type of allergic airway inflammation, which is similar in many ways to the human disease, in response to different aeroallergens [ ] . importantly, these models are capable of recapitulating only the allergic type of human asthma and have less relevance for other types of asthma (i.e., endotypes induced by medication, obesity, and air pollution). as with many human diseases, asthma has a complex and multifaceted etiology, where environmental factors, genetic susceptibility, and microbial colonization all contribute; thus, it is important to take strain differences into consideration. generations of inbreeding have created mouse strains that differ not only in coat color and disposition but also from a physiological, immunological, and genetic perspective. different strains may be more susceptible to allergic airway inflammation or pulmonary fibrosis, whereas others are more or less resistant. choosing the right strain to model a specific disease or pathologic event is thus essential. the most widely used strains for models of allergic airway inflammation are balb/c and c bl/ . these strains differ regarding the type of immune response mounted to an inhaled allergen: c bl/ is generally considered a t h -skewed strain, whereas balb/c is regarded as a t h -skewed strain [ ] . due to their strong t h response, and subsequent development of robust asthmatic responses, balb/c has been commonly used to model asthma [ ] . however, most humans do not express such a strongly t h -skewed immune system, suggesting this strain may not be the best model of human disease; instead, c bl/ may be more suitable as immune responses in this strain are more similar to those of atopic human subjects [ ] . furthermore, as c bl/ is the most commonly used strain for the development of genetically manipulated mice, using these mice allows for very specific investigations into disease pathology; thus, this strain is increasingly used in models of human lung disease. besides the genetic differences in the mouse strains used in these models, the etiology (the method of disease induction) of commonly used models of asthma is highly variable. in humans with allergic asthma, environmental allergen exposure occurs at the airway mucosa; the immune response is coordinated in the bronchopulmonary lymph nodes, and the t cells, macrophages, and eosinophils recruited as part of this response travel to the lung where they mediate the cardinal features of asthma: airway inflammation, structural remodeling of the airway wall, and airway hyperreactivity [ ] . ideally, these features should be found in a physiologically relevant mouse model of asthma. however, for the sake of cost and convenience, early mouse models of asthma used the surrogate protein ovalbumin (ova) [ ] rather than an environmental allergen to induce an immune response, which also requires the use of a powerful t h -polarizing adjuvant such as alum delivered via the intraperitoneal route, followed by ova nebulization-a clear divergence from the etiology of human asthma [ ] . in terms of disease presentation, mice develop some hallmarks of asthma, including airway eosinophilic inflammation, goblet cell metaplasia, and increased airway smooth muscle density [ ] . after the cessation of ova exposure, most of the remodeling resolves, although some structural alterations remain up to month after the last challenge [ ] . based on these attributes, the ova model is primarily a model to investigate the initiation of inflammation, rather than the chronic progression and maintenance of inflammation [ ] . a clear advantage with the ova model is the number of studies where it is used; both the pros and cons are familiar. it is easy to find a suitable protocol, and the model is readily accessible and flexible regarding the number of sensitizations and allergen doses. the model is relatively easy to reproduce, as ova and different adjuvants are easily obtained. however, the resolution of remodeling following the cessation of allergen provocations is a disadvantage, as is the practical problem with the nebulization of an allergen-it ends up in the mouse's coat and is ingested during grooming, potentially resulting in systemic exposure (this is particularly relevant in models employing systemic, intraperitoneal sensitization). in addition, concerns have been raised against the use of adjuvants to induce the immunological response, as well as the clinical relevance of ova as an allergen, which have driven the development of more clinically relevant allergens and models [ ] . the common environmental aeroallergen house dust mite (hdm) extract is increasingly used to initiate disease in mouse models of allergic airway inflammation, as it is a common human allergen (around % of asthmatics are sensitized to hdm [ ] ) that evokes asthma attacks and other allergic responses in susceptible individuals. in addition, hdm has inherent allergenic properties, likely due to components with protease activity [ ] , so there is no need to use an adjuvant, thus improving the etiological similarity of these models with the clinical situation [ ] . in contrast to ova, prolonged exposure of hdm (up to weeks) induces asthma-like severe airway inflammation with prominent eosinophilia, severe hyperreactivity to methacholine, and robust remodeling of the airway wall [ ] , i.e., the presentation of chronic respiratory hdm exposure in mice effectively recapitulates the key features of human allergic asthma. importantly, the airway structural changes induced by chronic hdm exposure, such as increased collagen deposition, airway smooth muscle thickening, and microvascular alterations, persist for at least weeks after the cessation of hdm exposure [ ] , another commonality with human asthma in which airway remodeling is currently considered to be irreversible. thus, the advantages of using hdm as the allergen in mouse models of asthma are the clinical relevance of the allergen [ ] and the route of delivery via the respiratory tract. moreover, studies have shown that the type of inflammation and characteristics of tissue remodeling are relatively similar to those seen in human asthmatics [ , , ] . one disadvantage is the complexity of hdm extract; as a consequence of this complexity, variations exist in some components between batches, particularly regarding the content of lipopolysaccharide, so reproducibility in these studies may be problematic. with similarity to hdm, these models were developed to be as clinically relevant as possible, as many patients suffer from allergy toward cockroach allergen, molds, and other environmental irritants. a common feature of these allergens is their complex nature, as they commonly consist of a mix of different allergic epitopes and fragments. this complexity is most likely why the immunological reaction in mice is relatively similar to that seen in asthmatics [ ] . cockroach allergen (cra) is a common allergen, known to induce asthma in susceptible individuals; thus, it shares with hdm the advantage of being highly clinically relevant [ ] . cra induces peribronchial inflammation with significant eosinophilic inflammation and transient airway hyperresponsiveness, both of which can be increased by repeated administrations of the allergen [ ] . colonization of the airways with aspergillus fumigatus is the cause of allergic bronchopulmonary aspergillosis (abpa), a disease where the lungs are colonized by the fungus, but allergens from aspergillus fumigatus can also induce asthma similar to other allergens [ ] . the reaction to aspergillus allergens is robust, and often no adjuvants are needed to elicit inflammation [ ] . in addition to aspergillus, other fungi such as penicillium and alternaria can also induce asthma in humans and have been used to model disease in mice [ ] . a common difficulty with these allergens is the method of administration, as the physiological route is believed to be the inhalation of dry allergens; mimicking this route with a nebulizer introduces the risk of the animals ingesting the allergen and thus causing systemic responses [ ] . exacerbations of asthma are defined as the worsening of symptoms, prompting an adjustment in treatment, and are believed to be associated with increased inflammation in the distal airways. clinically, exacerbations are believed to be induced by infections (most common), allergen exposure, or pollutants, which can be modeled in different ways [ , ] : . infections with viruses and bacteria or exposure to proteins/ dna/rna derived from these microbes. . administration of a high dose of allergen in a previously sensitized animal. . exposure to environmental pollutants, such as diesel exhaust or ozone. modeling exacerbations adds a layer of complexity, as robust ongoing allergic airway inflammation needs to be established first, before challenge with the exacerbating agent. both the ova and hdm models are used in this respect, and in both cases chronic protocols extending for several weeks before triggering an exacerbation have been used [ ] . chronic obstructive pulmonary disease (copd) is characterized by chronic airway obstruction, in contrast to asthma where the obstruction is reversible (particularly in response to bronchodilator treatment). clinically, in copd, chronic bronchitis and emphysema can occur either separately or in combination. copd is almost always associated with either first-or secondhand tobacco smoking or in rare cases with a deficiency in the production of α antitrypsin (a serpin that prevents elastin breakdown as a result of neutrophil degranulation) [ ] . the etiology of copd is highly complex and is believed to develop after many years of smoking in combination with other known factors such as genetic susceptibility or environmental factors [ ] . in similarity to asthma, inflammation is a major component in copd, but the leukocyte profile is very different: the most prominent players in copd-related inflammation are neutrophils and, to some degree, macrophages [ ] . due to the complex etiology of copd, it is difficult to recapitulate all aspects of this disease in a single model, so in most cases, the aim is to induce copd-like lesions by exposing mice to tissue-damaging substances (usually cigarette smoke) or to mimic emphysema by the administration of tissue-degrading enzymes [ , ] . clearly, mice do not smoke cigarettes on their own, so to model copd by cigarette smoke (cs) inhalation, the mice need to be exposed to unfiltered cs in an induction chamber; moreover, in an attempt to better model the chronic aspects of copd, this needs to be performed for a prolonged period of time. mice are very tolerant to cs, but eventually (over a period of several weeks), cs induces pulmonary neutrophilic inflammation that is associated with some degree of tissue degradation and destruction [ ] . an important advantage of this model is the fact that cs is the actual irritant responsible for disease in humans, and mice develop several features similar to the clinical disease, making this model highly clinically relevant [ ] . a significant drawback is the self-limitation of the model-the pathological changes do not progress after the cessation of cs exposure [ ] . furthermore, the exposure time needed for mice to develop copd-like pathology is extensive, i.e., studies have shown that an exposure protocol of days per week for a minimum of months is needed to generate robust structural changes to the lung [ ]. the pathological image in copd is complex and varies greatly between patients, commonly encompassing chronic bronchitis and bronchiolitis, emphysema, fibrosis, and airway obstruction. although mice develop some of these symptoms when exposed to cs, they do not develop all the symptoms of human disease; thus, cs has advantages as a model but fails to mimic the complexity of the clinical situation and disease presentation [ ] . other models of copd rely on the administration of proteases (protein-degrading enzymes) that are believed to be involved in the pathology of this disease in a subset of patients, such as elastindegrading elastase. this approach mimics the emphysematous changes seen in copd, but the pathological process underlying tissue destruction is likely very different compared to the clinical situation [ ] , as very few patients show evidence of elastase dysregulation [ ] . however, if the aim of the study is to investigate the general effect of protease-induced tissue destruction and regeneration, then this is a highly relevant method [ ] . some studies on copd have also used genetically modified animals, such as mice overexpressing collagenase, which results in tissue destruction without inflammation or fibrosis with an end result fairly similar to the type of emphysema observed in copd [ ] . pulmonary fibrosis, the accumulation of fibrotic tissue within the alveolar parenchyma, is merely a symptom of disease, and the etiology of this pathology in humans varies greatly [ ] . the most enigmatic class is perhaps the idiopathic interstitial pneumonias, especially idiopathic pulmonary fibrosis (ipf). ipf is a debilitating and progressive disease with a grave prognosis, characterized by progressive fibrosis believed to reflect aberrant tissue regeneration [ ] . as the reason behind this defective repair is unknown, although a combination of immunological, genetic, and environmental factors are suspected, it is very difficult to model disease in a clinically relevant fashion [ ] . the most common method used to model pulmonary fibrosis in mice is administration of the chemotherapeutic agent bleomycin; this agent is known to cause pulmonary fibrosis in humans as well, but this may not accurately reflect the true etiology of most cases of human disease. the strain of choice is c bl/ , as it is prone to developing pulmonary fibrosis, whereas balb/c is relatively resistant, a feature believed to reflect the cytokine response following cellular stress and damage [ ] . bleomycin administration can be performed locally or systemically, producing very different results. the most common model of pulmonary fibrosis is a single intranasal or intratracheal administration of bleomycin, with analysis to weeks later. during this time, the drug causes acute tissue damage in a restricted area of the lung (where the solution ends up during administration), followed by intense inflammation in this area and subsequent fibrosis, which gradually resolves within weeks. however, if older mice are used, the fibrosis will persist longer than in younger mice, which is in accordance with clinical ipf, where the majority of the patients are years of age or older [ , ] . a great advantage of this model is how well-characterized it is. in addition, local administration is labor-effective, as only one administration is required and the result is highly reproducible. the fibrosis is robust, only affects the lungs, and the accumulation of extracellular matrix can be easily measured using standard techniques [ ] . furthermore, as it is used throughout the world, studies performed in different labs and by different groups can be compared relatively easily. unfortunately, the intense pulmonary inflammation may be lethal, and fatalities are to be expected with this model [ ] , representing an important ethical limitation. furthermore, fibrosis is heterogeneous-it develops where the bleomycin solution is deposited. the solution usually deposits within the central lung, a localization that is not in agreement with the clinical situation where fibrosis is located in the more distal regions of the lung parenchyma. in addition, the fibrosis that develops as a result of severe tissue damage is self-limiting and reversible, unlike what is observed clinically [ ] . the severe degree of tissue damage induced by bleomycin may in fact be more relevant for modeling acute lung injury (ali) or acute respiratory distress syndrome (ards). bleomycin can also be administered systemically, through intravenous or subcutaneous injection. in contrast to local administration, this route requires multiple administrations and is thus more laborintensive [ ] . some studies have described the usage of osmotic mini-pumps, where bleomycin is slowly administered over a short period of time, and then fibrosis continues to develop over subsequent weeks [ ] . irrespective of the route of delivery, systemic administration results in more homogenous fibrosis, affecting the entire lung through the pulmonary endothelium and persisting much longer than following local administration [ ] . the main advantages of systemic administration are that inflammation is limited, while the fibrosis is more apparent and displays a more distal pattern, all of which mimics the clinical situation relatively well. the multiple administrations allow for lower doses with each injection; this is less stressful to the animals and results in little to no mortality [ ] and is thus more ethically acceptable. a major disadvantage with this model is that it takes time for fibrosis to develop [ ] , which may be the reason it is used relatively scarcely, and thus the pathological development is less well-understood. in addition, as ipf is a local disease, local administration of the etiologic agent may better mimic the clinical reality [ ] . the administration of fluorescein isothiocyanate (fitc) induces focal inflammation, primarily involving mononuclear cells and neutrophils, and localizes in areas where the fitc solution is deposited [ ] . antibodies against fitc can be detected after week, and the fibrosis persists for up to months after instillation [ ] . the benefits of this model are mainly related to the persistent fibrosis that does not appear to be self-limiting, thus reflecting the clinical situation, and it is also very easy to determine which part of the lung has been exposed to fitc, as the molecule is fluorescent [ ] . it is also an advantage that both c bl/ and balb/c mice are susceptible and develop fibrosis following fitc administration [ ] . the disadvantages of this model include profound variability due to differences between batches of fitc, as well as in the method used to prepare the solution before instillation. importantly, given the characteristics of the etiologic agent used to induce this model of ipf, this model is considered a very artificial system with limited clinical relevance [ ] . adenovirus vectors have been used to overexpress the pro-fibrotic cytokine transforming growth factor (tgf)-β, which results in pulmonary fibrosis. as tgf-β overexpression in the lungs is known to be crucial in the development of fibrosis in humans [ ] , this model mimics an important feature of disease etiology. however, the delivery system has some drawbacks, as the virus itself initiates an immune response. moreover, adenoviruses display significant tropism for epithelial cells and rarely infect other cell types such as fibroblasts [ ] , which are the cells meant to be targeted in this model. as tgf-β has major effects on fibroblast biology, the main feature of this model is the effect of epitheliumderived tgf-β on fibroblasts and myofibroblasts, resulting in the deposition of ecm proteins and areas of dense fibrosis [ ] . an advantage of this model is the relatively low degree of inflammation, as well as what appears to be a direct effect on fibroblasts/ myofibroblasts [ ] , which is in accordance with the clinical situation (as we understand it today). silica administration induces a similar pathology in mouse lungs as in humans exposed to silica, and as is also observed in human silicainduced fibrosis, structural remodeling persists when administration is halted [ ] . following the administration of silica particles, fibrotic nodules develop in mouse lungs, with considerable resemblance to the human lesions that develop after exposure to mineral fibers [ ] . the fibrotic response is accompanied by a limited inflammatory response, and different pro-fibrotic cytokines such as tgf-β, platelet-derived growth factor, and il- are involved in disease development, which is in accordance with the clinical situation [ ] . another advantage is that nodules develop around silica fibers, and these fibers are easy to identify by light microscopy. the response in this model is strain-dependent, with c bl/ mice being the most susceptible. the main drawbacks are the time required to establish disease, i.e., - days, and the need for special equipment to aerosolize the silica particles. however, since the route of administration, the driving etiologic agent, and the resulting pathobiology are all similar to the characteristics of this subtype of pulmonary fibrosis [ , ] , the silica exposure model can be considered to have very good clinical relevance. what does the future hold for mouse models of human disease? medical research using experimental animals (not only mice but other animals including rats, guinea pigs, zebrafish, and fruit flies) has greatly contributed to many important scientific and medical advances in the past century and will continue to do so into the near future. these advances have contributed to the development of new medicines and treatments for human disease and have therefore played a vital role in increasing the human life span and improving quality of life. despite the acknowledged benefits of performing research using experimental animals, a number of considerations must be made before embarking on this type of research. of course, the financial aspects of conducting this type of work are an important limitation, as the costs of purchasing and housing mice can be prohibitive, especially when genetically modified mice and colony maintenance are required for the study. the practicalities of working with animals such as mice may also be an issue, as this type of work requires specialized facilities, equipment, and staff to ensure studies are carried out in a manner that is safe for both the researchers and the animals. moreover, as discussed in detail in this chapter, the relevance of the selected animal model to human disease must be carefully evaluated to ensure that these experiments provide robust results that are translatable to human health and disease. another important and demanding aspect of biomedical research using animals is the ethics of imposing pain and suffering on live animals. although there has been a considerable reduction in the numbers of animals used in research in the last years, animal research remains a vital part of biomedical research. however, no responsible scientist wants to cause unnecessary suffering in experimental animals if it can be avoided, so scientists have accepted controls on the use of animals for medical research. in the uk, this ethical framework has been enshrined in law, i.e., the animals (scientific procedures) act . this legislation requires that applications for a project license to perform research involving the use of "protected" animals (including all vertebrates and cephalopods) must be fully assessed with regard to any harm imposed on the animals. this involves a detailed examination of the proposed procedures and experiments, and the numbers and types of animal used, with robust statistical calculations to support these numbers. the planned studies are then considered in light of the potential benefits of the project. both within and outside the uk, approval for a study involving protected animals also requires an internal ethical review process, usually conducted by the research institution where the work is taking place, with the aim of promoting animal welfare by ensuring the work will be carried out in an ethical manner and that the use of animals is justified. additionally, the uk has a national animal use reduction strategy supported by the national centre for the replacement, refinement and reduction of animals in research (nc rs; london, uk). this consortium was established in to promote and develop high-quality research that takes the principles of replacement, refinement, and reduction (the rs) into account. replacement strategies often involve the use of alternative, non-protected species (e.g., zebrafish, fruit flies, flatworms) and in vitro correlates (two-dimensional cell culture or threedimensional organoids containing multiple cell types) to test hypotheses and assess the effects of therapeutic interventions. the main obstacle with studies on non-protected animals is the difficulty of accurately mimicking the complex physiological systems involved in human health and disease, as described in detail above. for example, the fruit fly drosophila melanogaster is an excellent model organism for studies on genetic diseases, aging, and pathogen-borne illnesses but may be less relevant for studies on complex lung diseases. importantly, model organisms such as fruit flies, zebrafish, and flatworms do not possess lungs, which somewhat limits the translatability of research on these animals in the field of respiratory disease. as such, it is likely that rodents will remain the model organism of choice for studies into lung disease for some time to come. there has been considerable progress recently in imitating single organs such as the liver, lung, and brain in vitro using multiple cell types and a physical scaffold. as an important advantage, these in vitro tests have replaced a large number of rodents in initial drug discovery experiments, while also speeding up the process [ ] . these studies still require further refinement and validation to establish them as suitable models for an entire organ; importantly, these in vitro organoids cannot take into account interactions between organ systems in complex, multisystem diseases such as copd. refinement involves selecting the most clinically relevant model for the disease available, informed by the discussion above on closely recapitulating the etiologic agent and disease pathobiology associated with clinical cases. another important factor is refining the management of pain. an assessment of the procedures used and the effects of the substance on the animal, as well as the degree of handling, restraint, and analgesia, are other important aspects of refinement. this standard of animal care is achieved through strict regulations and controls on how personnel are trained to carry out experiments on live animals. adequate training is an important aspect of refinement and should be reviewed and improved on an ongoing basis. moreover, refinement can be achieved by improving animal housing by environmental enrichment, e.g., providing a place for mice to hide in the cage and housing social animals such as mice in appropriate-sized groups. these simple changes can improve the physiological and behavioral status of research animals; this not only increases animal well-being but also contributes to the quality of the experimental results by reducing stress levels. the rs aspect of reduction focuses on the statistical power of experiments and by following the animal research: reporting of in vivo experiments (arrive) guidelines, originally published in plos biology in . these guidelines provide a framework to improve the reporting of research performed on live animals by maximizing the quality of the scientific data and by minimizing unnecessary studies. the arrive guidelines provide a checklist of aspects that must be considered in good quality research using live animals. the guidelines are most appropriate for comparative studies involving two or more groups of experimental animals with at least one control group, but they also apply to studies involving drug dosing in which a single animal is used as its own control (within-subject experiments). the guidelines provide recommendations on what should be considered when preparing to report on the results of experiments involving live animals, i.e., by providing a concise but thorough background on the scientific theory and why and how animals were used to test a hypothesis, a statement on ethical approvals and study design including power and sample size calculations, a clear description of the methods used to ensure repeatability, objective measurements of outcomes and adverse effects, and interpretation of the results in light of the available literature and the limitations of the study. in addition to the positive impact of the arrive guidelines on reducing the number of animals used in experiments, this checklist provides an easy-tofollow roadmap on what is required for good quality reporting of experimental results. in conclusion, the use of animals in research will continue to be an important aspect of medical research, and these procedures can be ethically justified provided the proper controls are in place. the benefits of animal research have been vital to the progress of medical science; abandoning these studies would have severe negative consequences on human health. by considering aspects such as the rs and the arrive guidelines in planning experiments involving live animals, the number of animals used and suffering of these animals for the benefit of human health can be minimized. this requires a strong regulatory framework such as that found in the uk and many other countries, as well an ongoing public debate on the advantages and limitations of animal experimentation. use of house mice in biomedical research the laboratory mouse a comparative encyclopedia of dna elements in the mouse genome principles of regulatory information conservation between mouse and human of mice and men: aligning mouse and human anatomies mouse models of human disease: an evolutionary perspective structure and composition of pulmonary arteries, capillaries, and veins 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bleomycin-induced pulmonary inflammation and fibrosis in mice (r)-resolvin d ameliorates bleomycin-induced pulmonary fibrosis in mice extracellular matrix alterations and acute inflammation; developing in parallel during early induction of pulmonary fibrosis smad signaling involved in pulmonary fibrosis and emphysema adenovector-mediated gene transfer of active transforming growth factor-beta induces prolonged severe fibrosis in rat lung the ethics of animal research. talking point on the use of animals in scientific research key: cord- -ymhcfyxx authors: gromeier, matthias; lu, hui-hua; wimmer, eckard title: mouse neuropathogenic poliovirus strains cause damage in the central nervous system distinct from poliomyelitis date: - - journal: microb pathog doi: . /s - ( ) - sha: doc_id: cord_uid: ymhcfyxx poliomyelitis as a consequence of poliovirus infection is observed only in primates. despitea host range restricted to primates, experimental infection of rodents with certain genetically well defined poliovirus strains produces neurological disease. the outcome of infection of mice with mouse-adapted poliovirus strains has been described previously mainly in terms of paralysis and death, and it was generally assumed that these strains produce the same disease syndromes in normal mice and in mice transgenic for the human poliovirus receptor (hpvr-tg mice). we report a comparison of the clinical course and the histopathological features of neurological disease resulting from intracerebral virus inoculation in normal micewith those of murine poliomyelitis in hpvr-tg mice. the consistent pattern of clinical deficits in poliomyelitic transgenic mice contrasted with highly variable neurologic disease that developed in mice infected with different mouse-adapted polioviruses. histopathological analysis showed a diffuse encephalomyelitis induced by specific poliovirus serotype isolates in normal mice, that affected neuronal cell populations without discrimination, whereas in hpvr-tg animals, damage was restricted to spinal motor neurons. mouse neurovirulent strains of poliovirus type differed from mouse neurovirulent poliovirus type derivatives in their ability to induce cns lesions. our findings indicate that the characteristic clinical appearance and highly specific histopathological features of poliomyelitis are mediated by the hpvr. our data lead us to conclude that the tissue tropism of mouse-adapted poliovirus strains in normal mice is fundamentally different from that of poliovirus in hpvr-tg mice and primates, and that this is indicative of an as yet unknown mechanism of adsorption and uptake of the virus into cells of the murine cns. poliomyelitis is a rare neurological complication of primate infection with poliovirus (pv), a member of the picornavirus family, genus enterovirus. ingestion of virulent particles results in intestinal uptake, presumably through m-cells, initial viral replication in subjacent lymphatic tissue, spread to deeper cervical and mesenteric *author to whom correspondence should be addressed. - / / + $ . / o academic press limited lymph nodes (lymphatic phase), and ultimately entry of the virus into the bloodstream (viremic phase). the latter is a prerequisite for passage of the blood brain barrier and subsequent lytic infection of motor neurons. only a small proportion of pv infections lead to a distinctive neurological syndrome that ranges in severity from transient flaccid monoparesis to progressive flaccid paraplegia with respirato.ry impairment and sometimes bulbar involvement. the hallmark of poliomyelitis histopathology is selective damage to anterior horn motor neurons along the entire spinal cord. spinal neurons outside the motor neuron system are characteristically spared, in spite of their close anatomical relationship to the target of polioviral attack. the predominant molecular determinant of pv tropism is the hpvry the nucleotide sequence of hpvr identified it to be a member of the immunoglobulin superfamily, whose four mrna isoforms are the result of alternative splicing events, and give rise to different receptor molecules. ' hpvrc~ and hpvr& are integral membrane proteins with divergent cytoplasmatic domains, whereas hpvr/~ and hpvr are secreted molecules lacking the putative transmembrane domain. the hpvr is a highly glycosylated protein with an apparent molecular weight of kda the animal model for poliomyelitis in hpvr-tg mice showed pv-induced damage of comparable anatomical distribution as in primates, °' an observation confirming views of the hpvr as the critical determinant conferring pv susceptibility. unexpectedly, hpvr mrna and hpvr-related proteins were shown to be present in a wide variety of tissue homogenates not known to be sites of pv replication, ~' ° an observation suggesting additional limiting factors of pv susceptibility, mrnas specifying the simian and murine ~ homologues to hpvr have been isolated, but only the monkey-specific pvr can promote pv infection. ~ attempts to use rodents as possible models of pv-induced disease resulted in the isolation of mouse-neurovirulent (ran) strains. a pv serotype field isolate from lansing, michigan, [pv (l)], which caused a syndrome described as 'polioencephalitis' upon intracerebral injection in the cotton rat, tm provided the first system of pv encephalitogenesis in the wild type (wt) mouse. ~s histopathological analyses of murine infection with the rodent-passaged pv (l) isolate described a pattern of damage in accordance with concepts of primate poliomyelitis. ~ a structural element conferring mouse neurovirulence to pv (l) was determined to map in the capsid region. ~ sufficient in causing this effect was a segment within the bc-ioop of vp since mouse avirulent pv type (mahoney) [pvi(m)], after transposition of the lansing bc-ioop, caused neurological disease in mice. ' surprisingly, point mutations in distant regions of vp and vp could be shown to exert a mn phenotype. °. ~ the histopathological features of neurological disease caused by these genetically well defined mn pv strains have not been reported thus far. in addition to the selection of wt pv strains expressing a mn phenotype in mice, attenuated pv strains with a mouse host range phenotype but reduced neurovirulence have also been described [pv type , strain w ]. the attenuated (att) phenotype of pv (w ) is reminiscent of the sabin strains of pv that express an att phenotype for primates. the genetic determinants of viral neurotropism have been studied in several viral systems. most frequently, these determinants mapped to the envelope gene; examples are the alphaviruses sindbis virus we have infected swiss-webster-, and icr-mice with a variety of mn virus isolates of different serotypical origin. type strains pv (l), pv (mef- ), a recent pv isolate from india (ind), and pv (w ) caused a fatal diffuse encephalomyelitis in these mice with considerable differences in intensity between individual viral strains. pvl(lsa), a mouse-adapted derivative of pvl(m), caused a characteristic non-progressive panmyelitic syndrome. we have also studied the histopathology of murine infection with pvi(m), carrying a single mutation in position of capsid protein vp that we constructed according to a published report. ~ infections with each of these strains did not follow the stereotypic course of predictable progression seen in pv-induced poliomyelitis in hpvr-tg icr-mice. syndromes with distinct and consistent features followed intracerebral infection with each group of strains. these syndromes could be separately characterized and distinguished from hpvr-mediated poliomyelitis, on both clinical and histopathological grounds. poliovirus isolates and experimental animals. pv transgenic icr-mice expressing the hpvr ~° were a generous gift from a. nomoto (the university of tokyo, japan). swiss-webster-and normal icr-mice were obtained from taconic (germantown, ny, u.s.a). ultraviolet (uv) irradiation conditions. uv irradiation was performed in a uv-stratalinker (stratagene, lajolla, ca, u.s.a) a suspension of pv was irradiated at a distance of ca. cm with an intensity of ca. . j/m z. virus was exposed to the irradiation source in ice-cooled plastic dishes at a solution depth of ca. ram. the loss of infectivity was confirmed in a plaque assay. poliovirus intracerebral infections. virus preparations were used to infect tg or normal mice with the desired input titer by intracerebral inoculation. mice were anesthetized, and a gauge hypodermic needle was used to inject maximally pl of virus suspension in dulbecco's minimal essential medium (dmem). the point of injection was the middle on the median between the ear pinnacle and the eye. infected mice were regularly observed for symptoms. none of the treated animals showed any external signs of damage or neurological disturbances in h following injection. tissue processing, sectioning, and staining. affected animals in the final stage of their disease were sacrificed according to approved protocols, and their bodies were immediately perfused with ml of phosphate buffered saline (pbs), followed by ml of % neutral buffered paraformaldehyde. the brain and spinal cord were removed and fixed for h at room temperature in the fixative used for perfusion. tissue specimens were rinsed for rain in icecold pbs, then placed in % ethanol over night. dehydration was achieved through a scheme of gradually increasing ethanol concentration, followed by clearing in toluene for h and infiltration with paraffin at . °c for h. neural tissues were embedded and cut on a rotary microtome at a thickness of /~m. tissue sections were placed on microscopic slides treated transgenic mice expressing the pv receptor tm were infected intracerebrally with pvi(m) with an amount of virus ranging from to x plaque forming units (pfu). all infected mice developed a characteristic neurological syndrome displaying stereotypic clinical features irrespective of input titer of virus and differing only with regard to onset of symptoms (table ) . once visible signs of functional impairment were apparent, the progression of disease followed a predictable course. two to five days after intracerebral injection, initial signs were invariably a flaccid paralysis of the lower extremities and tail (fig. a) . the condition was rapidly progressive leading to complete immobilization and respiratory difficulty within h. respiratory distress caused visible signs of bobbing of the head, strenuous respiratory effort, insufficient thoracic excursions, and nasal flaring. animals in the final stage of the disease were killed and their cns tissues processed according to standard procedures. histopathological analysis of the cns of pvl(m)-infected hpvr-tg mice revealed the spinal pathology of poliomyelitis described in earlier reports. °' selective loss of anterior horn motor neurons along the entire spinal cord was invariably present (fig. b) . foci of virally-induced damage in the higher cervical cord extended into the brain stem and were accompanied by minor signs of inflammation in a predominantly perivascular distribution. characteristically, apart from a clearly defined lesion in the pyramidal cell layer of the hippocampal formation, lesions above the brain stem were absent in all cases analyzed. the appearance of initial lesions in the lumbar spine, distant from the injection site without evidence of damage to cortical motor neurons or descending tracts, indicated that virus had been disseminated via the hematogenous or cerebrospinal fluid route. twenty eight day old swiss-webster-and icr-mice were injected intracerebrally with pvi(m), pv (l), pv (mef- ), pv (ind), or pv (w ), with amounts of virus ranging from to x . three groups of four animals each with different genetic backgrounds, swiss-webster and icr, were injected with the same viral strain. it is important to note that we were unableto detect clinical or histological evidence for differences in susceptibility towards pv infection between both outbred mouse strains used. therefore, in the following text, the term 'normal mouse' will refer to swiss-webster mice. all mn pv strains assayed caused poliomyelitis when injected into hpvr-tg mice (clinical and histopathological details are described later). none of the normal mice injected with pvi(m) showed clinical signs of neurological damage, whereas inoculation of type pv strains produced signs of cns infection ( table ) . mice infected with pv (mef- ) and pv (ind) were most severely affected. initial symptoms appeared - days post infection (p.i.) in all animals but they were inconsistent regarding the sites of manifestation and quality of functional impairment. motor symptoms consisted predominantly of spastic weakness involving the lower or upper extremities in a random fashion ( table ) . paraplegic animals had a characteristic posture marked by kyphoscoliotic deformity (fig. b) . the progression of motor symptoms did not follow any apparent topographical scheme. pareses frequently were accompanied by gait ataxia or motor incoordination. clinical signs of respiratory involvement as described above usually did not appear during the course of the disease ( table ). the clinical course proceeded to a terminal stage within days after onset of symptoms. preterminal animals were severely emaciated once functional impairment supervened, and refused intake of fluid and food offered within their reach. compared to pv (mef- ) and pv (ind) a proportionally lower number of pv (l)infected animals died (table ) . their clinical syndrome was less variable, but also diverged from the regular pattern of disease localization and progression seen in poliomyelitic hpvr-tg mice. motor symptoms similar to those in pv (mef- ) infected littermates dominated the clinical picture. progression of motor involvement did not follow any recognizable pattern and it only rarely included respiratory function ( table ). eventually immobilization led to quick deterioration of the starving animals. pv (w ) was previously reported to be of attenuated neuropathogenicity with respect to pv (l) in mice. accordingly, the proportion of infected animals that developed disease, and the severity and pace of progression of symptoms, were less than in animals infected with other pv type isolates (table ). this observation confirms the attenuated nature of the strain." the spectrum of functional deficits observed was identical to pv (l)-induced disease. likewise, there was considerable variability in the sites involved in production of symptoms, course of progression, the clinical discrepancies between wt pv-induced poliomyelitis in hpvr-tg mice, and mouse-adapted pv infections in normal mice, were confirmed by histopathological differences. the severity and variability of clinical signs secondary to infection with the pv strains in normal mice was consistent with the histopathological findings. extent, morphology and localization of viral lesions in swiss-webster-and icr-mice were comparable. the range of vitally-induced damage encompassed a variety of lesions indiscriminately affecting structures within the cerebral hemispheres and the entire spinal cord. characteristically, spinal pathology was patchy and irregular, and it did not follow the consistent pattern of damage to the entire cord seen in pvinfected hpvr-tg mice. unexpectedly, anterior horn motor neurons remained frequently unaffected in normal mice infected with mn pv , although severe pathological changes within the spinal cord were apparent (fig. c,d) . in contrast, routine poliomyelitis in hpvr-tg mice invariably led to complete and exclusive elimination of the motor neuron population in the spinal cord with only minor infiltrative changes ( fig. b) . unlike the limitation of vitally-induced lesions in pv infections of hpvr-tg mice to the spinal cord, pv -induced disease involved the entire cns. microglial nodules accompanied by mixed lymphocytic and neutrophilic infiltrates were scattered throughout the brain and were found within the insular, piriform and temporal cortex (fig. f) , and the basal ganglia and thalamus (fig. h) . these structures were never affected in infected hpvr-tg mice (fig. e,g) . perivascular cuffing and dense infiltration of perivascular and periventricular parenchyma were distributed ubiquitously in the cns. the cerebral white matter was a frequent site of viral lesions. lymphocytic infiltrates within the cerebral or cerebellar peduncles, the internal capsule, or the long descending tracts and posterior columns within the upper cervical cord, occasionally caused rarefaction necrosis with secondary demyelination (fig. ) . immunohistochemical staining for viral proteins with a polyclonal anti-pv antiserum revealed positive signals in those structures frequently involved by virally- fig. . signs of widespread lesions and diffuse encephalomyelitis were most commonly associated with the isolates pv (mef- ) and pv (ind), whereas in pv (l) cases a myelitic pattern of disease predominated over encephalitis. parallel to the clinical findings, overall cns damage induced by pv (w ) was moderate in comparison with the other serotype isolates. neurological damage focused on the spinal cord with rare cerebral involvement. spinal pathology qualitatively resembled the pv panmyelitis described above but the extent and number of lesions were reduced (data not shown). to analyze the clinical course of murine infection with pv in mice expressing the hpvr, tg mice were inoculated intracerebrally with pv (mef- ) or pv (l). the resulting clinical picture featured signs typically seen in murine poliomyelitis. the onset of disease was marked by a flaccid paraparesis, followed by ascending progressive symptoms as in poliomyelitis. all affected animals developed a preterminal dyspneic stage before they were killed. associated histopathology showed elements characteristic of hpvr-mediated poliomyelitis, as well as pv -induced encephalomyelitis. anterior horn motor neurons had changes typical for poliomyelitis. in addition, there was almost always severe hemispheric involvement, never associated with hpvr-tg murine poliomyelitis resulting from infection with pvi(m). lesions equivalent to those seen in pv -induced encephalomyelitis were distributed in the same widespread indiscriminate manner throughout the cns. gray matter structures were affected as well as cerebral white matter (data not shown). two groups of ten -day-old swiss-webster-and icr-mice were each infected intracerebrally with pvi(ls-a) at a range of to x pfu. as in previous assays, there was no notable difference in clinical signs and histopathological features in mice with different genetic background. all infected animals developed a specific neurological syndrome with stereotypical onset, clinical course, functional deficits, and pattern of progression. four days p.i., mice showed the first signs of an insidious spastic paraparesis (fig. c) . no ascending motor deficits occurred, respiratory function remained unaffected, and there were no fatalities. intracerebral inoculation of pvl(ls-a) was required to produce symptoms, since intravenous injection of virus with concomitant intracerebral needle puncture produced no neurological impairment. intracerebral inoculation of equal particle numbers of pvi(ls-a) virus, inactivated by uv-irradiation, also caused no neurological signs of cns damage. this finding indicated viral replication to be a prerequisite for pvi(ls-a) neuropathogenicity. histopathology of the neurological syndrome caused by this variant centered exclusively on the spinal cord. extensive infiltrates, originating from spinal blood vessels, invaded both the gray and white matter. pathologic changes involved the entire spinal cord, but did increase in extent of damage caudally (fig. a,b) . there was no apparent predilection for any cell subtype. motor neuron damage was seen within areas of destructive necrotic tissue change secondary to the inflammation. at no time during the infection could damage to motor neurons within the thoracic or cervical cord be distinguished (fig. b) , despite prominent inflammation affecting these regions. spinal sections taken from animals which underwent partial reversal of neurological defects, weeks p.i., revealed complete regression of infiltrative changes and preservation of motor neuron populations (fig. c ). a mutant pvi(m) virus, which had previously been reported to exert neuropathogenic potential in normal mice was tested in a similar manner as the above mentioned strains. pvl(vp - ) carried a point mutation at position (p s) within capsid protein vp . intracerebral inoculation of each four swiss-webster-and icr-mice with at least i x pfu resulted in visible signs of neurological damage in % of affected animals in both groups. with the genetic variant constructed in this laboratory, this large inoculum was required to induce clinical signs. the nature of the neurological syndrome was partly obfuscated by the vigorous host response to the application of excess viral antigen, and the resulting clinical deterioration. sick mice showed prominent systemic signs of disease such as ruffled fur, reduced activity, and emaciation. symptoms of minor motor impairment were present in half of the diseased mice, but the limb pareses were difficult to assess in quality due to the general weakened state of the animal. mild limb weakness did not progress with any apparent disease pattern. severely weakened, emaciated animals succumbed to the effects of infection, without the clear causal relationship of neurological disease and fatal outcome seen in poliomyelitis, hpvr-tg mice injected with pv (vp - ) developed a neurological condition indistinguishable from pvi(m) related poliomyelitis (data not shown). similar to clinical findings, the histopathologic features induced by pvl(vp - ) were less defined than in the other described infections. there was no supraspinal involvement, and spinal cord sections at all levels displayed widespread parenchymal invasion and reactive migroglial proliferation. no targeted attack against specific cell populations was apparent (fig. d) . histopathologic evidence for a primary thoracic and cervical cord affection was not present. with the rare exception of certain serotype pv strains, e.g. pv (mef- ) and pv (l), naturally occurring pv strains can only infect primates, and even pv (mef- ) and pv (l) are mouse neurovirulent only when artificially inoculated by intracerebral injection. the narrow host range of pv results from its stringent dependence on the express exactly the same cell tropism in the murine cns as they do in the primate cns unlikely and, hence, that mn pvs would cause the same specific disease syndrome (poliomyelitis) in normal mice as they do in primates. to shed some light on these complex problems we have compared the disease syndromes caused by a variety of different pv strains in hpvr-tg and normal mice. we have come to the conclusion that mn pv strains do not produce poliomyelitis in normal mice. the occurrence of poliomyelitis in hpvr-tg mice corroborates the function of the hpvr as a major determining factor in the pathogenesis of the peculiar histopathological and clinical features of this disease. °' poliomyelitis in tg mice followed a stereotypic course: initial flaccid pareses of the lower limbs, followed by cranial progression, involving respiratory function, and fatal outcome. in contrast, the clinical symptoms resulting from mn pv infections in normal swiss-webster-and icr-mice could not be explained by classical terms of the syndrome poliomyelitis. infection of normal mice with mn pv strains caused a diffuse encephalomyelitis with highly variable neurological symptoms appearing in random order, at topographically unrelated sites. mouse neuropathogenicity was shared by several serotype field isolates, the mouse adapted attenuated strain pv (w ), the pvi(m) derivative pvi(ls-a), and pvi(m) with a mutation in residue of capsid protein vpi. interestingly, the type pv field isolates pv (mef- ) and pv (ind), have been reported to be mn without a lengthy process of adaptation, whereas other type [pv (l)] and type strains [pvi(ls-a)] were passaged in the rodent cns before they acquired the mn phenotype. mn type or type pv field isolates have not been described. the molecular basis underlying this peculiar property of type pv strains is not understood. earlier reports stressed the similarity between primate poliomyelitis and encephalomyelitis caused by pv (l) in normal mice. comparative studies at that time were impeded by the lack of a murine model of hpvr-mediated poliomyelitis. viral antigen was shown to be expressed in spinal anterior horn motor neurons, ~ but in situ hybridization revealed the presence of viral rna in cells in posterior portions of the spinal cord as well as the white matter. "s previous analyses of pv neurovirulence using mn strains were based on the assumption of a similar pathogenesis of mn pv infections in wt mice and in primates. one parameter to assess the potential of viral neurovirulence is the ldso value, and in earlier studies, animals showing evidence of neurological functional impairment were generally killed without further histopathological analysis (see for example, ref. ) . our results suggest that the expression of the mn phenotype of pv strains in mice should not be compared to the expression of pv neurovirulence in primates, the normal host. indeed, it appears that the expression of a mn phenotype in wt mice can result from very different genetic changes in pv strains, and that each genetic change can produce different syndromes. this is apparent not only from various type mn strains, but also from the type mn strain pvi(ls-a) [a derivative of pvi(m) whose genotype has been recently elucidated ]. histopathological changes within the cns should therefore be monitored when murine infections with mn pv strains are studied. a major determinant for the mn phenotype of pv (l) is the bc-ioop of vp ~ a surface protrusion of about amino acids located at the apex of the poliovirion that functions as a neutralization antigenic site. exchange of the vp bc-ioop of the mouse-inert pvi(m) with the bc-ioop of pv (l) produces the mn phenotype, ~ ' an observation that prompted speculation that the vp bc-ioop is involved in the recognition of a putative mouse receptor. no evidence for this hypothesis has been obtained as yet. strain pvi(ls-a), a mn derivative of pvi(m), accumulated point mutations during passage in non-human tissue, of which mutations led to amino acid exchanges in the capsid region these capsid mutations, however, were insufficient to produce the mn phenotype. instead, the mutations in capsid protein vp plus, surprisingly, five mutations in the coding region of the non-structural protein a "r°, a proteinase, produced mouse neurovirulence. the syndrome pv (ls-a) ir~duced in normal mice, however is distinct from the encephalomyelitis caused by type pv strains. a pathological entity different from those observed with all other mn poliovirus strains, wes seen with pv (vp - ), a virus that we constructed according to a previous report. pv (vp - ) is a mn derivative of pvi(m) that carries only a single amino acid exchange in capsid protein vp (p s). the mutation, located at an interpentameric interface inside the capsid, was suggested to destabilize the virion in the mouse cns, but the neurological syndrome caused by infection with pv (vp - ) was not histopathologically characterized. infection of mice with pv (vp - ) led to neurological damage only after intracerebral inoculation of excess viral antigen. the poorly defined histopathological features of cns involvement lacked characteristics of specificity observed in hpvr-mediated poliomyelitis. the genotypic differences between mn pv strains and the clinical syndromes they cause, which differ from hpvr-mediated poliomyelitis, challenge the hypothesis of common determinants of a mn phenotype. rather, it appears that a multitude of non-related genetic elements affect this phenotypic marker in various ways. as indicated before, the nature of the receptor(s) used by the mn pv strains in the mouse cns remains to be determined. available data suggest that the mouse homologue to the hpvr does not serve as surrogate for the mn pv strains. it is more likely that the mn pv strains enter neuronal tissue via cell-surface protein(s) unrelated to hpvr. if so, it is not surprising that the syndromes produced by these viral strains are distinct from poliomyelitis. in recent years picornaviruses other than poliovirus have been implicated as causative agents of neurological disease. these include enterovirus (ev) , the etiologic agent of acute hemorrhagic conjunctivitis, or ev . however, it has also been reported that the encephalomyelitis caused by the newly emerging human pathogen ev did not always resemble poliomyelitis. s° the evolution of enterovirus strains with new neuropathogenic properties distinct from previously non-neuropathogenic ancestors might be due to adaptation to new receptor entities. the mouse-neurotropic pv variants with altered cell tropism constitute a precedent for the emergence of non-poliomyelitic picornaviral cns disease. we thank a. nomoto for the generous gift of the hpvr-tg mouse strain used in this study and b. jubelt and o. kew for kindly providing pv type strains. we are grateful to p. coyle for critical review of this manuscript. we thank n. peress for helpful discussion and d. colflesh for help with microscopic imaging. this work was supported in part by nci grant ca , and nih grants ai and ai . m.g. is a recipient of a grant from the stipendienprogramm infektionsforschung, heidelberg, germany. poliovirus type enters the human host through intestinal m cells emerging concept of poliomyelitis infection poliovirus crystals within the endoplasmic reticulum of endothelial and mononuclear cells in the monkey spinal cord onuf's motoneuron is resistant to poiiovirus the poliovirus receptor protein is produced both as membrane-bound and secreted forms cellular receptor for poliovirus: molecular cloning, nucleotide sequence, and expression of a new member of the immunoglobulin superfamily the poliovirus receptors molecular characterization of the cellular receptor for poliovirus transgenic mice susceptible to poliovirus transgenic mice expressing a human poliovirus receptor: a new model for poliomyelitis a second gene for the african green monkey poliovirus receptor that has no putative n-glycosylation site in the functional n-terminal immunoglobulin-like domain molecular cloning and expression of a murine homolog of the human poliovirus receptor gene the experimental transmission of poliomyelitis to the eastern cotton rat, sigmodon hispidus hispidus successful transfer of the lansing strain of poliomyelitis virus from the cotton rat to the white mouse pathogenesis of human poliovirus infection in mice. i. clinical and pathological studies mapping of sequences required for mouse neurovirulence of poliovirus type lansing engineering a poliovirus type antigenic site on a type capsid results in a chimaeric virus which is neurovirulent for mice poliovirus host range is determined by a short amino acid sequence in neutralization antigenic site i molecular characterization of mouse-virulent poliovirus type mahoney mutants: involvement of residues of polypeptides vp and vp located on the inner surface of the capsid protein shell host range determinants located on the interior of the poliovirus capsid localization of genomic regions specific for the attenuated, mouse-adapted poliovirus type strain w- genetics of poliovirus molecular basis of sindbis virus neurovirulence in mice sindbis virus mutations which coordinately affect glycoprotein processing, penetration, and virulence in mice two mutations in the envelope glycoprotein e of semliki forest virus affecting the maturation and entry patterns of the virus alter pathogenicity for mice chimeric tick-borne encephalitis and dengue type viruses: effects of mutations on neurovirulence in mice genetic determinants of dengue type virus neurovirulence for mice glycosylation of neuraminidase determines the neurovirulence of influenza a/wsn/ virus rabies virulence: effect on pathogenicity and sequence characterization of rabies virus mutations affecting antigenic site iii of the glycoprotein physical mapping of the paralysis-inducing determinant of a wild mouse ecotropic neurotropic virus the v a . envelope glycoprotein deletion mutant of mouse hepatitis virus type is neuroattenuated by its reduced rate of spread in the central nervous system hemagglutinin variants of reovirus type have altered central nervous system tropism pathogenesis of early and late disease in mice infected with theiler's virus, using intratypic recombinant gdvii/da viruses retrovirus-induced murine motor neuron disease: mapping the determinant of spongiform degeneration within the envelope gene molecular basis of viral neurotropism isolation of a non-neurotropic variant of type poliomyelitis virus mouse-neurovirulence determinants of poliovirus type strain ls-a map to the coding regions of capsid protein vp and proteinase ~ pr° studies on rodent adapted poliomyelitis virus. io cerebral resistance induced in the rhesus monkey transmission to rodents of lansing type poliomyelitis virus originating in the middle east van der ploeg m. in situ hybridization of dna sequences in human metaphase chromosomes visualized by an indirect fluorescent immunocytochemical procedure manual of histological staining methods ofthe american armed forces institute of pathology poliovirus antigenic hybrids simultaneously expressing antigenic determinants from all three serotypes poliovirus infection of cyclophosphamide-treated mice results in persistence and late paralysis: i. clinical, pathologic, and immunologic studies molecular pathogenesis of type poliovirus in mice the three-dimensional structure of poliovirus at . ,a, resolution antigenic structure of picornaviruses radiculomyelitis following acute haemorrhagic conjunctivitis an apparently new enterovirus isolated from patients with disease of the central nervous system enterovirus type infections: a varied clinical pattern sometimes mimicking paralytic poliomyelitis key: cord- -pgyzluwp authors: nan title: programmed cell death date: journal: experientia doi: . /bf sha: doc_id: cord_uid: pgyzluwp nan it is widely held that all developmental cell death is of a single type (apoptosis) and that neuronal death is primarily for adjusting the number of neurons in a population to the size of their target field through competition between equals for target-derived factors. we shall draw on our research and on that of others to criticize these views and replace them by the following. at least three types of neuronal death occur, only one of which resembles apoptosis; a neuron can choose between several self-destruct mechanisms depending on the cause of its death. the purpose of the death is to regulate connectivity, not neuron number. competitors for trophic factors are unequal, and many losers have made axonal targeting errors. a neuron's survival and differentiation depend on multiple anterograde and retrograde signals. activity affects retrograde signals and some but not all anterograde ones. the pattern of activity is more important than the overall amount. in rodents, the period of naturally occuring cell death of motoneurons is followed by a period of supersensitivity to axonal injury. thus, in newborn rodents lesion of the facial nerve leads to a rapid degeneration of the injured motoneurons. we have tested whether overexpression, in rive, of the bcl- proto-oncogene was capable of preventing death of axotomized motoneurons. to address this question we used transgenic mice whose motoneurons overexpress the bcl- protein. one of the two facial nerves of newborn mice was transected on the nd- rd post-natal day. seven days after the lesion, the morphology of the facial nuclei was analyzed. in control mice, and when compared to the intact nucleus, to % of axotomized motoneurons had disappeared. in contrast, in the transgenic animals, the number of motoneurons on the lesioned side remained unchanged when compared to the eontralateral nucleus. furthermore, their axons remained visible up to the distal lesion site. these experiments show that, in rive, motoneurons overexpressing the bcl- protein survive after axotomy, and suggest that, in rive, bcl- protect neurons from experimentally induced cell death and could be a target for treatment of motoneurons degenerative diseases. messmer s., mattenberger l., sager y., blatter-garin m-c., pometta d., kate a., james r.w. drpt de mrdeeine, drpt. de pharmacologie, div. de neurophysiologie clinique, facult de mrdecine, gen~ve. clusterin is a widely expressed glycoprotein, highly conserved across species. numerous functions have been postulated for this protein. the most important are roles in lipid transport, as elusterin is associated with apolipoprotein ai in hdl, complement regulation and tissue remodelling, in particular during cell death and differentiation. using cultures of rat spinal cord neurones ( % neurons and - % non-neuronal cells), we have studied the expression of clusterin and ape e in glutamate-induced neuronal cell death to examine potential roles in lipid management. up-regulation of the two proteins was observed. clusterin and ape e appear in the conditioned medium respectively h and . h after incubation with glutamate. control studies, in the presence of a noncompetitive nmda receptor agonist showed the secretion of clusterin and ape e to be diminished by > %. no up-regulation of either protein was observed in complementary studies with exclusively non-neuronal cell cultures. the cellular origin of the secreted proteins is presently under investigation. programmed cell death and tissue remodelling are consequences of hormonally induced restructuring of the rat ventral prostate after castration and the rat mammary gland after weaning. we used the "differential display"-method (liang and pardee, , science : ) to detect and isolate edna fragments whose corresponding rnas are regulated either coincidentally, or in an organ specific fashion during mammary gland involution and postcastrational prostate regression. partial sequencing of clones revealed high, but not absolute homology of fragments with sequences, previously characterized in different biological contexts. these five encode functions which could be anticipated to be important for cell growth and/or programmed cell death, we are presently investigating the functions of several of these transcripts in cell culture and in rive. antisense oligos are being employed in vivo to determine whether these genes contribute to the phenotype of programmed cell death. b epitopes derived from the envelope gp glycoprotein (ep ) or from the viral superantigen of mmtv have been incorporated into inert or live vaccines. the inert vaccine consists of purified chimeric proteins which contain the b epitopes alone or fused to multimeric promiscuous t helper epitopes from tetanus toxin. mice were immunized subcutaneously with these chimeric proteins. the live vaccine consists of an avirulent strain of salmonella typhimurium which expresses the mmtv epitopes in the form of chimeric proteins fused to the nucleocapsid protein of hepatitis b virus. this vaccine is given to mice in one oral dose. the level, duration and isotype of the immune response generated by each vaccine have been measured and compared. the level of protection has been investigated by systemically challenging immunized mice with the relzovims. a reduced binding of oxytocin (ot) occurs with aging in some, but not all, areas of the rat brain (arsenijevic et al., experientia , , a ) . the candate putamen showed the most impressive loss of ot receptors. two other regions, the hypothalamic ventromedial nucleus (vmh) and the islands of caueja (icj) had also an important deficit of ot binding sites. on the other hand, these two regions were known to be sensitive to sex steroids. in the present work, we treated from month old rats during one month with testosterone propionate ( #g/kg s.c., once every days) dissolved in oil. three rats of the same age injected with oil only served as controls. we labelled ot receptors throughout the brain of old rats using a i-labelled ligand specific for ot receptors. analysis of autoradiograms by an image analyzer revealed that the testosterone treatment increased ot binding sites in the vmh, in the icj, and, to a lesser extent, in the bed nucleus of the stria terminalis, a region also sensitive to sex steroids, by contrast, in the caudate putamen, the disappearance of ot receptors was not compensated. in conclusion, the decrease of ot receptors occurring in vmh and icj with aging can be reversed by administration of gonadal steroids. in contrast, the loss of ot receptors in the striatum appears to depend on another mecanism. vasopressin (avp) receptors are expressed transiently in the facial nucleus during development (tribollet et el., , dev. brain res., , - ) . avp may therefore play a role in the maturation of neuromuscular connexions in the neonate rat, and possibly in the restanration of these connexions after nerve lesion in the adult. in order to investigate the latter proposition, we have sectionned the facial nerve in adult rats and used quantitative autoradiography to look at avp binding sites in the facial nucleus at various postoperative times. we observed a massive and transient increase of avp binding sites on the operated side. the number of facial avp binding sites reaches a maximum about one week after nerve section, remains stable during - weeks, then begin to decrease towards control level. the induction of avp receptors is markedly delayed if the proximal stump of the nerve is ligated. to assess whether other motor nuclei would also react to axotomy by up-regulating the expression of avp receptors, we have sectionned the hypoglossal nerve and the sciatic nerve. in both cases, the binding of avp receptor ligand increases massively in the respective motor nuclei, with a time-course similar to that found in the facial nucleus. altogether, our data suggest that central avp could be involved in the process of nerve regeneration. cytotoxic t-cell mediated apoptosis schaerer,e, karapetian,o.,adrian,m. and tschopp,j. inst.de biochimie, univ.de lausanne, epalinges. an apoptotic cell death mechanism is used by cytolytic t cells (ctl) to lyse appropriate target cells. ctl harbor cytoplasmic storage compartments, containing the lytic protein perforin and serineproteases (granzymes), whose content is released upon target cell interaction. we show that these granules are multivesieular bodies and that degranulation releases these intragranular vesicles (igv) having granzymes, t-cell receptor and yet undefined proteins associated. isolated igvs and perforin induce dna breakdown in target cells within minutes. microscopic analysis demonstrates that igv specifically interact with target cell via the t-cell receptor and that their contents is taken up by the target cell. already min. after interaction, distinct igv proteins are found in the nucleus of the target cell.one of the molecules has been identified to be granzyme a, previously reported to be involved in apoptosis. we propose that lymphocytes transfer apoptosisinducing proteins to the nucleus of the target cells using vesicles as vehicles for delivery. cytotoxic t cells kill their targets by a mechanism involving membranolysis and dna degradation (apoptosis). recently, two sets of proteins have been proposed as dna breakdown-inducing molecules in t cells: granzyme a, b and tia-i. in this study, we cloned and further characterized the tia-i mouse homologue. aa sequence comparison with the human tia- showed an overall identity of %. devoid of a signal peptide, tia is yet localized to cytotoxic granules, probably targeted via a gly-tyr-motif. as tia-i, its mouse homolcgue contains three rnabinding domains. expression of tia during development shows a very strong signal in the brain and weaker signals in thymus, heart and other organs. during embryonic development several structures that contribute to organogenesis form transiently and are later eliminated by apoptosis. this pattern of tia expression could indicate its involvement in apoptosis. prostate involution occurs after castration in rats and is associated with the death by apoptosis of a large fraction of the epithelial cells. we have isolated several genes from a prostate involution bacteriophage lambda library using differential screening methods. among these clones, one d~monstrated an especially strong signal when used as a probe against northern blots of prostate mlhna obtained before, and at different times after castration. this gene is down-regulated after castration by -fold within days. intramuscular injection of a testosterone depot resulted in complete restoration of expression within hours. upon sequencing it became apparent that this clone has a high degree of homology to a known ndah dehydrogenase encoded in mitochondrial dna. the clone failed to hybridize to any transcripts from rat organs other than prostate. we are now in the process of isolating the htm~n hc~olog to this gene for use as a biomarker in study of benign hyperplasia and developing carcinoma. this gene is a possible indicator for testosterone-independent cell populations or of cells lacking ftl~ctional testosterone receptor. during the first three postnatal weeks the rat lung undergoes the last two developmental stages, the phase of alveolarization and the phase of microvascular maturation. the latter involves a decrease of the connective tissue mass in the alveolar septa and a merging of the two capillary layers to a single one. speculating that programmed cell death may play a role during this remodeling, we searched for the presence of apoptotie cells in rat lungs between days and . lung paraffin sections were treated with y-terminal transferase, digoxigenin-dutp, and anti-digoxigeninfluorescein-f(ab)-fragments, and the number of fluorescent nuclei was compared between sections at different days. while the number of apoptotie ceils was low until the end of the second week and at day , we observed an about eight fold increase of fluorescent nuclei towards the end of the third week. we conclude that programmed cell death is involved in the structural maturation of the lung. brunner, a., wallrapp, ch., pollack, i, twardzik, t. and schneuwly, s. lehrstuhl genetik, biozentrum universit~t w~rzburg, mutants in the giant lens (g/l) gene show a strong disturbance in ommatidial development. in the absence of any gene product, additional phetoreceptors, cone cells and pigment cells develop. opposite effects can be seen in flies in which the gene product of the giant lens gene can be ectopically expressed by heat shock. a second very typical phenotype is the disturbance of photoreceptor axon guidance. molecular analysis of gil shows that it encodes a secreted protein of aa containing three evolutionary conserved cystein-motives very similar to egf-like repeats. we propose that gil functions as a secreted signal, most likely a lateral inhibitor for the development of specific cell fates and that gil, either directly or indirectly, is involved in targeting photoreceptor axons into the brain. the decrease in cellularity during scar establishment is mediated through apoptosis desmouliere, a., redard, m., darby, i., and g. gabbiani department of pathology, cmu, rue michel server, gen~ve dudng the healing of an open wound, granulation tissue formation is characterized by replication and accumulation of fibroblastic cells, many of which acquire morphological and biochemical features of smooth muscle cells and have been named myofibroblasts (sch rch et el., histology for pathologists, t ). as the wound evolves into a scar, there is an important decrease in ceuuladty, including disappearance of myofibroblasts. the question adses as to which process is responsible for myofibroblast disappearance. during a previous investigation on the expression of (z-smooth muscle actin in myofibroblasts, we have obsewed that in late phases of wound healing, many of myofibroblasts show signs of apoptosis end suggested that this type of cell death is responsible for the disappearance of myofibroblasts (darby et al., lab. invest. : , ) . we have tested this hypothesis by means of electron microscopy and morphometry and by in situ end-labeling of fragmented dna (wijsman et al., j. histochem. cytochem. : , t ) . our results show that the number of apoptotic cells increases as the wound closes and suggest that this may be the mechanism for the disappearance of myofibroblasts as well as for the evolution of granulation tissue into a scar. (supported by the swiss national science foundation, grant n~ s - r. jaggl, a. marti and b. jehn. universit~t bern, akef, tiefenaustr. , bern at weaning the mammary gland undergoes a reductive remodelling process (involution) which is associated with the cessation of milk protein gene expression and apoptosis of milk-produclng epithelial cells. this process can be reversed by returning the pups to the mother within day. elevated nuclear protein kinase a (pka) activity was observed from one day post-lactation, paralleled by increased c-los, junb, ]und and to a lesser extent c-]un mrna levels. ap- dna binding activity was transiently induced and the ap- complex was shown to consist principally of cfos/jund. oct- dna binding activity and oct- protein were gradually lost from the gland over the first four days of involution, whereas oct- m_rna levels remained unchanged. comparing nuclear extracts from normal mammary glands with nuclear extracts from glands which had been cleared of all epithelial cells three weeks after birth revealed that pka activation, ap- induction and oct- inactivation are all dependent on the presence of the epithelial compartment. the increased fos/jtm expression and the inactivation of oct- may be consequences of the increased pka activity. when involution is reversed, both, pica activity and ap- dna binding activity (and fos andjun mrna levels) are reduced to basal levels. our data suggests a role for pka and ap- on progranlmed cell death of manlnmry epithelial ceils. bcl- ~ does not require membrane attachment for its survival activity c. borner*, i. martinout, c. mattmann*, m. irmler*, e. sch&rrer*, j.-c. martinou-j-, and j. tschopp*. * institute of biochemistry, university of lausanne, epalinges, institute of molecular biology, glaxo inc., plan los ouates. cl- (z is a mitochondrial or perinuclear-associated oncoprotein that prolongs the life span of a variety of cell types by interfering with programmed cell death. how it exerts this activity is unknown but it is believed that membrane attachment is required. to identify critical regions in bcl- o~ for subcellular localization and survival activity, we created by site-directed mutagenesis, various mutations in regions which are most conserved between the different bcl- species. we show here that membrane attachment is not required for the survival activity of bcl- o< a truncation mutant of bcl- (z lacking the last amino acids (t ) including the hydrophobic domain is soluble, yet fully active in blocking apoptosis of sympathetic neurons induced by ngf deprivation or l fibroblasts induced by tnfc~ treatment. we further provide evidence for a putative functional region in bcl- which lies in the conserved domains and upstream of the hydrophobic cooh terminal tail. the breakdown of nuclear dna is considered to be a hallmark of apoptosis. we previously identified the perinuclear membrane localized dnase i as the endonuclease involved in the formation of oligonucleosomal-sized fragments (dna ladder). it is not clear how the nuclease is activated and has access to the dna. we show that in thymocytes induced to undergo apoptosis, lamin breakdown preceded dna laddering. by transfeeting hela cells with a constitutively active cdc mutant, nuclear envelope breakdown and typical apoptotic features (ehromatin condensation) were observed. moreover, co-transfection with cdc mutant and dnase i led to dna degradation. we propose that apoptosis can be induced by wrongly timed and hence abortive mitosis leading to uncontrolled nuclear membrane disintegration. s - s - platelet-derived growth factor (pdgf) is thought to play an active role in fibrosing diseases. bronchiolitis obliterans-organizing pneumonia (boop) is a condition characterized by intraluminal proliferation of connective tissue inside distal air spaces. to evaluate pdgf expression in boop we performed immunohistoehemistry on lung biopsies from patients and controls free of fibrosis. sedal sections were stained with an antibody against either pdgf or the monoeyte/macrophage marker cd , in both groups the pdgf ~ cells were essentially tissue macrophages. using point counting to measure volume fraction (vv) , pdgf-pesitive cells represented . + . % (mean+sd) of the volume occupied by lung tissue in the boop cases, and , + . % in the controls (! < , ). similarily, . + . % of the lung tissue was occupied by cd e~ macrophages in the boop cases, compared to . :~ . % in the controls (p