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Antimicrobial Agents and Chemotherapy, February 2003, p. 494-500, Vol. 47, No. 2
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.2.494-500.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
-Defensin, Prevents the Entry and Intercellular Spread of Herpes Simplex Virus Type 2
Department of Pediatrics and Microbiology, Mount Sinai School of Medicine, New York, New York,1 Department of Medicine, UCLA School of Medicine, Los Angeles, California2
Received 24 June 2002/ Returned for modification 16 September 2002/ Accepted 14 November 2002
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-defensin, protects cells in vitro from infection by clinical and laboratory isolates of herpes simplex virus type 2 (HSV-2). Incubation of concentrated virus stocks for 1 h with noncytotoxic concentrations of NP-1 reduces subsequent infection by >98%. Pretreating cells with NP-1 for 1 h prior to inoculation with untreated virus also prevents infection. NP-1, a cationic peptide, does not compete with viral envelope glycoproteins for binding to cellular heparan sulfate receptors, but it prevents viral entry. No VP16, a major viral tegument protein, is transported to the cell nucleus in the presence of NP-1. Infectious center assays demonstrate that NP-1 also inhibits cell-to-cell viral spread. Thus, NP-1 prevents virally mediated fusion events, entry, and cell-to-cell spread. This unique mechanism of anti-HSV activity, coupled with established antibacterial and possible anti-human immunodeficiency virus type 1 activities of defensins, render this family of compounds excellent candidates for further development as topical microbicides. |
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Earlier approaches to topical microbicide development focused on spermicidal detergents, especially nonoxynol-9 (N-9)the most commonly used contraceptive worldwide. Although N-9 was initially considered safe, it is highly cytotoxic to primary human cervical or vaginal epithelial cells in vitro (13) and in vivo (5). In a recently completed clinical trial, women who used N-9 gel became infected with human immunodeficiency virus (HIV) at a 50% higher rate than women who used a placebo gel, and they had a significantly higher incidence of inflammatory lesions than the placebo group (5). This experience highlights the need for novel candidate topical microbicides and for their rigorous preclinical evaluation.
Defensins are endogenous, cysteine-rich, 3- to 4-kDa cationic peptides that exert antimicrobial activity through membrane permeabilization (11, 42, 43). Three subfamilies of defensins exist among mammals. In humans,
-defensins are found in neutrophils (19), T and B lymphocytes (1), Paneth cells of the small intestine (24), and portions of the female genital tract (29). In rabbits, but not in humans,
-defensins are also prominent in pulmonary alveolar macrophages (10).
ß-Defensins are produced by many, if not all, human epithelial cells, and their expression can be constitutive, induced, or both. At least four different ß-defensins are expressed by humans (18), and numerous additional ß-defensin genes were recently identified in the human genome (32). Circular minidefensins constitute the third mammalian defensin subfamily and were first delineated in the leukocytes and bone marrow of rhesus monkeys (20, 38, 40). These minidefensins are cyclic octadecapeptides with three intramolecular cysteine disulfide bonds, and they can protect cells in vitro from infection by HIV type 1 (HIV-1) (7).
Although certain human and rabbit
-defensins (8, 17) have been shown to inactivate herpes simplex virus (HSV) and other enveloped viruses, their mechanism of antiviral activity is unknown. Possibly, the insertion of defensins into the viral lipid envelope interferes with its function in ways analogous to their effects on bacterial cell membranes. Defensins may also play a role in the degradation and inactivation of phagocytosed virions (41). Recent studies suggest that human
-defensins contribute to the anti-HIV-1 activity found in CD8 cytotoxic T-lymphocyte supernatants (44).
Genital herpes is the most common cause of genital ulceration in the developed world. Seroepidemiologic studies suggest that one of five persons aged 12 or above nationwide has already been infected with HSV type 2 (HSV-2) (9), and an estimated 500,000 new cases of herpes occur in the United States each year (9, 35). Although both HSV-1 and HSV-2 can cause genital herpes, HSV-2 predominates and causes intermittent lifelong recurrences.
NP-1 is a prototypic rabbit
-defensin that is abundant in rabbit granulocytes (polymorphonuclear [PMN] cells) and rabbit alveolar macrophages. NP-1 was initially purified from rabbit alveolar macrophages (25, 34), and it was first called MCP-1 (macrophage cationic peptide-1). Later sequencing proved that NP-1 from rabbit PMNs (33) and MCP-1 were identical. These studies were undertaken to explore the mechanism of NP-1's activity against HSV-2.
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Vero (monkey kidney epithelial) and CaSki (human cervical epithelial) cells were obtained from the American Type Culture Collection and grown as previously described (14, 16). Three viral strains were laboratory-adapted isolates: HSV-1(17), HSV-2(333), and HSV-2(G). The MMA and MTWTA strains were clinical isolates from STD clinic patients and have been partially sequenced (39). The DT-1 (acyclovir-susceptible) and DT-2 (acyclovir-resistant) strains were isolated from a neonate (23).
Antiviral activity of NP-1.
NP-1 (10 to 100 µg/ml) or its peptide-free vehicle was incubated with concentrated stocks of HSV-2 (
108 PFU/ml) for 1 h at 37°C. The mixtures were then diluted
10,000-fold to yield noninhibitory peptide levels (
0.01 µg/ml), and duplicate aliquots containing 100 to 500 PFU/well were inoculated onto Vero cell monolayers. Alternatively, cells that had been preincubated with 25 µg of NP-1/ml or vehicle for 1 h at 37°C were either washed extensively or left alone prior to inoculating them with virus. Plaques were quantified 48 h postinfection.
Time course assays.
Confluent monolayers of cells were cooled to 4°C and inoculated with
200 to 1,000 PFU of virus/well at 4°C for 3 h. After unbound virus was removed by washing the cells three times, the cultures were temperature shifted to 37°C for 1 h to permit penetration. After inactivating any nonpenetrant viruses by washing the monolayer with a citrate buffer, pH 3.0 (12, 31), fresh medium was added and plaques were counted 48 h postinfection. As further described below, NP-1 or its vehicle was added (i) during the 4°C binding period (t = 0 h); (ii) when cells were shifted to 37°C (t = 3 h); or (iii) at select times post-citrate treatment to determine whether the compound inhibited infection if present during these time windows. Additionally, to determine if the drug could remove bound virus after the 4°C adsorption period, in some experiments the cells were washed thrice with 25 µg of NP-1/ml (5 min, 5 min, and 1 h) before being temperature shifted.
Binding studies. To determine if NP-1 inhibited binding of the viral envelope or the envelope glycoprotein B (gB-2) to cells, binding studies with purified HSV-2 or recombinant gB-2 were conducted as previously described (6). CaSki cells were exposed to serial dilutions of purified HSV-2 for 5 h at 4°C or to recombinant gB-2 for 1 h at 37°C in the absence or presence of NP-1 or heparin as a control. After the binding period, unbound virus or gB-2 and the peptide were removed by washing the cells extensively. Cell-bound virus or glycoprotein was analyzed by Western blotting of cell lysates with anti-gD or anti-gB monoclonal antibodies (Abs), respectively (antibody 1103 for virus and antibody 1123 for recombinant gB; Goodwin Institute Plantation). Blots were subsequently incubated with horseradish peroxidase-conjugated goat anti-mouse immunoglobulin G (IgG) and developed using the ECL kit (DuPont, Boston, Mass.) as previously described (28). Western blots were scanned and analyzed using the GELDOC 2000 Bio-Rad system linked to an IBM PC, and the relative number of viral particles or quantity of gB-2 was determined.
VP16 indirect immunofluorescence.
The ability of VP16, a viral tegument protein, to translocate to the host cell nucleus was examined as described previously (27). Concentrated stocks of virus (
109 PFU/ml) were preincubated with 25 µg of NP-1/ml, 0.1% acetic acid, or 100 µg of acyclovir/ml for 1 h at 37°C. The mixture was diluted and used to infect Vero cells on glass coverslips at a multiplicity of infection (MOI) of 100 PFU/cell. Four hours postinfection, cells were washed, fixed in 0.5% paraformaldehyde, and permeabilized with 100% acetone. The cells were blocked overnight with 10% goat serum and 1% bovine serum albumin in PBS, then incubated with a 1:50 dilution of anti-HSV monoclonal Ab (mouse anti-VP16; Santa Cruz Biotechnology), washed extensively, and subsequently incubated with a 1:500 dilution of a goat anti-mouse Ab conjugated to fluorescein isothiocyanate (FITC; Calbiochem). Cells were preserved overnight in a 0.1% solution of Mowoil (Sigma) with 2.5% 1,4-diazabicyclo-octane (Sigma) as an antibleaching agent and sealed under a coverslip with nail polish. Cells were visualized under a Zeiss Axioskop fluorescence microscope.
Infectious center assay.
Infectious center assays were performed as previously described (12, 30). Briefly, Vero cells (donor cells) were exposed to virus at 37°C to allow entry (MOI of 3 to 5 PFU/cell). Cells were washed with citrate buffer (pH 3.0) to inactivate residual extracellular virus 1 to 2 h after infection. Then, 4 to 5 h after infection, the infected cells were detached with trypsin-EDTA and counted, and
100 cells were plated onto duplicate monolayers of uninfected cells in medium containing pooled human IgG (Sigma) in the presence of NP-1 or control buffer. The pooled human immunoglobulin neutralizes infection by virus released into the medium. Plaques were quantified after 48 h by using a black plaque immunoassay (15).
Cytotoxicity assays. The cytotoxic effects of NP-1 compared with that of N-9 on Vero or CaSki cells were determined by quantifying cell viability using an MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] assay (Cell Titer 96; Promega). Cytotoxicity was examined following 1, 4, 8.5, or 20 h of exposure (acute) or a 2-h daily exposure for 7 consecutive days (chronic) to serial dilutions of NP-1, N-9, or 0.1% acetic acid buffer.
Statistical analysis. The data presented are means with standard deviations. Differences between groups were compared by using the Mann-Whitney test, as indicated below in the figure legends.
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FIG. 1. Direct inactivation of virus by NP-1. Laboratory and clinical isolates of HSV (at a concentration of 108 PFU/ml) were mixed with increasing concentrations of NP-1 (or 0.1% acetic acid diluted in PBS for control) and incubated at 37°C for 1 h. The virus-drug mixture was then diluted to yield 100 to 500 PFU/ml and noninhibitory concentrations of drug prior to infecting cells. Plaques were quantified 48 h postinfection. Results are presented as PFU formed in the presence of NP-1 as a percentage of PFU formed in the presence of control buffer. Each point is the mean of two independent experiments performed in duplicate; error bars indicate standard deviations. Isolates include the laboratory strains HSV-1(17) and HSV-2(333) and the clinical isolates WTW1A, MMA, DT-1 (acyclovir susceptible), and DT-2 (acyclovir resistant).
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90% of viral infection when added at t = 0 h. An antiviral effect persisted, albeit reduced, if the peptide was added at the time of temperature shift or even 1 h postentry. At later time points (3 and 7 h post-citrate treatment), there was no reduction in viral plaque numbers but there was a marked diminution in plaque size, suggesting that the peptide might be preventing cell-to-cell spread (data not shown).
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FIG. 2. Antiviral activity of NP-1 added at different times during viral infection. Cells were cooled to 4°C and inoculated with HSV-2(G) in the presence of control buffer or NP-1 added at different times as described in Materials and Methods. Shown are the means of two experiments, each performed in triplicate; error bars indicate standard deviations. Results are presented as PFU formed in the presence of NP-1 as a percentage of PFU formed in control wells. At each time point, the effects of NP-1 were compared to those of control medium by using the Mann-Whitney test; asterisks indicate a significant reduction in viral infection (P < 0.004).
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Effect of NP-1 on binding. We speculated that NP-1 might prevent HSV-2 infection by competing with gB-2 for its heparan sulfate receptor sites on the cell plasma membrane. gB-2 plays the key role in mediating binding of HSV-2 to cells and is also required for viral entry (6). To assess this possibility, we examined the effects of NP-1 on viral and recombinant gB-2 binding to cells. NP-1 failed to inhibit the binding of virus or gB-2 to CaSki cells, whereas heparin completely abolished viral and glycoprotein binding (Fig. 3). Thus, NP-1 does not competitively inhibit viral binding.
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FIG. 3. Effects of NP-1 and heparin on binding of HSV-2 or recombinant gB-2 to cells. (a) Cells were exposed to twofold dilutions of purified HSV-2(G) (equivalent to an MOI of 1, 0.5, 0.25, 0.12, 0.06, and 0.03 PFU/cell; lanes 1 to 6, respectively) for 5 h at 4°C in the absence (upper gel) or presence of 25 µg of NP-1/ml (middle gel) or 100 µg of heparin/ml (lower gel). After washing away unbound virus, cell lysates were prepared and separated by SDS-PAGE, and cell-bound virus was visualized by Western blotting with anti-gD monoclonal Ab. The gels are representative of at least two independent experiments. (b) The relative particle numbers of viral input and bound virus were quantified by densitometry scanning of the Western blots of equal portions of input and bound virus. (c) Alternatively, cells were exposed to recombinant gB-2 (10-5 µg/cell) for 1 h at 37°C in the absence or presence of the indicated concentrations of heparin or 100 µg of NP-1/ml, and the bound gB-2 was compared by Western blotting of cell lysates probed with anti-gB monoclonal Ab.
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FIG. 4. Effect of NP-1 or acyclovir on VP-16 translocation to the host cell nucleus. Cells were mock infected (a) or inoculated with HSV-2(G) that had been preincubated for 1 h at 37°C with 0.1% acetic acid (b), 25 µg of NP-1/ml (c), or 100 µg of acyclovir/ml (d). After 4 h at 37°C, cells were fixed, permeabilized, and incubated with mouse monoclonal anti-VP16 Ab, followed by incubation with goat anti-mouse IgG conjugated to FITC. Cells were visualized using a Zeiss Axioskop fluorescence microscope. The number of cells expressing VP16 in the nucleus as a percentage of the total cells visualized per high-power field were counted in four to eight fields per experiment. The graph depicts the mean ± standard deviation obtained from three to four independent experiments; the asterisk indicates a significant reduction in VP16 translocation, by the Mann-Whitney test (P < 0.0001).
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100 infected cells in the presence of pooled immunoglobulin. Under these experimental conditions, HSV spreads presumably via intercellular junctions created by local fusion events between the plasma membrane of infected and neighboring uninfected cells, but released virus is neutralized by the IgG. The number and size of plaques formed in the presence of NP-1 or control buffer were compared. NP-1 reduced the number of plaques by 59.0% ± 16.6% compared to control acetic acid buffer. Moreover, infectious centers formed in the presence of NP-1 were significantly smaller than control infectious centers (Fig. 5). These results suggest that NP-1 prevents cell-to-cell spread of virus and would be effective at inhibiting transmission of cell-associated HSV.
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FIG. 5. Effect of NP-1 on cell-to-cell spread. Vero cells were infected with HSV-2(333) at 37°C to allow viral entry and treated with citrate buffer 2 h after infection to inactivate residual extracellular virus. Five hours after infection, cells were trypsinized, counted, and plated onto monolayers of uninfected cells in the presence of pooled human immunoglobulin to neutralize released virus and 0.1% acetic acid (left) or 25 µg of NP-1/ml (right). After 48 h plaques were visualized by immunostaining.
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FIG. 6. Cells were incubated for increasing lengths of time in the presence of the indicated concentrations of NP-1. Results are presented as cell viability in the presence of drug as a percentage of cell viability in the absence of compound and are means ± standard deviations of two independent experiments performed in triplicate. To assess cytotoxicity following chronic exposure to NP-1 or N-9, cells were exposed to 25- or 100-µg/ml concentrations of each (or the equivalent amount of acetic acid buffer) for 2 h each day for 7 consecutive days. Results are presented as cell viability in the presence of drug as a percentage of cell viability in the presence of medium and are means ± standard deviations of quadruplicates. Asterisks indicate a P value of <0.05 (Mann-Whitney).
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-defensin used in these studies, rabbit NP-1, is active against T. pallidum, but not against N. gonorrhoeae (4). Although the activity of rabbit NP-1 against HIV-1 has not been described, a recent study demonstrated that human
-defensins 1, 2, and 3 have anti-HIV activity and may be a component of CD8 antiviral factor, the anti-HIV activity secreted by CD8 T cells from HIV-infected long-term nonprogressors (44). In addition, certain circular (
) minidefensins afford substantial protection to human cells challenged by M- and T-tropic HIV-1 strains in vitro (7). Results obtained in these studies show that NP-1 inactivates HSV and prevents viral entry and cell-to-cell spread. NP-1 does not prevent viral binding but, rather, blocks fusion events important in HSV acquisition and transmission. NP-1 prevents entry of cell-free virus, as evidenced by inhibition of VP16 translocation to the cell nucleus, and prevents cell-to-cell spread, as evidenced by a reduction in plaque size when NP-1 was present in the culture medium postentry and in infectious center assays. Inhibition of cell-to-cell spread is important for topical microbicide development because a source of sexual acquisition also may be cell-associated virus. Following infection of a cell, HSV spreads to neighboring cells via intercellular junctions created by local fusion events between the plasma membranes of infected and uninfected cells. Presumably, NP-1 prevents these fusion events by targeting the membrane of the infected and/or uninfected cell.
The observation that NP-1 inhibits viral entry independent of any effects on viral attachment makes this peptide distinct from most other compounds in development as topical microbicides. Most candidate microbicides are detergents, surfactants, or polyanionic compounds (2, 12, 15, 26). Among the candidate agents presently being evaluated are the detergents SDS and C31G and the sulfated polymers dextran sulfate, carageenan, polystyrene sulfonate, cellulose sulfate, and PRO 2000 (a naphthalene sulfonate polymer). Preliminary studies suggest that these sulfated (or sulfonated) polymers competitively inhibit binding of HSV to cell surface heparan sulfate (12).
The observation that a peptide produced by neutrophils might exhibit antiviral activity is consistent with observations suggesting that neutrophils play an important role in the initial response to genital herpes. Studies in mice have shown that large numbers of PMN cells infiltrate the vaginal mucosa within 24 h following vaginal HSV-2 infection (21, 22). Neutrophil depletion of the mice prior to vaginal inoculation resulted in significantly enhanced local viral replication, suggesting that PMNs play a key role in HSV clearance. The exact mechanism by which neutrophils help clear HSV is unknown; however, murine neutrophils completely lack
-defensins. Consequently, the beneficial effects of neutrophils observed in this murine model are more likely attributable to phagocytosis of free virus or virus-infected cells, release of antiviral cytokines, antibody-dependent cell-mediated cytotoxicity, and/or as-yet-unidentified factors.
A potential role of defensins in the host response to vaginal viral infection is suggested by the recent finding that human ß-defensin-1 (HBD-1) is especially prominent within the female reproductive tract. In situ hybridization localized the HBD-1 mRNA to the epithelial layers of the vagina, ectocervix, endocervix, uterus, and fallopian tubes (36, 37). Moreover, the
-defensin HD-5 has also been identified in the upper genital tract of women.
The results obtained warrant further exploration of endogenous host defense peptides as candidate microbicides. Because these peptides generally have a rapid onset of action and exhibit little or no cytotoxicity at therapeutic concentrations, they have potential for topical vaginal and rectal application. The unique mechanism of anti-HSV activity of NP-1 also suggests that it may be useful alone, or in combination with other candidate agents, in the development of multitargeted combination therapies to prevent STIs.
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