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Clinical and Vaccine Immunology, February 2007, p. 173-181, Vol. 14, No. 2
1071-412X/07/$08.00+0 doi:10.1128/CVI.00347-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Institute for Animal Experimentation, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan,1 National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand,2 Hokkaido University Research Center for Zoonosis Control, Sapporo 060-0818, Japan,3 National Institute of Health Research and Development, Jakarta, Indonesia,4 Laboratory of Experimental Animal Science, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo 060-0818, Japan,5 Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii 968136
Received 19 September 2006/ Returned for modification 30 October 2006/ Accepted 29 November 2006
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Each hantavirus appears to have coevolved with a specific rodent species, in which it maintains an enzootic cycle. As the only known presumed exception, Thottapalayam virus (TPMV) was isolated from an insectivore, Suncus murinus (musk shrew) captured in southern India in 1964 (3). Either very low or no antigenic cross-reactivity has been observed between TPMV and other hantaviruses (4, 5). And as evidenced by nucleotide and amino acid sequence analyses of the full-length S segment, TPMV is the most genetically divergent of all other hantaviruses (6, 17). Analyses of the recently acquired full-length M and L segments of TPMV are congruent (J.-W. Song and R. Yanagihara, unpublished observations). However, since detailed epizootiological and epidemiological surveys of TPMV infection have not been conducted, the fundamental biology of TPMV, including its true natural host and pathogenicity to humans, is unclear.
Previously, we have developed enzyme immunoassays using baculovirus-expressed recombinant N (rN) antigens of various hantaviruses (including HTNV, SEOV, PUUV, and DOBV) for the serological diagnosis of hantavirus infections (1, 7, 8, 18). With this method, the monoclonal antibody (MAb) clone E5/G6 is utilized as an effective capture antibody, since it binds to a linear epitope of the N protein among all hantaviruses (11, 18). Thus, after determining the antigenic profile of TPMV, we developed a robust serological assay to diagnose TPMV infections in animals and humans, using the TPMV rN antigen manipulated to contain specific amino acid substitutions to allow binding with MAb E5/G6. Using this assay, we detected anti-TPMV antibodies in a human with febrile illness and in two musk shrews. These results indicate that TPMV is carried by musk shrews in nature and is capable of causing infections in humans.
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MAbs and immune sera. Monoclonal antibodies (MAbs) and immune rabbit sera for N of HTNV and SEOV and MAbs to Gn and Gc of HTNV, as described previously, were used (2, 18). Immune rabbit serum for PUUV N was kindly provided by Hiroaki Kariwa of the Graduate School of Veterinary Medicine, Hokkaido University. Immune rabbit serum to TPMV N was prepared by intradermal injections of an 11-week-old Std:JW/CSK rabbit (specific-pathogen-free rabbit; SLC, Shizuoka, Japan) with 350 µg of TPMV rN expressed in Escherichia coli and 500 µg of Freund's complete adjuvant. A booster immunization of the same antigen with Freund's incomplete adjuvant was administered at 24 days, and blood was collected at 58 days. Immune mouse sera to TPMV were obtained 4 weeks following intraperitoneal inoculation of BALB/c mice (CLEA Japan, Osaka, Japan) with 2.0 x 103 focus-forming units of native TPMV (indirect immunofluorescence antibody [IFA] titer against TPMV was 1:12,800). Finally, sera were obtained from shrews (CLEA Japan) inoculated subcutaneously with 5.2 x 104 focus-forming units of native TPMV at 40 days postinoculation.
Human patient and wild shrew sera. Of the 478 human sera available for testing, 284 were collected between 2003 and 2004 from patients in Surin Province who had leptospirosis-like symptoms but who were serologically negative for both Leptospira and dengue virus. The other 194 sera were collected from patients with febrile illnesses of unknown etiology as part of the Emerging and Re-emerging Infectious Diseases collaborative project, conducted by the Thai National Institute of Health and the Japan International Cooperation Agency in Nongkhai Province in 2005. In addition, sera were collected from 14 wild shrews (Suncus murinus) captured in Thousand Islands, Indonesia, in July and October 2005.
Preparation of recombinant TPMV N antigen. Culture supernatant of TPMV-infected Vero E6 cells was ultracentrifuged (265,000 x g, 4 h, 4°C), and RNA was isolated from the viral pellet and dissolved with Isogen (Invitrogen) following the manufacturer's instructions. Reverse transcription-PCR was performed using the KOD-plus system (Toyobo, Tokyo, Japan) to amplify the entire TPMV N-coding S segment with primers 5'-TTCAG AATTC GATGA CTCAA GGGAA AATGA CTCCC GAAGA-3' and 5'-TATCC TCGAG TTACA GTTTA ATAGG CTCCT GACTT GAAAT C-3' (the EcoRI and XhoI sites are shown in italics). After amplification, the DNA fractions were subcloned into the pET-43b(+) vector using restriction enzymes that recognized the restriction sites added by PCR and transformed into E. coli strain Origami (Invitrogen). A single colony was inoculated into Circle growth medium (BIO101 systems, Carlsbad, CA) containing tetracycline, kanamycin, and ampicillin for small-scale culture incubation at 37°C overnight. The culture fluid was then centrifuged, the collected cells were inoculated into 100 ml of fresh medium, and isopropyl-ß-D-thiogalactopyranoside induction was performed according to the procedure for pET system expression. The cultured cells were collected by centrifugation, resuspended in 5 ml of 0.5 M NaCl binding buffer (0.5 M NaCl, 20 mM imidazole, 20 mM potassium phosphate), and sonicated four times for 15 s each on ice. Thereafter, the fusion protein was purified using a His trap column (Amersham Biosciences, Piscataway, NJ) according to the manufacturer's instructions.
IFA test. An IFA test was performed using previously described procedures (18). Acetone-fixed smears of Vero E6 cells infected with hantavirus or High Five cells infected with recombinant baculovirus were used as antigens. Alexa Fluor 488 goat anti-mouse immunoglobulin G (IgG) (heavy plus light chains) antibody (1:2,000; Molecular Probes, Eugene, OR) was used as a secondary antibody to MAbs. For rabbit and human sera, fluorescein isothiocyanate-conjugated protein A (1:2,000; Sigma, St. Louis, MO) was used. IFA titers were expressed as the reciprocal of the highest serum dilution that produced characteristic intracytoplasmic fluorescence.
Peptide synthesis and antigenic analysis. Peptides were synthesized and analyzed by previously published methods (11). Briefly, using an Autospot ASP222 peptide synthesizer (ABiMED, Langenfeld, Germany), a variety of 10-mer peptides were spotted on a membrane. The spotting membrane was blocked in Block Ace (Yukijirushi Co., Tokyo, Japan) for 30 min at room temperature, stained with an E5/G6 hybridoma culture supernatant for 60 min, and detected using horseradish peroxidase (HRP)-conjugated anti-mouse IgG antibody (1:500; Zymed, South San Francisco, CA) and 3-amino-9-ethylcarbazole (Sigma).
Construction of recombinant baculovirus expressing TPMV N with an E5/G6 epitope. The subcloned DNA fragment was excised from pET-43(+), described above, by digestion with the same enzyme and inserted in the donor plasmid pFAST-BAC1 (Gibco). Based on the results of the E5/G6 epitope analysis of TPMV N, amino acid-altering nucleotide mutations required for E5/G6 binding were added, using the GeneTailor site-directed mutagenesis system (Invitrogen). TPMV wild-type rN (rN/wt) and TPMV rN with the E5/G6 epitope (rN/E5G6) were expressed using the Bac-to-Bac baculovirus expression system according to the manufacturer's instructions (Gibco). These baculoviruses were inoculated into High Five cells to acquire the rN antigen, using previously described methods (1).
Western blotting analysis. Western blotting was performed using previously published methods (19). The infected High Five and Vero E6 cells were separated using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to a nitrocellulose membrane (ATTO, Tokyo, Japan). Immune rabbit serum to hantavirus N was used to detect antigen on the membrane. Binding antibodies were detected using HRP-conjugated protein A (Prozyme, San Leandro, CA), and 4-chloro-1-naphthol (Sigma) was used as the peroxidase substrate.
ELISA.
Enzyme-linked immunosorbent assays (ELISAs) using whole HTNV, PUUV, SNV, and TPMV rN were performed according to previously described methods (1, 7, 8, 18). MAb E5/G6 (2 µg/ml) was used as a capture antibody to coat 96-well plates for 60 min at 37°C. Nonspecific binding was blocked with 3% bovine serum albumin in phosphate-buffered saline (PBS). After a 60-min incubation, the plates were washed three times with PBS containing 0.05% Tween 20. Each antigen was added and incubated for 60 min at 37°C, followed by three washings. For detection of rabbit IgG, HRP-conjugated goat anti-rabbit IgG antibody (1:5,000; Jackson, Bar Harbor, ME) was used as the secondary antibody, and o-phenylenediamine (Sigma) was added as the peroxidase substrate. Absorbance at 450 nm was measured using a SpectraMax 340 microplate spectrophotometer (Molecular Devices, Sunnyvale, CA). For detection of human IgG, alkaline phosphatase-conjugated goat anti-human IgG (
-chain specific) antibody (1:2,000; Sigma) was used as the secondary antibody and p-nitrophenyl phosphate (Sigma) was added as the substrate before measuring the absorbance at 405 nm. For detection of shrew IgG, HRP-conjugated protein A (1:5,000; Prozyme) was used as the secondary antibody and o-phenylenediamine was added as the peroxidase substrate.
FRNT. Endpoint titers of neutralizing antibodies were determined by the focus reduction neutralization test (FRNT), as described elsewhere (1). Foci of virus-infected cells were detected by staining the cells with Alexa Fluor 488-labeled MAb 5B7, which recognizes the Gc of hantaviruses (10). FRNT titers were expressed as the reciprocal of the highest serum dilution leading to a greater than 80% reduction in the number of infected cell foci.
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TABLE 1. Reactivities of MAbs to TPMV and rodent-borne hantaviruses
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FIG. 1. Western blotting analysis of hantavirus antigens using polyclonal rabbit immune sera. We tested the cross-reactivity of each hantavirus, including TPMV, using sera from rabbits immunized with rN antigens expressed in E. coli. For HTNV, PUUV, and TPMV antigens, viruses were inoculated on Vero E6 cells, harvested, dissolved, and used. For SNV antigen, High Five cells expressing SNV rN by use of recombinant baculovirus were used (7). Lanes 1, molecular weight marker; lanes 2, HTNV; lanes 3, PUUV; lanes 4, SNV; lanes 5, TPMV; lanes 6, uninfected Vero E6 cells. Arrows indicate the band at 50 kDa.
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FIG. 2. A. E5/G6 epitope analysis of TPMV N. Using a variety of synthesized 10-mer peptides, we confirmed E5/G6 reactivity against TPMV sequence. Further, we determined which amino acid changes in this region were essential for E5/G6 binding. The peptide changes at positions 178 (R V), 182 (K R), 183 (Q K), and 184 (H P) were sufficient for MAb E5/G6 binding. B. Insertion of several amino acid mutations changing E5/G6 binding. C. Confirmation of the antigenicitiy of each baculovirus-infected High Five cell antigens expressed by recombinant baculoviruses. The rN antigen having the original sequence (rN/wt) reacted with immune serum but not with MAb E5/G6. On the other hand, the rN with the E5/G6 epitope (rN/E5G6) reacted with immune serum, as well as MAb E5/G6. D. Western blotting analysis using sera from rabbits immunized with E. coli-expressed rN antigens. Both rN antigens (rN/wt and rN/E5G6) were detected by a band of about 50 kDa, which corresponded to authentic TPMV N. Lane 1, rN/wt; lane 2, rN/E5G6; lane 3, TPMV-infected Vero E6 cells.
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Developing the E5/G6 capture ELISA system for TPMV. Using the TPMV rN/E5G6 antigen, we developed an IgG antibody-detecting capture ELISA system, according to methods described previously (1, 7, 8, 18). Figure 3A shows the results of an ELISA with twofold dilutions of TPMV rN/E5G6 to a constant dilution of rN-immune rabbit sera (1:200 dilution), and Fig. 3B shows the results of an ELISA with a constant amount of TPMV rN/E5G6 antigen (1:40 dilution) to serial twofold dilutions of rN-immune rabbit sera. The ELISA assay system using the TPMV rN/E5G6 antigen detected anti-TPMV antibodies with high sensitivity. Results with sera from shrews experimentally infected with TPMV also supported the sensitivity of this assay system (Fig. 3C).
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FIG. 3. A. To determine a suitable dilution of the antigen for the ELISA, we tested the reactivities of serial twofold dilutions of rN/E5G6 to a constant amount (1:200 dilution) of antibodies from TPMV rN-immune rabbit. The 1:20 to 1:40 dilution seemed to be appropriate. B. The results of ELISA using a constant amount of rN/E5G6 antigen (1:40) to twofold dilutions of the immune rabbit serum. TPMV antibodies could be detected at serum dilutions at or exceeding 1:200,000. C. Detection of antibodies against TPMV in sera from shrews experimentally infected with TPMV.
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TABLE 2. Cross-reactivities in capture ELISA among TPMV and representative disease-causing hantaviruses
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FIG. 4. Serological surveys for TPMV infection in Southeast Asia. We examined 478 sera from patients with fever in Thailand and found two sera (B-3 and B-4 from the same patient at different phases of illness) with anti-TPMV IgG antibodies. Results of the ELISA are shown in panel A. Sera B-3 and B-4 reacted with TPMV antigen. HTNV, PUUV, and HPS patient immune sera served as positive controls. In addition, we tested sera from 14 wild shrews (Suncus murinus) captured in Indonesia in 2005 (B). Serum no. 69 was positive for anti-TPMV IgG antibodies, while sera no. 2, 49, and 79 were weakly positive.
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FIG. 5. A. Results of IFA test using TPMV-infected Vero E6 cell antigens. As a positive shrew serum control, serum from a shrew experimentally infected with TPMV was used. Sera no. 49 and 69 were positive against TPMV antigen. But sera no. 2 and 79 were negative by the IFA test (data not shown). B. Western blotting analysis of TPMV-positive sera with TPMV antigen. The human positive sera B-3 and B-4 in ELISAs also reacted with TPMV-infected Vero E6 antigen by Western blotting analysis. On the other hand, for shrews, only no. 49 and 69 showed a band at 50 kDa with TPMV antigen, and sera no. 2 and 79 did not. Lanes 1 (B-3) and 2 (B-4) are human positive samples in ELISA; lane 3 (no. 2), lane 4 (no. 49), lane 5 (no. 69), and lane 6 (no. 79) are shrew positive samples in ELISA; lane 7 (no. 2 serum from a shrew experimentally infected with TPMV) is a positive control. Lane 6 (normal shrew serum) is a negative control.
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TABLE 3. FRNT with native TPMV in human and shrew seraa
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Serological survey of TPMV infection in wild shrews captured in Indonesia. Of sera collected from 14 shrews captured in Indonesia in 2005, one (no. 69) was positive for anti-TPMV IgG antibodies by ELISA. Sera from three other shrews (no. 2, 49, and 79) were weakly positive by ELISA (Fig. 4B). By contrast, in the IFA test using TPMV-infected Vero E6 cells as antigen, sera no. 49 and 69 were positive (Fig. 5A), whereas sera no. 2 and 79 were negative. Sera no. 49 and 69 were also positive by Western blotting analysis using TPMV-infected Vero E6 cell antigens (Fig. 5B). Only no. 49 was positive by FRNT (Table 3).
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To address this limitation, we first compared the antigenic profile of TPMV with those of representative hantaviruses, which segregate into three groups according to the subfamilies of their rodent reservoir hosts: that is, Murinae-, Arvicolinae- and Sigmodontinae-associated hantaviruses (13, 16). Viruses in each group have antigenic properties similar to each other's (5, 7). As determined by the IFA test using MAb and polyclonal immune sera, TPMV had the most divergent antigenic profile among hantaviruses, which conforms to data from an earlier report using the plaque reduction neutralization test (5). Moreover, immune serum, prepared by inoculating BALB/c mice with TPMV, had a high IFA titer against TPMV of 1:12,800. However, in Western blotting analysis, the mouse immune serum did not detect TPMV antigen in TPMV-infected Vero E6 cell lysates or in TPMV rN antigen prepared with E. coli, whereas other hantavirus N proteins were detected by mouse serum immunized with the respective hantavirus (data not shown). These data suggest that TPMV induces either no or very low levels of linear epitope-recognizing antibodies in mice. The antigenic difference of TPMV N from that of other hantaviruses indicated a requirement for a new ELISA system for the serological diagnosis of TPMV infection.
We have developed an E5/G6 capture ELISA system which has excellent specificity and sensitivity profiles for the diagnosis of hantavirus infection (1, 7, 8, 18). In this ELISA system, each rN antigen is captured in wells coated with MAb E5/G6. Since TPMV seemed to have no affinity to MAb E5/G6, we inserted several amino acid mutations into the region corresponding to the E5/G6 epitope of TPMV N. Because antibodies against the E5/G6 epitope are not induced in hantavirus-infected patient sera and E5/G6 does not compete with other antibodies induced by hantavirus infections (18), we expected that inserting amino acid-altering point mutations within this region would not change its antigenicity. Finally, we succeeded in developing an E5/G6 capture ELISA which can identify TPMV rN-immune rabbit sera and sera of shrews experimentally infected with TPMV with high specificity.
We previously proposed that three kinds of whole-length rN antigens of HTNV, PUUV, and SNV were required for the serological diagnosis of rodent-borne hantavirus infections (7). Now, by adding TPMV rN/E5G6, it is possible to diagnose both rodent- and insectivore-borne hantavirus infections. Using these four rN antigens, we examined 478 serum samples from patients with high fever in Thailand who were serologically negative for leptospirosis and dengue fever and found two anti-TPMV IgG antibody-positive sera from a single individual. Anti-TPMV IgG antibodies in these sera were confirmed by IFA, Western blotting, and FRNT. Because the patient came to the hospital after his condition had worsened, the relationship between his illness and TPMV infection could not be accurately determined. Thus, while this case suggests the infectivity of TPMV for humans, its pathogenicity for humans remains uncertain.
In testing sera from 14 wild shrews captured in Indonesia in 2005, one sample (no. 69) reacted strongly against TPMV, and three other samples (no. 2, 49, and 79) reacted weakly by ELISA. In the IFA test, using TPMV-infected Vero E6 cells as the antigen, two of these sera (no. 49 and 69) were positive, and this was confirmed by Western blotting analysis. However, only serum no. 49 neutralized TPMV by FRNT, suggesting the possible existence of TPMV variants or other antigenically distinct insectivore-borne hantaviruses in nature. To fully demonstrate that shrews are the natural reservoir of TPMV, it is necessary to survey additional species and detect the viral genome using RT-PCR assays in the future.
This is the first report of TPMV infection serologically confirmed with both humans and shrews. Our data indicate that TPMV can infect humans and be maintained in musk shrews as its natural host. The availability of newly developed serological assays for TPMV will facilitate future studies aimed at further elucidating the epizootiology and molecular phylogeny of insectivore-borne hantaviruses. Moreover, such studies will provide important insights about the role of TPMV and TPMV-like hantaviruses in the pathogenesis of febrile illnesses.
Published ahead of print on 20 December 2006. ![]()
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