1. Field of the Invention
The present invention relates generally to animal models for studying and treating human diseases. More specifically, the present invention provides transgenic mouse lines expressing angiotensin-converting enzyme-2 (ACE2) and their use as human coronavirus infection models for microbiological, immunological, pathological, clinical and epidemiological studies of severe acute respiratory syndrome (SARS) in man and development and testing of antivirals and vaccines for the disease, and as models for infection by other related viruses such as human NL63 virus, which utilize ACE2 for virus entry into host cells.
2. Description of the Related Art
An outbreak of severe acute respiratory syndrome (SARS), caused by the SARS-CoV (coronavirus) a highly transmissible human pathogen, occurred in the fall of 2003. Originating in Guangdong, China, the disease spread rapidly to other parts of Asia and then to the rest of the world. Following the application of intensive public health measures, the disease was successfully contained about 8 months later but not before causing ˜8000 clinical cases with a ˜10% case fatality and tremendous economic impact worldwide.
The most likely hypothesis for the emergence of SARS-CoV is that the virus from the natural reservoir, presumably the Chinese horseshoe bat, Rhinolophus sinicus, adapted to infect civets, which were permissive, and resulted in an epidemic among civets, which were sold in the southern China food markets [19,21]. The virus then spread to humans and underwent further genetic adaptation, particularly to the spike protein to become more efficiently transmissible among the human population [22,35]. It seems unlikely that this first emergence of SARS will be a unique event, because many viruses such as Ebola, Venezuelan equine encephalitis, and epidemic influenza viruses have all returned after a hiatus in transmission. Thus, the need for effective antiviral agents and vaccines would be essential should SARS reemerge in the future. Despite this, there is neither an effective antiviral therapy nor vaccine available to treat SARS.
Animal models are crucial to understanding the pathogenesis of human SARS and developing and evaluating the efficacy of antiviral drugs and vaccines. Although it is known that angiotensin-converting enzyme 2 is a functional receptor for SARS-CoV [20] and that a mouse transgenically expressing human angiotensin-converting enzyme 2 may be a useful animal model of SARS [21] there are no suitable animal models for this disease. None of the several animal models proposed can reproduce human disease including non-human primates (i.e., macaques, African green monkeys, and marmosets), ferrets, hamsters, and mice, including young and aged Balb/c, C57BL/6, and types lacking components of the immune system (i.e., Stat1- and RAG1-knockout mice) [9, 18, 23, 31, 32, 36 and 37]. These animals were shown to be susceptible to SARS-CoV infection and showed viral replication, some degree of histopathology, and, occasionally, limited clinical illness. However, none exhibited consistent clinical illness or mortality. Additionally, all suffer from some disadvantages including high cost, poor availability of reagents, and an immunological response profile to the infecting virus quite unlike that observed in the human disease.
Although the virus infected a few strains of laboratory mice, the infection was of an abortive type associated with no respiratory or systemic symptoms characteristic of SARS and no significant pathological changes in the lungs of the mice. Additionally, the infected mice exhibited no mortality. Thus, the infection of these mice did not mimic human disease. Aged mice, in keeping with elderly humans, have more pathology than do younger normal mice. However, even in the older mice, a mild weight loss has been the only clinical manifestation in response to SARS-CoV infection. Stat1-deficient mice show more pronounced changes than do normal mice, but there is no mortality and the pathological changes are not typical of those found with human SARS. The tropism of coronaviruses is determined primarily by the interaction of the spike (S) protein and the cellular receptors for the virus.
Human angiotensin-converting enzyme 2 (hACE2) has been identified as a major receptor for SARS-CoV. The spike protein of SARS-CoV has a much higher binding affinity to hACE2 than do those of mice, rats, and other animal species, which correlates with much less permissiveness of these animals to this virus [22].
Thus, prior art is deficient in an animal model for SARS that can effectively be used to study infectivity, tissue distribution of SARS-CoV, virus-associated histopathology, inflammatory responses, clinical manifestations, and to test antivirals and vaccines for the disease. The current invention fulfils this long standing need in the art.
In one embodiment of the present invention, there is provided an expression vector. Such an expression vector comprises a constitutive promoter, an intron, a polyadenylation site of rabbit β globin and a nucleotide sequence encoding a human angiotensin converting enzyme-2.
In a related embodiment of the present invention, there is provided a transgenic mouse expressing human angiotensin converting enzyme-2 (ACE-2). Such a mouse is derived using the vector described supra.
In another related embodiment of the present invention, there is provided a method of screening for an anti-coronaviral compound. Such a method comprises administering a pharmacologically effective amount of the compound to the transgenic mouse described supra followed by infecting the mouse with the coronavirus. The mouse is then monitored for development of phenotype of the disease caused by the coronavirus, where absence of the development in the presence of the compound indicates that the compound inhibits the binding of the virus to the angiotensin converting enzyme-2 or viral replication and/or maturation subsequent to viral entry, thereby screening for the anti-coronaviral compound.
In yet another related embodiment of the present invention, there is provided a method of screening for a compound that inhibits infectivity of a human coronavirus. This method comprises administering a pharmacologically effective amount of the compound to the transgenic mouse described supra. This transgenic mouse and a control mouse are infected with the human coronavirus. This is followed by comparing the incidence of disease caused by the coronavirus in the mouse subjected to the administration with the incidence of disease in the control mouse lacking the administration, where an absence or a reduced incidence of the disease in the mouse subjected to the administration indicates that the compound inhibits the infectivity of the human coronavirus.
In yet another related embodiment of the present invention, there is provided a method of screening for a vaccine candidate that prevents, or alleviates the symptoms, shortens the course, or reduces the mortality rate, of human corona virus infection.
The appended drawings have been included herein so that the above-recited features, advantages and objects of the invention will become clear and can be understood in detail. These drawings form a part of the specification. It is to be noted, however, that the appended drawings illustrate preferred embodiments of the invention and should not be considered to limit the scope of the invention.
SARS is an emerging infectious disease. The morbidity and mortality due to the disease is unparalleled in the recent history of microbiology. Its impact on a national economy is also enormous. Additionally, it inflicts tremendous damage to human psychology and the societal costs for containing the disease are exceedingly high. Thus, it is imperative to have methods of treatment and prevention of the disease in place before the next epidemic strikes. Hence, the present invention developed a transgenic mouse model for SARS that could be used for the development of antiviral therapeutics and vaccines as well as for conducting studies, which enhanced the understanding of basic science (including microbiological and immunological), clinical and epidemiological aspects of the disease.
Animal models for SARS in well-characterized species that consistently reveal signs of illness, pathological findings, and mortality are highly desirable not only for studying pathogenesis, but also for evaluating the safety and efficacy of antiviral therapeutics and vaccine candidates against SARS-CoV infection. The present invention is directed towards developing a 55 small animal model for SARS using transgenic mice expressing hACE2, the major cellular receptor for SARS-CoV [20]. Not only does this transgenic mouse model support more robust viral growth than its non-transgenic littermates, but it also manifests respiratory and generalized illness, along with tissue pathology and inflammatory cytokine responses. Most significantly, transgenic AC70 mice developed clinical illness, regardless of the route of inoculation, and died uniformly within 8 days after infection, whereas transgenic AC63 mice eventually recovered from the infection, despite the manifestations of clinical illness.
Mice transgenic for hACE2 exhibit distinct clinical courses following SARS-CoV infection which are not seen in infected wild type mice. SARS-CoV infection in the Balb/c and C57BL/6 strains appeared to be short-lived with the viral clearance occurring within 4-8 days after infection. It is noteworthy that these infected wild type strains of mouse did not elicit specific antibody response to SARS-CoV until day 21-28 after infection. Furthermore, mutant mice lacking key immune components, including RAG1−/−, CD1−/−, and bg−/− mice, were shown to clear the infections as efficiently as wild-type mice, suggesting that the classic host anti-viral immune responses might not be critical for resolving SARS-CoV infection in mouse.
Although a prolonged replication of SARS-CoV, accompanied with the onset of clinical illness, was observed in Stat1−/− mice, the patterns of the clinical manifestations appeared to be atypical, in which no evidence of acute inflammatory response in any organ could be observed. Nevertheless, the compromised ability of Stat1-deficient mice to clear virus highlights the importance of innate immunity in controlling SARS-CoV infection in the mouse [9, 12, 36]. Furthermore, as Balb/c mice one year or older of age were more susceptible than younger mice to SARS-CoV, resulting in the development of a limited and non-fatal illness, showing increased pathological changes in the respiratory tract, age is a key determinant of the susceptibility to SARS in animals as in the case for humans [3, 28, 42]. Here again, contrary to the severe and often fatal outcome of SARS in elderly patients, aged mice effectively recovered from the disease, without any mortality. Thus, the transgenic mouse model of the present invention is unique in that it provides defined end-points, including death, weight loss, and respiratory and neurological symptoms as well as virological data and pathological changes, and thus allows for the definitive analysis of the efficacy of antivirals and vaccines to SARS.
Studies of the kinetics and tissue distribution of viral replication in intranasally (i.n.) challenged AC70 mice demonstrated that the lungs are the major sites of SARS-CoV replication before dissemination to other tissues, particularly the brain (
SARS is generally recognized as an acute viral pneumonia with the lungs as its main pathological target. However, like other human and animal coronaviruses (CoV), many of which are known to establish acute and persistent infections in neural cells [1, 2, 4, 15], SARS-CoV has been detected by RT-PCR, in situ hybridization, and IHC in the brains and other extra-pulmonary tissues of patients who died of SARS [5, 10, 11, 47]. This neurotropic potential of SARS-CoV is underscored by findings in an experimental mouse model, in which infectious virus was recovered from the brains of infected C57BL/6 mice [9]. Also, several neuronal cell lines of human or rat origins as well as human glioma cell lines are permissive for SARS-CoV replication [48]. Thus, the identification of the brain as a major extra-pulmonary site of SARS-CoV infection, particularly in Tg+ mice, falls within the spectrum of coronavirus pathogenesis.
It has been well established that the spread of respiratory viruses to the brain could be mediated either directly through synaptically linked neurons of the olfactory and trigeminal systems, as described in the animals models for Venezuelan equine encephalitis virus (VEE), pseudorabies virus, and avian influenza virus A (H5N1) infection [8, 14, 25, 33], or through the hematogenous route, via the damaged blood-brain barrier. Although the exact route(s) of SARS-CoV dissemination to the CNS remains to be determined, the revelation of low-level viremia in infected (i.n.) Tg+ mice at day 2, along with the detection of high virus titers in the brains, but not in the lungs, of intraperitoneally challenged Tg+ mice might provide the basis for a hematogenous route of viral transmission.
Autopsy studies have indicated that diffuse alveolar damage (DAD) is the most characteristic pathology in SARS [6, 7, 11, 26]. While SARS-associated diffuse alveolar damage could be caused directly by viral destruction of permissive cells lining the alveoli, the marked heterogeneity of the disease course and the outcome of the infection suggest that host responses may play an important role in the pathogenesis of SARS. Specifically, elevated and prolonged expression of inflammatory mediators, such as CCL2/MIP-1, CXCL8, CXCL9, and CXCL10/IP-10, have been found in SARS patients and experimentally infected (i.n.) C57BL/6 [9, 10, 13, 42, 44, 46]. Although an early enhanced expression of IP-10 has been implicated to be an prognostic indicator for the adverse outcome of SARS-CoV infection [38], the exact protective and/or pathological nature and the spectrum of such exaggerated inflammatory responses in the lungs of SARS patients, especially during the early stages of the infection, has never been explored, as invasive procedures required for such studies were not possible during such an explosive outbreak. Therefore, the robust and highly sustainable SARS-CoV infection in the transgenic mouse model makes it unique to investigate the inflammatory responses within the local tissues, i.e., the lungs and brain.
In contrast to Tg− mice that failed to elicit significant inflammatory responses to SARS-CoV infection, infected Tg+ mice promptly released elevated levels of IL-1b, IL-12p40, CXCL1/KC, CCL5/RANTES, CCL2/MIP-1, and IL-12p70 within the lungs at days 1 and 2 p.i. (
Despite the extensive involvement in the viral infection and the subsequent inflammatory secretion of the CNS, neither necrosis nor cellular infiltrates could be observed in this vital tissue at this stage of the infection. It has been shown that primary cultures of mouse neurons, astrocytes, and microglia were capable of producing innate inflammatory cytokines in response to neurovirulent MHV-JHM infection [30]. Thus, the absence of leukocyte infiltrates in the brains of infected Tg+ mice at day 3 might suggest that the resident brain cells are the likely source of these innate inflammatory cytokines. Although the significance of these inflammatory cytokines and chemokines in the pathogenesis of SARS-CoV infection in this transgenic mouse model is currently unknown, some morphologically subtle changes in the CNS of infected Tg+ mice may underlie inflammatory cytokines and chemokines-mediated functional derangement of the CNS [29,43], which could be central to the pathogenesis of SARS-CoV infection. Preliminary studies of SARS-CoV infection with mice of the AC63 line indicated that this lineage was also permissive to infection but resistant to the fatal outcome of SARS-CoV infection (
In summary, the present invention demonstrates that transgenic mice expressing hACE2 are highly susceptible to SARS-CoV infection, resulting in a wide spectrum of clinical manifestations, including death, depending upon the transgenic lineages. Hence, these transgenic mice will be useful for studying the pathogenesis of SARS and preclinical testing of antiviral agents and vaccine candidates against SARS.
The present invention is directed to an expression vector, comprising a constitutive promoter, an intron, a polyadenylation site of rabbit β globin and a nucleotide sequence encoding a human angiotensin converting enzyme-2. Generally, the constitutive promoter drives global expression of ACE-2. Representative examples of such a promoter includes but is not limited to CAG, CMV, SV40, RSV, PGK or β-actin promoters.
Representative examples of such an expression vector include but are not limited to pCAGGS-ACE.
The present invention is also directed to a promoter which is specifically active in the lungs. Examples of such promoters include but are not limited to lung-specific promoters such as CC10 and SPC promoters and epithelium specific promoters, such as human keratin 10, keratin 14 and keratin 18 promoters.
The present invention is also directed to a transgenic mouse expressing human angiotensin converting enzyme-2 (ACE-2), where the mouse is derived using the above-described vector. Generally, the transgenic mouse with an inbred genetic background is a mouse with a C57BL/6J or a BALB/cJ background. The human ACE-2 is expressed in spleen, stomach, heart, muscle, brain, kidney, lung, liver, intestine or testis of the mouse. Representative examples of such a mouse includes but is not limited to Tg-AC12, Tg-AC22, Tg-AC50, Tg-AC63 or Tg-AC70 mouse. Generally, the Tg-AC70 mouse expresses the transgene abundantly in the lungs and the brains. In addition, the Tg-AC-63 mouse expresses lower levels of the transgene and the expression is restricted to the lungs. Additionally, AC-70 mouse is infected with human coronaviruses. Examples of the coronavirus infecting such a mouse includes but is not limited to severe acute respiratory syndrome causing coronaviral strain (SARS-CoV) or a NL63 strain. In general, such an infection elicits an acute inflammatory cytokine response. Specifically, the cytokine response comprises expression of IL-1b, IL-6, IL-12p40, IL-12p70, G-CSF, CXCL1 (KC), MIP-1α and MCP-1 in the lungs and the brain of infected transgenic mice. Additionally, the expression of the cytokines is delayed and more intense in the brain. Furthermore, the AC-70 mouse infected with the SARS-CoV exhibits the phenotype of severe acute respiratory syndrome (SARS) in humans and dies within 8 days. Additionally, a high virus titer in the lungs and brain is detected in these mice. The phenotype exhibited by such a mouse comprises gross and microscopic abnormalities in the lungs and other organs such as brain, abnormal cardiovascular and renal functions in maintaining electrolyte homeostasis, impaired reproductive functions, high mortality or a combination thereof. Further, the AC-63 mice infected with SARS CoV exhibits the phenotype of severe acute respiratory syndrome (SARS) in humans without any mortality. Specifically, virus titers are observed in the lungs but not in the brain of the infected AC-63 mice.
The present invention is further directed to a method of screening for an anti-coronaviral compound, comprising: administering a pharmacologically effective amount of the compound to the transgenic mouse described supra, infecting the transgenic mouse with the coronavirus; and monitoring the infected mouse for development of phenotype of disease caused by the coronavirus, where absence of the development in presence of the compound indicates that the compound inhibits the binding of the virus to the angiotensin converting enzyme-2, thereby screening for the anti-coronaviral compound.
Examples of the compound inhibiting the binding of the coronavirus to the angiotensin converting enzyme-2 and viral replication include but are not limited to a protease inhibitor, an interferon, a steroid receptor blocking peptide, a siRNA or a natural antiviral compound. Such a compound may be administered by any route known to a person having ordinary skill in this art, e.g., oral, intravenous, intranasal or inhalational. Examples of the coronavirus infecting such a mouse includes but is not limited to severe acute respiratory syndrome causing coronaviral strain (SARS-CoV) or a NL63 strain.
The present invention is further directed to a method of screening for a compound that inhibits infectivity of a human coronavirus, comprising: administering a pharmacologically effective amount of the compound to the transgenic mouse described supra, infecting the transgenic mouse and a control transgenic mouse with the human coronavirus, and comparing the incidence of disease caused by the human coronavirus in the mouse subjected to the administration with the incidence of disease in the control mouse lacking the administration, where an absence or a reduced incidence of the disease in the mouse subjected to the administration indicates that the compound inhibits the infectivity of the human coronavirus.
Generally, the compound inhibits the infectivity by inhibiting the binding of the human coronavirus to angiotensin converting enzyme-2, by eliciting a protective response against the human coronavirus or a combination thereof. Examples of the compound inhibiting the binding of the coronavirus to the angiotensin converting enzyme-2 includes but is not limited to a peptide that blocks receptor binding of the virus. Such a compound may be administered by any route known to a person having ordinary skill in this art, e.g., oral, intravenous, intramuscular or subcutaneous.
Additionally, the compound or reagent eliciting the protective immune response against the human coronavirus is an immunogenic compound effective as a vaccine. Examples of such a compound or reagent includes but is not limited to the one that comprises a viral antigen, a peptide, a viral-like particle, an inactivated virus, a live attenuated virus or a viral DNA. Such a compound or reagent is administered intramuscularly, intranasally or percutaneously. Additionally, parameters for the analysis of vaccine efficacy include prevention of disease, alleviation of symptoms and shortening of the disease course and reduction of mortality rate.
Generally, the human coronavirus whose infectivity is inhibited is a coronavirus that uses human angiotensin converting enzyme-2 as a receptor for entry. Examples of such coronaviruses include but is not limited to SARS-causing coronaviral strain or a NL63 strain. Additionally, the compound is administered concurrent with or prior to the infection of the mouse with the coronavirus.
The following examples are given for the purpose of illustrating various embodiments of the invention and are not meant to limit the present invention in any fashion. One skilled in the art will appreciate readily that the present invention is well adapted to carry out the objects and obtain the ends and advantages mentioned, as well as those objects, ends and advantages inherent herein. Changes therein and other uses which are encompassed within the spirit of the invention as defined by the scope of the claims will occur to those skilled in the art.
The cDNA coding for hACE2 was generated by RT-PCR amplification from a human colon carcinoma cell line, Caco2, which supported SARS-CoV replication [24]. The resulting PCR product was cloned into the pSTblue-1 cloning vector (Novagen) and the entire region corresponding to the ACE2-gene was confirmed by sequencing. The cDNA fragment containing ACE2 sequences was subsequently cloned into a eukaryotic expression vector, pCAGGS/MCS (from Dr. Yoshihiro Kawaoka, University of Wisconsin at Madison), under the control of the CAG promoter, a composite promoter consisting of the CMV-IE enhancer and the chicken β-actin promoter, and containing the rabbit globin splicing and polyadenylation site. To verify the expression of hACE2, human embryonic kidney 293 cells were transfected with the resulting plasmid construct, designated pCAGGS-ACE2 (
Transgenic mice expressing human ACE2 were generated by microinjecting the expression cassette, which was excised from pCAGGS-ACE2 by AvrII/SalI digestion and purified by agarose gel electrophoresis, into pronuclei of zygotes from the intercross of (C57BL/6J×C3H/HeJ) F1 parents. Transgenic mice were initially identified by PCR of genomic DNA with hACE2-specific primers: forward 5′-AGG ATG TGC GAG TGG CTA-3′ (SEQ ID NO. 1) and reverse 5′-AGG GCC ATC AGG ATG TCC-3′ (SEQ ID NO. 2), amplifying a transgene-specific fragment of 195 bp (data not shown). A total of five lineages, expressing different levels of hACE2 in the tail biopsies, were established. Two of the lineages, designated AC70 and AC63, respectively, were investigated with regard to the tissue distribution of hACE2 transgene expression by RT-PCR with the same hACE2-specific primers as above, followed by agarose gel analysis of PCR products.
The Urbani strain of SARS-CoV at the Vero 2nd passage level, provided to us by Dr. T. G. Ksiazek, Centers for Disease Control and Prevention (Atlanta, Ga.), was used. Vero E6 cells (American Type Culture Collection) were used to grow virus stocks and as indicator cells for the virus infectivity assay. Stocks of SARS-CoV were prepared by passaging them twice in Vero E6 cells at a low MOI (0.001), generating cell-free viral stocks with titers expressed as a 50% tissue culture infectious dose (TCID50)/ml sample (typically, 1×108 TCID5O/ml), aliquoted and stored at −80° C. All experiments involving infectious virus were conducted at the University of Texas Medical Branch (Galveston, Tex.) in approved biosafety level 3 laboratories and animal facilities, with routine medical monitoring of staff.
All animal experiments were carried out in accordance with animal protocols approved by the IACUC committee at UTMB. Mice used in this study were backcrossed 2-3 times onto either C57BL/6 or Balb/c background. No difference with regard to the susceptibility to SARS-CoV was observed among mice derived from the different genetic background. Briefly, anesthetized transgenic mice and their non-transgenic littermates at the ages of 8-20 weeks were inoculated, via the intranasal (i.n.) route, with 103 or 2×105 TCID50 of virus in 40 ml saline. Animals were weighed and observed daily for sign of illness and mortality. In some experiments, infected mice were sacrificed at indicated time intervals after inoculation to obtain selected tissue specimens to define viral distribution by viral titration in Vero E6 cells and by quantitative RT-PCR assay and for histopathology analysis.
In addition to blood, throat and nasal turbinate washes, and urine, solid tissue specimens (i.e., the lungs, brain, heart, liver, kidney, spleen, mesenteric lymph nodes (mLNs), small and large bowels, and feces were weighed and homogenized in a PBS/10% FCS solution using the Tissue Lyser-Qiagen (Retsch, Haan, Germany) to yield 10% tissue/PBS suspensions. These suspensions were clarified by centrifugation and subjected to virus titration with the standard infectivity assay using Vero E cells. The virus titer of individual samples was expressed as TCID50 per ml or per gram of sample.
Total RNA was isolated from tissues of infected mice at indicated time intervals after infection using an RNeasy Mini Kit (Qiagen Sciences). Contaminating genomic DNA was removed upon digestion with DNase I during the extraction procedure. Resulting RNA specimens were subjected to one-step Q-RT-PCR analysis for assessing the expression of SARS-CoV-specific subgenomic mRNA1 and mRNA5, according to the methodologies established in our laboratories [40,41]. The following primers and detection probes were used: for RNA 5: forward 5′-AGG TTT CCT ATT CCT AGC CTG GAT T-3′ (SEQ ID NO. 3), reverse 5′-AGA GCC AGA GGA AAA CAA GCT TTA T-3′ (SEQ ID NO. 4), and the sequence of ACC TGT TCC GAT TAG AAT AG (SEQ ID NO. 5), as a detection probe; and for RNA 1: forward 5′-TCTGCG GAT GCA TCA ACG T-3′ (SEQ ID NO. 6), reverse 5′-TGT AAG ACG GGC TGC ACT T-3′ (SEQ ID NO. 7), and the sequence of CCG CAA ACC CGT TTA AA (SEQ ID NO. 8), as a detection probe, all of which were derived by using the Assays-by-Design software (Applied Biosystems). The selected primer set and Taq-Man probe for 18S rRNA were used as the endogenous control. Briefly, 80 ng RNA was transferred to separate tubes for amplifying the target genes and endogenous control (18S rRNA), respectively, by using a TaqMan one-step RT-PCR master mix reagent kit. The cycling parameters for one-step RT-PCR were: reverse transcription at 48° C. for 30 min, AmpliTaq activation at 95° C. for 10 min, denaturation at 95° C. for 15 sec and annealing/extension at 60° C. for 1 min. A total of 40 cycles was performed on an ABI PRISM 7000 real-time thermocycler (Applied Biosystems) following the manufacturer's instructions. DNA fragments encoding target genes were amplified in triplicate and relative mRNA levels for each sample were calculated as follows: A cycle threshold (ΔCT)=CT target genes−CT 18S rRNA. The relative abundance of the RNA for hACE2 or for SARS-CoV was expressed as 2−(
The brain (day 2 post-infection) and lungs (day 3 post-infection) of SARS-CoV-infected AC70 were fixed in formalin and embedded in paraffin. The paraffin sections were stained with antibodies for SARS-CoV antigen and counterstained with hematoxylin.
The viral antigens were present in the bronchial epithelial cells and the interstitial cells of the lungs, indicating viral replication in many cell types of this organ (
Inactivated (g-irradiation) tissue homogenates were used to define cytokine profiles by the Bio-Plex Cytometric Bead Array (Bio-Rad, Hercules, Calif.) analysis, according to the manufacturer's recommendation. This technology was used to simultaneously quantify up to 23 inflammatory mediators.
Viral titers and the contents of inflammatory cytokines and chemokines were compared between groups of mice and tested for significance in differences by Student's t test.
To verify hACE2 expression of pCAGGS-ACE2 plasmid (
Microinjection of this ACE2-expressing cassette DNA into F2 zygotes from F1 mice (C57BL/6J×C3H/HeJ) resulted in five viable founder animals, designated AC-12, -22, -50, -63, and -70, respectively. These founders were backcrossed to C56BL/6 or Balb/c mice. The hACE2 transgene in the litters was monitored by PCR, showing that all the founders appeared to transmit the transgene to their progenies. The hACE2 expression in different organs of AC70 and AC63 transgenic lineages was subsequently evaluated by RT-PCR. As shown in
High levels of ACE2 expression in AC70 mice prompted us to investigate the outcome of SARS-CoV infection in this particular lineage. The susceptibility of transgene-positive (Tg+) and their transgene-negative (Tg−) littermates, ranging from 2- to 6-months of age, was determined in a pilot study by inoculating mice with either 2×105 or 103 TCID50 of SARS-CoV per mouse, via the i.n. route. All infected Tg+ mice, but not their age-matched Tg− littermates, developed an acute wasting syndrome and died within 4 to 8 days post infection (pi) with either dose. Thus, the lower dosage, i.e., 103 TCID50, was adopted in the subsequent studies to verify the pathogenesis of SARS-CoV infection.
For the next experiment, Tg+ and Tg− AC70 mice were inoculated (i.n.), 10 animals in each group, with SARS-CoV. Infected mice were observed for signs of clinical illness daily. Early clinical manifestations of infected Tg+ mice included ruffled fur, lethargy, and rapid, shallow breathing, accompanied by the persistent weight loss, which could reach up to 35-40% in some mice (
The kinetics and tissue distribution of infectious virus next investigated by inoculating (i.n.) age-matched Tg+ and Tg− mice, 15 per group. Three mice in each group were sacrificed at daily intervals, except for the fifth day, at which only one Tg+ mouse survived the infection, and the titers of infectious virus in various tissues were determined in Vero E6 cells. Among the tissues examined, the lungs and the brain were the major sites of viral replication, particularly in Tg+ mice. As shown in
Viral replication was also detected in the brain of infected mice, with strikingly different kinetics from that of the lungs. A low-titer of the virus was first detected in the brain of Tg+ mouse on day 2 p.i. Thereafter, virus replication proceeded rapidly and reached a median of more than 108 TCID50/g at day 3 p.i. (
A low, but detectable, level of infectious virus, usually less than 104 TCID50/ml or g was also detected in 8 out of 12 ( 8/12) Tg+ and 4/15 Tg− nasal washes, 3/12 Tg+ and 1/15 Tg− liver specimens, and 1/12 Tg+ large bowels collected from infected animals at various time points. However, there was no detection of infectious virus in throat swabs, blood, heart, spleen, mLNs, kidneys, urine, or feces by the infectivity assay, in which the detection limit was greater than 103 TCID50/ml or g of tissues.
To investigate whether the virus spread to the brain was unique to the i.n. route of infection, AC70 mice were challenged with 103 TCID50 of virus through the intra-peritoneal (i.p.) route. While infected Tg− mice appeared to be healthy, Tg+ animals started to show signs of illness at day 4 p.i., and were thus sacrificed, along with four apparently “healthy” Tg− littermates, for determining the viral titers in the lungs and the brain. As shown in
Although infectious virus was detected in the circulation in the earlier studies, the extremely high recovery of infectious virus from the brains of i.p. challenged Tg+ mice prompted re-evaluation of the viremic status of infected animals. Five Tg+ mice were inoculated (i.n.) with 103 TCID50 of the virus. To increase the sensitivity of detection, instead of using the blood specimens that were diluted (1:10) and a small portion of the spleen in earlier studies, undiluted blood specimens were collected and the whole spleens of infected animals at day 2 p.i. for the infectivity assays. With this improved method, infectious virus was detected from both tissues in all of the infected animals at a titer ranging from 102 to 102.5 TCID50, a titer that was below the limit of detection in the earlier studies, suggesting that a low-level of viremia did exist in infected Tg+ mice.
The histopathology of SARS is characterized by an interstitial pneumonitis, diffuse alveolar damage, with extensive alveolar collapse and filling of remaining alveoli with fluid and desquamated epithelial cells [17, 26, 34]. Histological examination of infected AC70 mice at day 2 p.i. revealed a moderate interstitial pneumonitis with focal thickening of alveolar wall, and filling of alveolar sacs and small airways with cellular debris and macrophage-like cells. Immunohistochemical (IHC) staining showed that SARS-CoV antigen was readily detected in the bronchial epithelial cells and in association with the inflammatory infiltrate in the pulmonary interstitium of infected Tg+ mice (
High levels of SARS-CoV antigen expression were also detected at days 3 and 4 p.i. in abundant neurons and glial cells of the CNS of infected Tg+ mice (
The expression of hACE2 antigen was detected in the lungs, kidneys, liver, heart, skeletal muscle, spleen, LN, pancreas, gastrointestinal smooth muscle and ganglia, vascular endothelium, adrenal, and CNS of Tg+ mice. In the IHC assay, staining of hACE2 was specific for the human protein; no such expression was detected in Tg− mice and no staining was seen using normal goat serum as a negative control. Although two-color staining was not performed to co-localize hACE2 and viral antigen expression, in the lungs and GI, the viral distribution correlated well with the pattern of expression observed for hACE2. In the lungs of Tg+ mice, hACE2 was detected primarily in the pneumocytes, vascular smooth muscle, and ganglion cells (
The mechanism of SARS-associated lung pathology remains unknown. However, pathological studies with postmortem specimens of SARS patients reveal diffuse alveolar damage (DAD), hemophagocytosis, and prominent infiltration of activated macrophages (MF) in the lungs, which suggests that an intense and un-regulated inflammatory response within the lungs may be partially responsible for the pathogenesis of human SARS-CoV infection [26].
The severity of the disease developed in Tg+ mice in response to SARS-CoV infection prompted study of the host responses by measuring the contents of various inflammatory mediators in the lungs and brain, two of the most affected tissues. As shown in
Taken together, these results clearly demonstrate that Tg+ mice, which had much higher levels of SARS-CoV replication in the lungs and brain than their Tg− littermates, as shown in
The susceptibility of Tg+AC63 mice to SARS-CoV infection was initially evaluated by using the same challenge strategy, i.e., 103 TCID50 of SARS-CoV, via the i.n. route. The Tg+ AC63 mice were more susceptible to SARS-CoVinfection than their Tg-littermates, as evidenced by a moderate but progressive weight loss until day 8 (
As shown in
The following references were cited herein:
This U.S. national stage application is filed under 35 U.S.C. §363 and claims benefit of priority under 35 U.S.C. §365 of international application PCT/US2007/000744, filed Jan. 11, 2007, which claims benefit of priority under 35 U.S.C. 119(e) of provisional U.S. Ser. No. 60/758,189, filed Jan. 11, 2006, now abandoned.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US2007/000744 | 1/11/2007 | WO | 00 | 7/10/2008 |
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60758189 | Jan 2006 | US |