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Characterization of multiple molecular interactions between human cytomegalovirus (HCMV) and human immunodeficiency virus type 1 (HIV-1).

In transient gene expression assays we observed an increase in expression of the bacterial chloramphenicol acetyl-transferase (CAT) gene, under the transcriptional control of the HIV-1 LTR (pLTR-CAT), when this plasmid was cotransfected into Vero or MRC-5 cells with a plasmid containing either the HCMV immediate early 1 and 2 (E1, IE2) genes (pRL43a) or just the IE2 gene (pMP18). When the HCMV IE1 gene (pMP12) was cotransfected with pLTR-CAT into Vero cells the level of measurable CAT gene activity was below the level observed when pLTR-CAT was cotransfected with a nonspecific carrier plasmid (pGEM3). The negative influence of the HCMV IE1 gene product on the HIV-1 LTR in Vero cells was also observed when the HIV-1 tat gene (pLTR-TAT) was contransfected into Vero cells with pLTR-CAT and pMP12. However, when the HCMV IE1 gene was cotransfected into rhabdomyosarcoma (RD) cells with proviral HIV-1 DNA, an increase in viral production, as monitored by measurement of HIV-1 reverse transcriptase activity, was observed. In electrophoretic mobility shift assays, nuclear extracts obtained 15 hr post-HCMV infection (hpi) were found to contain a lower level of interaction with an oligonucleotide which corresponded to the HIV-1 LTR Sp-1 binding motif. Nuclear extracts obtained 40 hpi of MRC-5 cells had a greater level of interaction with, and changed the mobility of, the Sp-1 oligonucleotide relative to the uninfected nuclear extracts. HCMV-infected MRC-5 cell nuclear extracts also contain a factor(s) which interacted with the HIV-1 LTR between nucleotide positions -15 to -2 relative to the HIV-1 mRNA start site.

Animals↗

Laboratory diagnosis of HCMV-related disease in renal transplant patients - pp65 antigen detection versus nested PCR.

BACKGROUND: Sixty-five renal transplant (Tx) recipients were monitored for signs and symptoms of human cytomegalovirus (HCMV) infection. OBJECTIVES: Different diagnostic markers were evaluated for early and correct diagnosis of HCMV disease. STUDY DESIGN: Blood and urine samples were obtained in weekly intervals and the following markers were determined: (1) IgG and IgM antibodies in serum using immunofluorescence and ELISA tests; (2) viral shedding in urine by rapid centrifugation culture (RCC); (3) viral antigen (pp65) in peripheral blood leukocytes (PBL) by immunofluorescence and (4) viral DNA in PBL by nested PCR (NPCR). RESULTS: Twenty-two patients remained free of HCMV infection, 18 patients developed clinical symptoms of HCMV disease, and 25 patients remained asymptomatic in spite of laboratory signs of HCMV infection. For the early detection of HCMV disease, the highest sensitivity was achieved using NPCR (100%) and pp65 antigen detection (94%). RCC and IgM serology were less sensitive (62% and 40% respectively). The differences of sensitivity were significant. Clinical specificity was 47% for NPCR, 79% for pp65 antigen detection, 66% for RCC, and 68% for IgM serology. CONCLUSION: In contrast to NPCR, pp65 antigen detection was closely correlated with the appearance of clinical disease and proved to be a useful marker in the monitoring of antiviral therapy.

Journal Article↗

Breast milk as a source for acquisition of cytomegalovirus (HCMV) in a premature infant with sepsis syndrome: detection by real-time PCR.

Symptomatic disease due to human cytomegalovirus (HCMV) has been increasingly recognized in low birth weight (LBW) premature infants. Breast milk has been identified as a potential source for these infections. At approximately 60 days of life a LBW, premature infant was diagnosed with HCMV sepsis syndrome, prompting further investigation of the source for HCMV acquisition. The infant had received a combination of both fresh and frozen breast milk from his mother throughout his first 2 months of life. We utilized a real-time PCR assay for HCMV DNA to retrospectively examine viral genome copy number in serial samples of stored, frozen breast milk. This analysis indicated an increase in breast milk viral load over the first 45 days of life, heralding the HCMV sepsis syndrome that was observed clinically. Real-time PCR may be a useful tool in the evaluation of HCMV viral load in breast milk.

Adolescent↗

Development of a real-time PCR procedure including an internal control for the measurement of HCMV viral load.

Human cytomegalovirus (HCMV) infections are frequent in immuno-compromised patients. The recent development of real-time PCR procedures that allow the rapid quantification of genome load will be helpful for accurate monitoring of these infections. Two extraction procedures were evaluated using 30 blood samples that were processed pure and diluted (1/10). Repeatability and reproducibility of the quantitative PCR procedure using an internal control for amplification were analysed, and its sensitivity compared to a qualitative PCR procedure using 50 HCMV culture positive blood samples. The real-time PCR and qualitative PCR procedures were positive in 46 and 48 of the samples tested, respectively. Discrepancies were observed for samples with a low viral load. The sensitivity of the real-time PCR procedure was evaluated at 500 HCMV DNA copies per ml of sera. The use of an internal control concomitantly processed during the HCMV quantification did not alter the sensitivity of the procedure, and was relevant for the detection of putative PCR inhibitors that may interfere with the amplification process. This procedure was used to measure genome load in two bone marrow transplant patients with HCMV disease, confirming that this new PCR procedure should be used widely for diagnosing and monitoring HCMV infections in transplant patients.

Bone Marrow Transplantation↗

Human cytomegalovirus (HCMV) infection in osteosarcoma cell line suppresses GM-CSF production by induction of TGF-beta.

This study was performed to elucidate the possible mechanism of the disturbance of hemopoiesis by HCMV infection. Saos-2 cells constitutively express mRNA of GM-CSF, and its expression was profoundly decreased by HCMV infection, which required full replication of the virus and was mediated by soluble factors released from the HCMV-infected Saos-2 cells. TGF-beta1 production was statistically and significantly increased from one day after HCMV infection. Expression and production of GM-CSF in Saos-2 cells were restored when a culture supernatant of HCMV-infected Saos-2 cells was reacted with neutralizing anti-TGF-beta antibody. Conclusively, HCMV inhibits GM-CSF expression in Saos-2 cells partly by the increased production of TGF-beta1.

Cell Line↗

Impaired killing of HCMV-infected retinal pigment epithelial cells by anti-pp65 CD8(+) cytotoxic T cells.

PURPOSE: Host defense against infection by human cytomegalovirus (HCMV) is ensured in great part by cytotoxic CD8(+) T lymphocytes (CTLs) directed against the tegument protein pp65. The hyperimmediate release of incoming pp65 into the major histocompatibility complex (MHC) class I pathway after fusion of the virus with the cell membrane provides a very early mechanism of defense. In retinal pigment epithelial (RPE) cells HCMV is known to enter through endocytosis. This study was conducted to determine whether this means of penetration into the cells would allow the virus to elude immune surveillance. METHODS: Infection of RPE cells with HCMV AD169 was performed for 6 hours, 48 hours, and 8 days. Expression of intracellular pp65 in RPE cells and in the astrocytoma reference cell line U373MG was evaluated by flow cytometry, fluorescence microscopy, and Western blot analysis. Killing of both HCMV-infected cell lines by HLA-A2-restricted CD8(+) CTLs directed against pp65 was monitored by (51)Cr-release assays. RESULTS: RPE cells were not lysed by CTLs directed against incoming pp65, contrary to U373MG. Moreover, both cell lines were not killed by anti-pp65 CTLs later after infection, because of the MHC class-I-downregulating effect of HCMV unique short (US2-11) proteins. CONCLUSIONS: In RPE cells, both HCMV entry through endocytosis and the immunosuppressive effect of US proteins could allow the virus to evade immune surveillance at any stage of infection, which could promote viral spreading within the retina.

Blotting, Western↗

[Preparation of P52 recombinant antigenic protein from human cytomegalovirus (HCMV)].

Analysis of published reports helped us single out the most potent antigens among HCMV proteins: phosphoproteins pp150(UL32) and p52(UL44). Theoretical computer analysis of p52 epitopes showed the main antigenic determinants not cross-reacting with antigens of other viruses. Virus-containing (strain AD169) material was obtained and genome DNA was isolated. Amplification of a site of gene UL44 coding for unique determinants detected a PCR fragment of required electrophoretic mobility. The fragment was cloned in vector pLBE. The specificity of cloning was confirmed by restriction analysis of theoretical sites. Nucleotide sequence of cloned fragment of UL44 gene was studied by Maxam-Gilbert's method. Cloning in expressing bacterial vectors helped obtain HCMV recombinant protein p52 in the pure form and fused with beta-galactosidase. Enzyme immunoassay with HCMV-positive and negative donor sera and ABBOTT HCMV sera showed that recombinant p52 increased the sensitivity and specificity of a previously obtained recombinant pp150 as an antigen to HCMV-IgG and HCMV-IgM. The sensitivity and specificity is 100% with 98-99% reliability.

Amino Acid Sequence↗

[Clinical investigation on the treatment of HCMV hepatitis in children].

OBJECTIVE: To investigate the effective therapeutic method of human cytomegalovirus (HCMV) hepatitis in children. METHODS: Twenty-five children with HCMV hepatitis were randomly assigned to a treated group (n=13) or a control group (n=12). Both groups were treated with prednisone, glucurone, luminal and Xiaoyanlidanpian. But the treated group was given ganciclovir (GCV) + intravenous immunoglobulin (IVIG) in addition. Each infant of the two groups was checked for blood routine, liver function and HCMV copy numbers on admission and before discharge. They were seen at the third, sixth and ninth month after discharge. On each visit blood specimens were collected for HCMV copy numbers (fluorescence quantitative PCR, FQ-PCR). RESULTS: The viral load of the treated group decreased significantly. A significant difference in viral copy numbers was found between the two groups on admission, discharge, and third, sixth and ninth month after discharge (P less than 0.001). The number of HCMV DNA copy fell to 10(3) copies/ml on discharge while that of the control group fell to the same level after the third month. The differences between the two groups in the length of hospitalization, time of initial jaundice disappearance and complete disappearance were statistically significant (P less than 0.05). The need for transfusion in the treated group was significantly less than that in the control group (chi-square=4.012, P less than 0.05). CONCLUSION: Combination of GCV with a high dosage of IVIG to treat HCMV active infection could decrease viral load remarkably; The duration of disease, severity of symptoms, degree of anemia and the need for blood transfusion were reduced. No adverse effects related to the combination of GCV with IVIG therapy were observed.

Antiviral Agents↗

[Human anti-HCMV neutralizing Fab antibody generated by phage display library].

BACKGROUND: Cloning recombinant human Fab fragment against HCMV for the purpose of prophylaxis and control of HCMV infection. METHODS: The authors constructed a HCMV phage display library with 2 x 10(6) clones, then used purified HCMV viral lysates to pan the library, then screened by ELISA. RESULTS: Three clones showed positive responses in ELISA, they also showed high specificity in IFA, two of them could neutralize HCMV in neutralizing assays. CONCLUSION: The specific binding of Fab antibodies to HCMV was demonstrated by ELISA, IFA and neutralizing activities. These results provide us the basis for further research of neutralizing recombinant human whole IgG molecule.

Antibodies, Viral↗

[Transformation and identification of recombinant plasmid pAT153 containing HCMV gene Hind III F fragment and its clinical application].

Transformation of the recombinant plasmid pAT153 containing human cytomegalovirus (HCMV) gene Hind III F fragment into E.coli strain HB 101 was made by the CaCl2 method with a 24% of transformation efficiency. The bacterial colonies containing the recombinant plasmid were selected in colony hybridization with 32P-labelled HCMV Hind III F fragment. The recombinant plasmid was isolated by the modified alkaline lysis method which is characterized by high quality, great quantity, and time-saving. HCMV Hind III F fragment has no homology to the other herpes virus. The 32P-labelled HCMV Hind III F fragment probe could detect 0.25 pg homological sequences of HCMV DNA. The use of this probe allows the detection of HCMV in clinical specimens with the advantages of quickness, good sensitivity and specificity.

Cytomegalovirus↗

[Application of polymerase chain reaction (PCR) for the detection of DNA-HCMV in cerebrospinal fluid of neonates and infants with cytomegalovirus infection].

The goal of the work was to prove the usefulness of PCR for detection of DNA-HCMV in cerebrospinal fluid of the infected newborns and infants and to compare our results with clinical diagnosis. The studied group consisted of 24 newborns and infants with HCMV infection (presence of DNA-HCMV in urine and blood, presence of specific IgM, IgG antibodies in serum, and clinical symptoms). Among 12 children with symptoms from central nervous system, DNA-HCMV was detected in CSF of 11 patients. Additionally DNA-HCMV was found in cerebrospinal fluid of 2 children IgM, IgG anti CMV positive but without CNS symptoms. Extraction of DNA from pellet was the most effective method of DNA preparation from CSF for PCR reaction. Final results were obtained approximately 7-8 hours after taking the samples for examination. Our results suggest that PCR technique as a highly specific method is very helpful for the detection of DNA-HCMV in CSF of children with CNS symptoms of disease.

Cytomegalovirus↗

Human cytomegalovirus strain Towne pp28 gene: sequence comparison to pp28 of HCMV AD169 and stable expression in Chinese hamster ovary cells.

Human cytomegalovirus (HCMV) contains a 28-kDa (pp28) matrix phosphoprotein which has been shown to be highly immunogenic in humans. We have cloned and sequenced the gene encoding pp28 of HCMV Towne strain (pp28Towne) and have expressed this gene in stable Chinese hamster ovary (CHO) cell lines in order to examine the structural, functional, and antigenic properties of this protein. The pp28Towne gene had 99% nucleotide and 98.4% amino acid similarity to the pp28 gene of HCMV AD169 strain (pp28AD169). We identified three amino acid substitutions (Gly70 to Ser70, Ser76 to Asn76, and Thr85 to Ala85) in pp28Towne, all clustered in a short 16 amino acid stretch located in the N-terminal half of the protein. The pp28Towne gene was expressed in CHO cells using a vector in which transcription was driven by a human beta-actin promoter. The expressed protein, having an electrophoretic mobility similar to that of HCMV-derived pp28, reacted strongly in immunoblot analysis with pp28-specific murine monoclonal antibodies as well as HCMV-seropositive human sera.

Animals↗

A combination of human cytomegalovirus (HCMV)-specific murine monoclonal antibodies exhibits synergistic antiviral activity in vitro.

A combination of HCMV-specific monoclonal antibodies (MAbs) reactive with glycoproteins in gcI complexes which exhibit synergistic antiviral activity in vitro is described. MAbs directed against different structural and biological properties of HCMV have been selected to increase the antiviral activity against all possible strains, and to reduce the likelihood that resistant strains will emerge with prolonged exposure. Furthermore, in vitro analysis demonstrates that certain of the MAbs in the combination augment the virus-neutralizing activity of other component antibodies, thereby decreasing the amount of total antibody protein required to inhibit HCMV infection. Certain MAbs have been selected to inactivate extracellular virus during the early phase of HCMV infection, whereas others have been selected to prevent its spread once cells have been infected. These data suggest that a MAb cocktail may be useful for prophylaxis and treatment of patients at risk of life-threatening HCMV infections.

Antibodies, Monoclonal↗

HCMV strain comparison by restriction analysis of genomic virus DNA and of a PCR-amplified DNA fragment.

BACKGROUND: Human cytomegalovirus (HCMV) is ubiquitous and a major cause of disease in the immunocompromised which include the unborn fetus. HCMV strains are closely related and may be difficult to differentiate. OBJECTIVES: To analyze new HCMV isolates and highly passaged strains by conventional restriction fragment length polymorphism (RFLP) analysis of HCMV DNA and restriction analysis (RA) of a PCR-amplified a-sequence fragment to identify epidemiological relatedness. STUDY DESIGN: DNA from 14 low-passaged clinical isolates and the high-passaged strains S348 and AD169 were analyzed by RFLP analysis of BamHI, PstI or HpaII digestion as well as by PCR a-sequence amplification. The laboratory results were compared according to epidemiological findings. RESULTS: Of the 14 clinical isolates 13 could be distinguished from each other by RFLP analysis. Isolates from an infant and its mother had identical restriction fragment patterns. Eight of 13 clinical isolates were differentiated from each other by comparing a-sequence PCR fragments according to length and the presence of cleavage sites for 6 different restriction enzymes. The mother-infant isolates were identical by the a-sequence PCR criteria. All 14 low-passaged isolates differed from the high-passaged S384 and AD169 strains by both distinguishing approaches. CONCLUSIONS: Both RFLP and PCR-amplified a-sequence fragment analysis clearly differentiated between low- and high-passaged HCMV isolates and are useful epidemiological tools for determining viral strain relatedness.

Journal Article↗

A nested-PCR assay for the simultaneous amplification of HSV-1, HSV-2, and HCMV genomes in patients with presumed herpetic CNS infections.

To facilitate early diagnosis of herpes virus infection of the central nervous system (CNS), a nested polymerase chain reaction (nPCR) assay was developed to test simultaneously for the presence of HSV-1, HSV-2, and HCMV DNA in the cerebrospinal fluid (CSF) of patients with herpetic CNS disease suspected on clinical grounds. The virus type-specific PCR products were differentiated either by agarose gel electrophoresis or by DNA enzyme immunoassay. Using titrated viral stocks as standards, a sensitivity of at least 0.03 infectious units was obtained for HSV-1, HSV-2 and HCMV and no cross-reactions were recorded. Among 178 CSF specimens (171 patients), which were tested under routine conditions, three contained HSV-1 DNA, one contained HSV-2 DNA and one contained HCMV DNA. No double or triple infection was diagnosed. The presence of inhibitors of the Taq DNA polymerase was monitored by spiking aliquots of the above CSF samples with 3 infectious units each of HSV-1 and HSV-2 or HCMV. Whereas none of 93 samples spiked with HSV-1 and HSV-2 contained inhibitors, the PCR reaction was inhibited in three out of 175 samples (1.7%) spiked with HCMV. The complete procedure which requires only 150 microl of CSF is easily completed within 8 h. Through its speed, reliability and sensitivity, this nPCR assay has met the specific criteria of the diagnostic laboratory.

Base Sequence↗

Congenital HCMV infection: a collaborative and comparative study of virus detection in amniotic fluid by culture and by PCR.

Cytomegalovirus (HCMV) infection is the leading cause of congenital virus infection in developed countries, affecting an estimated 1% of births. This antenatal infection can cause serious sequelae. Strategies for prevention and treatment must, therefore, be agreed upon, entailing a preliminary performance assessment of antenatal virus diagnosis techniques. Between 1992 and 1999, HCMV serology status was established for 19456 pregnant women in four French hospitals. Seronegative patients (55.4%) were given serology screening, and antenatal diagnosis was given to 152 women who had shown seroconversion during their pregnancies (1.4%). The detection of HCMV transmission from mother to fetus was finally established in 95 cases, using polymerase chain reaction (PCR) and viral culture methods for detecting HCMV in the amniotic fluid. These results were compared with viral culture of children's urine after birth, enabling us to distinguish between children really infected in utero (30%) and non-infected children (70%). The results of the virus culture and those of PCR were identical in 94 of the 95 cases, with one discrepancy (culture-/PCR+). The two diagnosis techniques had identical sensitivity (72%), with culture proving slightly more specific than PCR (98.4% as opposed to 96.9%). Positive prediction values for culture and for PCR were, respectively, 95.6 and 91.3%. Antenatal virus diagnosis on amniotic fluid was negative with both techniques in 8 out of 29 cases of children born with HCMV infection (VPN=89%). Over half of these wrongly negative results can be explained by amniocentesis carried out too early in the pregnancy or too early with respect to the mother's primary infection.

Amniotic Fluid↗

Increases in [Ca2+]i mediated by the 92.5-kDa putative cell membrane receptor for HCMV gp86.

We determined that changes in intracellular Ca2+ concentration ([Ca2+]i) occur in human fibroblasts within the first hour of human cytomegalovirus (HCMV) infection when viral adsorption and fusion take place, and we investigated whether such changes also occur in response to monoclonal anti-idiotype antibodies (MAb2) that mimic HCMV gp86 and bind to a 92.5-kDa putative cell membrane receptor for gp86. Digitized image analysis of fura 2-loaded human embryonic lung fibroblasts indicated specific transient increases in [Ca2+]i beginning in some cells within the first 5 min of incubation with cross-linked MAb2 (70-750 nM, P < 0.01), which were similar in timing and intracellular distribution to those induced by HCMV. A primary source of Ca2+ appeared to be intracellular Ca2+ stores, since prior depletion of these stores with 30 nM thapsigargin inhibited the response (91.7 +/- 8.6%, P < 0.01); influx of Ca2+ from the extracellular medium was apparently necessary to maintain the intracellular Ca2+ stores. Transient increases in inositol trisphosphate (IP3) occurred in response to MAb2 (up to 3,329 +/- 84%, P < 0.001) or HCMV (92.8 +/- 19%, P < 0.01) during this same time period. These data suggest that the 92.5-kDa receptor for HCMV gp86 mediates an increase in IP3 and subsequent release of Ca2+ from intracellular stores.

Antibodies, Monoclonal↗

Experience with quantitative PCR for the management of HCMV disease.

Human cytomegalovirus (HCMV) is a major pathogen in newborn children and immunosuppressed individuals. There are various diagnostic methods for HCMV, but all test systems either suffer from limited sensitivity and specificity or are prone to sampling errors. Due to its unequaled sensitivity, strong hopes were pinned on the polymerase chain reaction (PCR) for the early diagnosis of active HCMV infections. However, when monitoring immunocompromised patients, unwanted positive results are often obtained without further evidence of active HCMV infection. To better discriminate between latent and active infections, different methods for the quantitation of viral genomes in clinical samples by PCR have been devised in the past years. Here we discuss the current standing of quantitative PCR in HCMV diagnostics.

Cytomegalovirus Infections↗