Abstract

Increased intestinal permeability has been proposed as a mechanism of rotavirus-induced diarrhea. Studies with humans and mice have, however, shown that rotavirus leaves intestinal permeability unaffected or even reduced during diarrhea, in contrast to most bacterial infections. Gastrointestinal permeability is regulated by the vagus nerve and the enteric nervous system, which is composed of neurons and enteric glial cells (EGCs). We investigated whether the vagus nerve, serotonin (5-HT), EGCs, and neurotropic factors contribute to maintaining gut barrier homeostasis during rotavirus infection. Using subdiaphragmatic vagotomized and 5-HT3 receptor knockout mice, we found that the unaffected epithelial barrier during rotavirus infection is independent of the vagus nerve but dependent on 5-HT signaling through enteric intrinsic 5-HT3 receptors. Immunofluorescence analysis showed that rotavirus-infected enterocytes were in close contact with EGCs and enteric neurons and that the glial cell-derived neurotrophic factor (GDNF) was strongly upregulated in enterocytes of infected mice. Moreover, rotavirus and 5-HT activated EGCs (P < 0.001). Using Ussing chambers, we found that GDNF and S-nitrosoglutathione (GSNO) led to denser epithelial barriers in small intestinal resections from noninfected mice (P < 0.01) and humans (P < 0.001) and that permeability was unaffected in rotavirus-infected mice. GSNO made the epithelial barrier denser in Caco-2 cells by increasing the expression of the tight junction protein zona occludens 1 (P < 0.001), resulting in reduced passage of fluorescein isothiocyanate dextran (P < 0.05) in rotavirus-infected monolayers. This is the first report to show that neurotropic factors contribute to maintaining the gut epithelial barrier during viral insult.IMPORTANCE Human and mouse studies have shown that rotavirus infection is associated with low inflammation and unaffected intestinal barrier at the time of diarrhea, properties different from most bacterial and inflammatory diseases of the gut. We showed by in vitro, ex vivo, and in vivo experiments that neurotrophic factors and 5-HT have barrier protective properties during rotavirus insult. These observations advance our understanding of how the gut barrier is protected against rotavirus and suggest that rotavirus affects the gut barrier differently from bacteria. This is the first report to show that neurotrophic factors contribute to maintain the gut epithelial barrier during viral insult.

Highlights

  • Increased intestinal permeability has been proposed as a mechanism of rotavirus-induced diarrhea

  • As vagus nerve stimulation can indirectly support gut barrier integrity during insult [19, 24, 27, 28], we investigated whether it plays a role in epithelial barrier homeostasis during rotavirus infection

  • No difference in permeability was observed between vagotomized and sham-operated infected mice, suggesting that the vagus nerve does not contribute to maintaining the gut barrier during rotavirus infection in mice (Fig. 1A)

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Summary

Introduction

Increased intestinal permeability has been proposed as a mechanism of rotavirus-induced diarrhea. Alterations in intestinal permeability and the ensuing potential electrolyte and water leakage as a mechanism of diarrhea have been proposed and investigated in vivo Such studies found that rotavirus does not alter intestinal permeability during diarrhea in humans [4,5,6] or mice [7], which is in contrast to the increased permeability observed during common enteric bacterial infections in humans [8, 9]. We have previously reported that rotavirus activates the ENS [10], stimulates serotonin (5-hydroxytryptamine [5-HT]) release from human enterochromaffin (EC) cells, and activates the nucleus of the solitary tract, part of the vomiting center, through vagus nerve signaling [11] These studies were recently extended to a double-blind, placebo-controlled study in which a 5-HT3 receptor antagonist attenuated rotavirus diarrhea in children [12], which confirmed a previous study with mice [13]. It is hypothesized that rotavirus and/or NSP4 stimulates release of 5-HT by EC cells and subsequent stimulation of enteric nerves followed by chloride and water secretion from crypt cells [1, 10, 11]

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