Abstract

Human cytomegalovirus (HCMV) latency is typically harmless but reactivation can be largely detrimental to immune compromised hosts. We modeled latency and reactivation using a traceable HCMV laboratory strain expressing the Gaussia luciferase reporter gene (HCMV/GLuc) in order to interrogate the viral modulatory effects on the human adaptive immunity. Humanized mice with long-term (more than 17 weeks) steady human T and B cell immune reconstitutions were infected with HCMV/GLuc and 7 weeks later were further treated with granulocyte-colony stimulating factor (G-CSF) to induce viral reactivations. Whole body bio-luminescence imaging analyses clearly differentiated mice with latent viral infections vs. reactivations. Foci of vigorous viral reactivations were detectable in liver, lymph nodes and salivary glands. The number of viral genome copies in various tissues increased upon reactivations and were detectable in sorted human CD14+, CD169+, and CD34+ cells. Compared with non-infected controls, mice after infections and reactivations showed higher thymopoiesis, systemic expansion of Th, CTL, Treg, and Tfh cells and functional antiviral T cell responses. Latent infections promoted vast development of memory CD4+ T cells while reactivations triggered a shift toward effector T cells expressing PD-1. Further, reactivations prompted a marked development of B cells, maturation of IgG+ plasma cells, and HCMV-specific antibody responses. Multivariate statistical methods were employed using T and B cell immune phenotypic profiles obtained with cells from several tissues of individual mice. The data was used to identify combinations of markers that could predict an HCMV infection vs. reactivation status. In spleen, but not in lymph nodes, higher frequencies of effector CD4+ T cells expressing PD-1 were among the factors most suited to distinguish HCMV reactivations from infections. These results suggest a shift from a T cell dominated immune response during latent infections toward an exhausted T cell phenotype and active humoral immune response upon reactivations. In sum, this novel in vivo humanized model combined with advanced analyses highlights a dynamic system clearly specifying the immunological spatial signatures of HCMV latency and reactivations. These signatures can be merged as predictive biomarker clusters that can be applied in the clinical translation of new therapies for the control of HCMV reactivation.

Highlights

  • Human cytomegalovirus (HCMV) is a ubiquitous and strict human herpesvirus

  • This promoter is strongly active immediately after HCMV infection, and immediate early protein 1 (IE1) expression is suitable for determining HCMV infection in several types of cells, including peripheral blood mononuclear cells (PBMCs) (Figure S1A)

  • Cryopreserved batches of HCMV/Gaussia luciferase (GLuc)-infected MRC-5 cells were produced and, after thawing, flow cytometry analyses showed that 70–90% of the viable cells expressed the HCMV glycoprotein B on the cell surface (Figures S1C,D)

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Summary

Introduction

Latency after primary infection is mostly harmless, HCMV reactivations have been known for more than 30 years to increase the non-relapse mortality for patients after allogeneic hematopoietic stem cell transplantation (alloHSCT) [1,2,3,4,5]. HCMV reactivations after allo-HSCT were shown to promote immune suppressive effects on T cells [12,13,14] and, on the other hand, immune stimulatory effects on B cells [15,16,17]. Despite its ubiquitous and global detrimental effects, vaccines, or immune therapies to protect against HCMV reactivations have not been approved [18]. Recapitulating the effects of HCMV reactivation on the immune system in an in vivo experimental system could guide toward predictive immunologic patterns for future testing of vaccines and immune therapies in humans

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