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Aug 20, 2014 - Establishment and characterization of a lethal mouse model for the Angola strain of. 1. Marburg virus. 2. 3. Author names: Xiangguo Qiu1*, ...
JVI Accepts, published online ahead of print on 20 August 2014 J. Virol. doi:10.1128/JVI.01643-14 Copyright © 2014, American Society for Microbiology. All Rights Reserved.

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Establishment and characterization of a lethal mouse model for the Angola strain of

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Marburg virus

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Author names: Xiangguo Qiu1*, Gary Wong1, 2, Jonathan Audet1, 2, Todd Cutts3, Yulian Niu4,

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Stephanie Booth4, and Gary P. Kobinger1, 2, 5, 6*

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Author affiliations:

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Canada, Winnipeg, MB, Canada

Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of

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Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada

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Applied Biosafety and Research Program, JC Wilt Infectious Diseases Research Centre, Public

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Health Agency of Canada, Winnipeg, MB, Canada

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Winnipeg, MB, Canada

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Department of Immunology, University of Manitoba, Winnipeg, MB, Canada

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Department of Pathology and Laboratory Medicine, University of Pennsylvania School of

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Medicine, Philadelphia, PA, USA

Molecular PathoBiology, National Microbiology Laboratory, Public Health Agency of Canada,

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Keywords: Marburg strain Angola; Mouse; Adaptation; Pathogenesis

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Running title: Mouse model for Marburg strain Angola

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*Corresponding authors: Xiangguo Qiu, M.D. Special Pathogens Program National Microbiology Laboratory Public Health Agency of Canada 1015 Arlington Street Winnipeg, MB, R3E 3R2 Canada Phone: (204) 789-5097 Fax: (204) 789-2140 E-mail: [email protected] Gary Kobinger, Ph.D. Special Pathogens Program National Microbiology Laboratory Public Health Agency of Canada 1015 Arlington Street Winnipeg, MB, R3E 3R2 Canada Phone: (204) 784-5923 Fax: (204) 789-2140 E-mail: [email protected]

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Abstract

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Infections with Marburg (MARV) and Ebola virus (EBOV) cause severe hemorrhagic fever in

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humans and non-human primates (NHPs) with fatality rates up to 90%.

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experimental vaccine and treatment platforms have previously been shown to be protective

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against EBOV infection. However, the rate of development for prophylactics and therapeutics

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against MARV has been slower in comparison, possibly because a small animal model is not

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widely available.

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pathogenesis of MARV Angola (MARV/Ang), the most virulent strain of MARV. Infection

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with the wild-type virus does not cause disease in mice, but the adapted virus (MARV/Ang-MA)

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recovered from liver homogenates after 24 serial passages in severe combined immunodeficient

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(SCID) mice caused severe disease when administered intranasally (IN) or intraperitoneally (IP).

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The LD50 was determined to be 0.015 TCID50 MARV/Ang-MA in SCID mice, and IP infection

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at a dose of 1000 x LD50 resulted in death between 6-8 days post-infection (dpi) in SCID mice.

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Similar results were obtained with immunocompetent BALB/c and C57BL/6 mice challenged IP

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with 2000 x LD50 of MARV/Ang-MA. Virological and pathological analyses in MARV/Ang-

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MA infected BALB/c mice revealed that the associated pathology was reminiscent of

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observations made in NHPs with MARV/Ang. MARV/Ang-MA infected mice showed most of

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the clinical hallmarks observed with Marburg hemorrhagic fever, including lymphopenia,

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thrombocytopenia, marked liver damage and uncontrolled viremia. Virus titers reached 108

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TCID50/ml in the blood, and between 106-10 TCID50/g tissue in the intestines, kidney, lungs,

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brain, spleen, and liver. This model provides an important tool to screen candidate vaccines and

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therapeutics against MARV infections.

A number of

Here we report the development of a mouse model for studying the

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Importance

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The Angola strain of Marburg virus (MARV/Ang) was responsible for the largest outbreak ever

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documented for Marburg viruses. At a 90% fatality rate, it is similar to Ebola virus, which

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makes it one of the most lethal viruses known to humans. There are currently no approved

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interventions for Marburg virus, in part because a small animal model that is vulnerable to

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MARV/Ang infection is not available to screen and test potential vaccines and therapeutics in a

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quick and economical manner. To address this need, we have adapted MARV/Ang so that it

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causes illness in mice resulting in death. The signs of disease in these mice are reminiscent of

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wild-type MARV/Ang infections in humans and nonhuman primates. We believe this will be of

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help in accelerating the development of life-saving measures against Marburg virus infections.

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Introduction

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Infection with filoviruses cause severe hemorrhagic fevers with high mortality rates. The family

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Filoviridae is divided into three genera: Ebolavirus, Marburgvirus, and Cuevavirus. Within the

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Ebolavirus genus, Zaire ebolavirus (Ebola virus; EBOV) is the most pathogenic in humans, with

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a case fatality rate of up to 90%, followed by the Sudan (54%) and Bundibugyo (34%) viruses.

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Together, ebolaviruses have been responsible for more than 1500 deaths since their discovery in

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1976 (4). In contrast, live Cuevavirus have not yet been isolated from insectivorous bats (17)

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and is not known to cause illness in humans, whereas outbreaks of Marburg virus (MARV) have

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been responsible for less than 400 deaths since its discovery in 1967 (5). Although MARV is a

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less visible threat to humans in terms of total number of outbreaks and deaths, it should be noted

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that one of the largest and deadliest filovirus outbreaks in history was caused by MARV. An

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outbreak of the Angolan variant of MARV (MARV/Ang) in Uige, Angola during 2004-2005

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resulted in 227 deaths out of 252 total cases, a 90% mortality rate (31). This rate is similar to

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that of the most devastating EBOV outbreak on record, and MARV/Ang infections currently

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account for over half of all documented MARV cases and deaths (5).

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The development of a mouse-adapted virus for modeling EBOV infections in mice (3) has

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provided an economical and efficient method for the screening of candidate vaccines and post-

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exposure therapies. Several promising strategies from these experiments have also demonstrated

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efficacy in higher animal models, highlighted by the vesicular stomatitis virus-based vaccine

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(VSVǻG/EBOVGP) (14) in addition to monoclonal antibody cocktails (ZMAb and MB-003)

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(23) (24) (18) (21). However, the number of promising prophylactics and therapeutics against

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MARV infections has lagged behind its EBOV counterpart; likely in part due to the lack of a

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widely-available rodent-adapted virus that recapitulates MARV disease.

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A rodent-adapted Ravn virus (RAVV) was developed previously to address this need. RAVV, a

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virus within the Marburgvirus genus, was first adapted to severe combined immunodeficient

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(SCID) mice (34), and then in immunocompetent BALB/c mice (35). Sequential passaging of

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the Musoke and Ci67 variants of MARV (MARV/Mus and MARV/Ci67, respectively) in SCID

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mice have also yielded lethal host-adapted variants to SCID mice (34); however, it is unknown

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whether the mouse-adapted MARV/Mus and MARV/Ci67 are also lethal to immunocompetent

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mice. Complicating matters further, these adapted viruses are not yet widely available for use

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amongst Biosafety Level 4 (BSL-4) labs. Additionally, RAVV has 21% nucleotide divergence

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from the MARV/Mus, whereas MARV/Ang is 7% divergent from MARV/Mus based on whole-

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genome analysis (34). The glycoprotein (GP) gene shows 22% divergence between RAVV and

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MARV/Ang in both nucleotide and amino acid sequences (31), suggesting that vaccines and

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therapeutics raised against RAVV GP may not be protective against MARV challenge, and vice

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versa. Indeed, studies have shown that vaccines based on Venezuelan equine encephalitis virus

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(VEEV) expressing the GP and nucleoprotein from MARV/Mus are protective against

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homologous virus challenge in cynomolgus macaques (13) but not protective against a RAVV

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challenge (6), indicating that the differences between the two virus lineages are sufficient to

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negatively impact the efficacy of potential candidate vaccines.

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There is a need to develop MARV models for immunocompetent small animals using variants

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that are antigenically distinct from RAVV. This is important for facilitating the development of

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MARV vaccines or therapeutics so that they can first be tested in small animals with a high

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predictability of protective efficacy, before follow-up studies in a higher animal species such as

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non-human primates (NHPs). A guinea pig-adapted MARV/Ang has been previously described

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(32), however sequence data for this MARV variant is not available. The aim of this study was

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to adapt MARV/Ang, the MARV variant most pathogenic in humans, to immunocompetent mice

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such that a challenge with a sufficient dose will kill the host within days. Here, we describe the

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development and characterization of a mouse-adapted virus (MARV/Ang-MA) for use in the

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immunocompetent BALB/c mouse. The adapted virus is characterized with regards to different

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inoculation routes, various clinical parameters, cytokine, chemokine and growth factor

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responses, as well as the pathology within the various organs during the course of disease.

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MARV/Ang-MA was also sequenced and compared to the full length MARV/Ang sequence, in

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order to distinguish the molecular differences between the two viruses.

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Materials and Methods

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Ethics statement

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All animal work was performed according to Animal use document (AUD) #H-11-007, which

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has been approved by the Animal Care Committee (ACC) based at the Canadian Science Center

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for Human and Animal Health (CSCHAH), in accordance with the guidelines outlined by the

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Canadian Council on Animal Care (CCAC). All infectious work was performed in the Biosafety

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Level 4 (BSL-4) facility at the National Microbiology Laboratory in Winnipeg, Canada.

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Cells and viruses

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The wild-type virus was Marburg virus, strain Angola (Marburg virus H.sapiens-

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tc/AGO/2005/Angola), termed MARV/Ang, which was isolated from a patient during the 2005

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Marburg outbreak in Uige, Angola.

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NML/M.musculus-lab/AGO/2005/Ang-MA-P2 (MARV/Ang-MA). Stocks of MARV/Ang and

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MARV/Ang-MA were grown on T-150 flasks (Corning) of VeroE6 cells (ATCC) for use in the

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studies.

The adapted virus is designated Marburg virus

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Animals and the virus adaptation process

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Severe combined immunodeficient (SCID) and wild-type BALB/c mice, female, 4-6 weeks old

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(Charles River) were used for these studies. For passaging experiments, two SCID mice were

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initially injected intraperitoneally (IP) with ~106 plaque forming units (PFU) of MARV/Ang in

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200μL of Dulbecco’s modified Eagle’s medium (DMEM), supplemented with 2% heat-

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inactivated fetal bovine serum (FBS) (Sigma). Serial passaging of MARV/Ang in SCID mice

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was then performed as follows. Livers were removed from euthanized mice at 7 days post-

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infection (dpi), pooled, and then homogenized by hand by grinding the livers against a steel

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mesh with a plastic plunger. The cells were suspended in 10mL of phosphate buffered saline

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(PBS) and centrifuged at 400 x g for 5 minutes. The supernatant was passed through a cell

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strainer, and the cell pellet was further mechanically homogenized with a tissue homogenizer.

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After centrifugation at 400 x g for 5 minutes, the supernatant was also passed through the cell

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strainer. Two naïve SCID mice were injected IP with 200μL of the liver homogenate, and the

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process was repeated again at 7 dpi until a MARV/Ang variant (termed MARV/Ang-MA) lethal

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to both SCID and BALB/c mice was produced after 24 passages. The virus was not plaque

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purified.

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Median lethal dose challenge and pathogenesis experiments

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For the median lethal dose (LD50) studies, 10-fold dilutions of MARV/Ang-MA ranging between

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27.2 to 2.72 x 10-3 TCID50 was administered per SCID or BALB/c mouse (n=3 or 4 per dilution).

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Mice were weighed daily and monitored for survival, weight loss and clinical signs of disease.

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For the pathogenesis experiments, groups of 10 C57BL/6 mice were given 2000 x LD50 (100

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TCID50) of MARV/Ang-MA IP, whereas groups of 10 BALB/c mice were administered 2000 x

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LD50 of MA-MARV IP, intramuscularly (IM), intranasally (IN) or subcutaneously (SC). Mice

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were weighed daily and monitored for survival, weight loss and clinical signs of disease.

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Serial sampling experiments

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BALB/c mice were infected either with 2000 x LD50 MARV/Ang-MA, or an equivalent titer of

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MARV/Ang. Four to 6 mice from each group were randomly chosen to be euthanized at planned

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time points between 0 and 6 dpi for necropsy. Blood was sampled from anaesthetized mice by

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retro-orbital bleeding.

Whole blood was collected in K2 ethylenediaminetetraacetic acid

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(EDTA) plus blood collection tubes (BD Biosciences) for blood counts and determination of

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viremia, and in SST plus blood collection tubes (BD Biosciences) for blood biochemistry

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studies. Whole blood from mice was also collected in EDTA plus blood collection tubes and

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spun at 1000 x g for 10 minutes at 4oC in order to isolate plasma for cytokine responses. Parts of

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organs including liver, spleen, kidney, lung, brain, and intestine were also harvested, weighed,

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put in 1mL of DMEM supplemented with 2% heat-inactivated FBS, and then homogenized in a

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tissue homogenizer. Samples were then spun at 400 x g for 5 minutes and frozen at -80oC until

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processing. For histopathological and immunohistochemical analysis, whole livers and spleens

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harvested from mice, and fixed in 10% phosphate buffered formalin in the BSL-4 laboratory for

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at least 28 days before processing.

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Blood counts and blood biochemistry

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Complete blood counts were performed with the VetScan HM5 (Abaxis Veterinary Diagnostics).

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The following parameters were included in the results: levels of white blood cells (WBC),

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lymphocytes (LYM), percentage of lymphocytes (LY%), monocytes (MO%), neutrophils

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(NE%), and levels of platelets (PLT). Blood biochemistry was performed with the VetScan VS2

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(Abaxis Veterinary Diagnostics). The following parameters were included in the results: levels

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of alkaline phosphatase (ALP), alanine aminotransferase (ALT), amylase (AMY), total bilirubin

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(TBIL), blood urea nitrogen (BUN), and glucose (GLU).

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Cytokine, chemokine and growth factor responses

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Mouse cytokine, chemokine and growth factor levels were quantified with the Cytokine Mouse

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20-Plex Panel for the Luminex platform (Life Technologies) and performed according to

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manufacturer instructions. The following parameters were included in the results: fibroblast

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growth factor (FGF-basic), interferon gamma (IFN-Ȗ), interleukin (IL)-1ȕ, IL-2, IL-4, IL-5, IL-6,

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IL-10, IL-12, IL-13, IL-17, IFN-Ȗ induced protein (IP)-10, keratinocyte chemoattractant (KC),

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monocyte chemoattractant protein (MCP)-1, monokine induced by IFN-Ȗ (MIG), macrophage

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inflammatory protein (MIP)-1Į, tumour necrosis factor (TNF)-Į and vascular endothelial growth

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factor (VEGF).

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Infectious virus titrations

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Titration of live MARV/Ang or MARV/Ang-MA was performed as follows. Whole blood or

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supernatants from harvested organs were first serially diluted 10-fold in DMEM supplemented

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with 2% heat-inactivated FBS. 100ȝL of the dilutions were then added in three replicates to a

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96-well plate (Corning) of pre-seeded VeroE6 cells at 95% confluence and incubated at 37oC for

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1 hour. The samples were removed and 100ȝL of fresh DMEM with 2% FBS was added to the

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wells and incubated for 14 days. The plates were scored for the presence of cytopathic effects

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(CPE) at 14 dpi, and titers were calculated with the Reed and Muench method (28) and

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expressed as TCID50/mL, or TCID50/g of tissue. The lower detection limit for this assay is 10

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TCID50/mL or 10 TCID50/g of tissue.

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Histology and Immunohistochemistry

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For histology studies, fixed liver and spleen tissues were embedded in paraffin wax to make

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paraffin blocks.

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microscope slides (Fisher) and incubated overnight at 37oC, deparaffinized with two changes of

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xylene, immersed in 100%, 90% and then 70% ethanol for 2 minutes each, washed with distilled

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water, and then stained with Hematoxylin (Thermo) as well as Eosin-Y (Therno) for 2 minutes

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and 30 seconds, respectively, with a 2 minute wash of distilled water in between. The sections

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are then dehydrated with 70%, 90% and 100% ethanol, cleared in two changes of xylene and

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mounted with Permount (Fisher) for viewing by routine light microscopy.

The blocks were then cut 5 microns thick and mounted on Superfrost

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For immunohistochemistry studies, paraffin blocks were deparaffinized, and washed with

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distilled water as described above. Sections were first incubated with 10mM sodium citrate

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buffer, pH 6.8 at 100oC for 10 minutes with the NxGen Decloaking Chamber (Inter Medico)

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before immunohistochemistry was performed with the UltraVision Quanto mouse on mouse

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HRP kit (Thermo) in the Lab Vision Autostainer (Thermo) following manufacturer instructions.

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The in-house monoclonal antibody 3H1, which recognizes MARV GP was used at a 1:1000

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dilution as a primary antibody.

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Statistical analysis

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Statistical comparison of the blood biochemistry, blood counts, and cytokine data was carried out

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using R 3.1.1 (26) along with the reshape2 (37), ggplot2 (36), and car (9) packages. The data

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used for the analysis consisted of 6 parameters for the blood biochemistry, 8 parameters for the

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blood counts, and 20 parameters for the cytokines. Only data from days where both groups were

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sampled was used. In order to account for the number of comparisons, three multiple analysis of

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covariance (MANCOVA) were used, one for the biochemistry data, one for the blood count data,

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and one for the cytokines.

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considered as categorical with 4 values: 1, 3, 5, and 6 (three for the cytokines: 3, 5, and 6). In all

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cases, the MANCOVAs were significant and were followed by individual ANCOVAs for each

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outcome. In the case where the ANCOVA was significant, a post-test consisting of Tukey’s

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Honest Significant Differences was used to compare the viruses at different times.

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assumption of homoscedasticity was tested for each outcome using Levene’s test. For the blood

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biochemistry data, all outcomes except GLU showed heteroscedasticity so a log-transform was

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used on all outcomes including GLU in order to keep the scales consistent.

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transformation, AMY still showed significant heteroscedasticity and a number of transformations

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were attempted (see output in Supplementary Material for details), but none corrected the

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problem. As a consequence, weights (1/y2) were applied to the regression to compensate for the

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increased impact of the highly variable values. For the blood count data, all outcomes passed

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Levene’s test, so no transformations were applied. For the cytokine data, all cytokines were

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heteroscedastic and three (IFNȖ, GM-CSF, and IL-1ȕ ) were still heteroscedastic after a log

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transformation. The source of heteroscedasticity for those samples appeared to be groups where

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all or most measurements were at background level; because there are no well-documented

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alternatives to the ANCOVA procedure, we elected to analyse those cytokines in the same

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manner but the p-values obtained were interpreted more conservatively. Scripts and output are

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provided in the supplementary materials. For all analyses, statistical significance was set at p