Viral-host interactions affecting neural differentiation of human progenitors

Congenital human cytomegalovirus (HCMV) infection is a major cause of central nervous system structural anomalies and sensory impairments in the newborn. It is likely that the timing of infection as well as the range of susceptible cells at the time of infection will affect the severity of the disease. A major goal of our research is to understand at a high-resolution the effects of HCMV infection on the neural lineage specification and maturation of stem and progenitor cells. Elucidation of the genes and cellular processes that are affected will serve as a basis for therapeutic strategies to ameliorate the effects of HCMV infection in newborns. The significance of our studies also extends to the serious problem of HCMV infection in immunocompromised individuals, with recipients of allogeneic transplants having a high risk of severe disease and allograft rejection. This potential problem in stem cell therapy has received little attention thus far. The proposed use of stem cell transplantation in treating neuronal injury and neurodegenerative diseases, as well as transplantation of other organ-specific precursors, makes it imperative to understand how disseminated HCMV infection in immunosuppressed recipients will affect the function and differentiation of the cells. This past year, we have made significant progress in accomplishing the goals of this project. We used human embryonic stem cells-derived primitive pre-rosette neural stem cells (pNSCs) maintained in chemically defined conditions to study host-HCMV interactions in early neural development. Infection of pNSCs with HCMV was largely inefficient and non-progressive. At low multiplicity of infection (MOI), we observed severe defects with regards to the proportion of cells expressing the major immediate-early proteins (IE) despite an optimal viral entry, thus indicating the existence of a blockade to specific pre-IE events. IE expression, even at high MOI, was found to be restricted to a subset of cells negative for the expression of the forebrain marker FORSE-1. Treatment of pNSCs with the caudalizing agent retinoic acid rescued IE expression, suggesting that the hindbrain microenvironment might be more permissive for the infection. Transactivation of the viral early genes was found to be severely debilitated and expression of the late genes was barely detectable even at high MOI. Differentiation of pNSCs into primitive neural progenitor cells (pNPCs) restored IE expression but not the transactivation of early and late genes. Increasing the number of viral particles bypassed this barrier to early gene expression and thus permitted expression of the late genes in pNPCs. Consequently, viral spread was only observed at high MOI but was largely restricted to one cycle of replication as secondarily infected cells failed to efficiently express early genes. Of note, virions produced in pNPCs and pNSCs were exclusively cell-associated. Finally, we found that viral genomes could persist in pNSCs culture up to a month after infection despite the absence of detectable IE expression by immunofluorescence. Clonogenic expansion of infected pNSCs revealed that the presence of viral DNA and IE proteins were insufficient to block host cell division therefore allowing the survival of viral genomes via cellular division rather than viral replication. These results highlight the complex array of hurdles that HCMV must overcome in order to infect primitive neural stem cells and suggest that these cells might act as a reservoir for the virus. To study in greater depth the molecular basis of the interaction of HCMV with cell of the neural lineage, we also have initiated high-throughput genomics approaches to analyze HCMV microRNAs, alterations in cellular microRNA and gene expression profiles, and global defects in host alternative splicing in infected and uninfected pNSC-derived NPCs. Interestingly, although there are many changes in host cell gene expression in the infected cells, there was only a small overlap with the set of changes we had found in infected human fibroblasts. This highlights the importance of performing these studies in the relevant targets of the virus in the developing fetus. We expect that the results of these studies will provide an unprecedented resolution of the effects on neurogenesis when HCMV infects a newborn, serve as a foundation for future therapeutic efforts in preventing the birth defects due to HCMV, and provide insight into the serious potential problem of disseminated HCMV in immunosuppressed individuals receiving transplanted allogeneic stem cells.

Congenital human cytomegalovirus (HCMV) infection is a major cause of central nervous system structural anomalies and sensory impairments in the newborn. A major goal of our research is to understand at a high-resolution the effects of HCMV infection on the neural lineage specification and maturation of stem and progenitor cells. Elucidation of the genes and cellular processes that are affected will serve as a basis for therapeutic strategies to ameliorate the effects of HCMV infection in newborns. The significance of our studies also extends to the serious problem of HCMV infection in immunocompromised individuals, with recipients of allogeneic transplants having a high risk of severe disease and allograft rejection. This potential problem in stem cell therapy has received little attention thus far. The proposed use of stem cell transplantation in treating neuronal injury and neurodegenerative diseases, as well as transplantation of other organ-specific precursors, makes it imperative to understand how disseminated HCMV infection in immunosuppressed recipients will affect the function and differentiation of the cells. This past year, we have made significant progress in accomplishing the goals of this project. We used human embryonic stem cell (hESC)-derived primitive pre-rosette neural stem cells (pNSCs) to study host-HCMV interactions in early neural development and found with several different lines of hESC-derived pNSCs that HCMV infection is inefficient and non-progressive. Differentiation of pNSCs into primitive neural progenitor cells (pNPCs) restored some viral early gene expression but not the transactivation of late genes. Impaired viral gene expression in pNSCs was not a result of inefficient viral entry or nuclear import of viral DNA but correlated with deficient nuclear import of the virion-associated protein UL82, which is believed to play a role in removing barriers to viral RNA synthesis. Additionally, we found that viral genomes could persist in pNSCs culture up to a month after infection despite the absence of detectable viral lytic gene expression, although we could also detect expression of viral latency-associated genes, suggesting that the virus becomes latent in pNSCs. To study in greater depth the molecular basis of the interaction of HCMV with cells of the neural lineage, we have continued high-throughput genomics approaches to analyze HCMV microRNAs, alterations in cellular microRNA and gene expression profiles, and global defects in host alternative splicing in infected and uninfected pNSC-derived NPCs. We found that in infected NPCs, there was specific downregulation of transcripts related to neuron differentiation. These findings demonstrate the capacity of HCMV infection to alter the neural identities of key precursor cells in the developing nervous system. We also analyzed our infected NPC RNA-seq database for differences in host mRNA polyadenylation patterns and found that over a hundred transcripts were significantly altered in terms of their 3' end cleavage site preference, with the majority of these events resulting in shortened 3' UTRs. Our finding that HCMV induces major changes in the transcriptome of NPCs, particularly at the level of neural genes, suggested that the virus might affect these cells functionally. To directly evaluate this, we differentiated pNSCs into midbrain dopaminergic (mDA) neurons and infected these cells at different times of the differentiation process. Seeding pNSCs in differentiation medium for 6 weeks yields a high frequency of mature neurons with long axonal projections. Infection of pNSCs at the start of differentiation greatly reduces generation of beta III-tubulin+ neurons 4 weeks later, and prevents differentiation to mature MAP2+ neurons. Infection after 1 week of differentiation also reduces the number of beta III-tubulin+ neurons and results in massive cell death. Infection at 2 weeks after differentiation start does not reduce the number of βIII-tubulin+ or MAP2+ neurons, but the cells display major anomalies. Since neurons are highly sensitive to oxidative stresses and HCMV infection increases the production of reactive oxygen species in fibroblasts, we investigated whether the same effect occurred in neuronal cultures. When pNSCs were infected at week 4 after differentiation, high levels of ROS were detected. These results suggest that the complex effects of HCMV infection at various stages of neural cell differentiation on both cell survival and maturation may account for the broad range of birth defects. We expect that the results of these studies will provide an unprecedented resolution of the effects on neurogenesis when HCMV infects a newborn, serve as a foundation for future therapeutic efforts in preventing the birth defects due to HCMV, and provide insight into the serious potential problem of disseminated HCMV in immunosuppressed individuals receiving transplanted allogeneic stem cells.

Congenital and childhood sensorineural hearing loss (SNHL) is a multifactorial disease that severely impacts quality of life. The single most important etiology of congenital SNHL is prenatal human cytomegalovirus (HCMV) infection, which accounts for 20-30% of all deafness in infants and children. Approximately 1 in 150 children is born with congenital HCMV, and 1 in 5 of these children will be born with or will develop permanent neural disabilities, the most common of which is SNHL. SNHL can be either bilateral or unilateral, and the severity of the hearing loss and its progression varies widely. Although the association of congenital HCMV infection and SNHL has been recognized for 50 years, how infection induces the hearing loss is unknown. Since the target of HCMV is cells of the neural lineage, a major goal of our research is to understand at high-resolution the effects of HCMV infection on neural lineage specification and maturation of stem and progenitor cells. Elucidation of the genes and cellular processes that are affected will serve as a basis for therapeutic strategies to ameliorate the effects of HCMV infection in newborns. The significance of our studies also extends to the problem of HCMV infection in immunocompromised individuals, with recipients of allogeneic transplants having a high risk of severe disease and allograft rejection. The proposed use of stem cell transplantation in treating neuronal injury and neurodegenerative diseases, as well as transplantation of other organ-specific precursors, makes it imperative to understand how disseminated HCMV infection in immunosuppressed recipients will affect the function and differentiation of the cells. This past year, we made significant progress in accomplishing the goals of this project. To study in greater depth the molecular basis of the interaction of HCMV with cells of the neural lineage, we continued high-throughput genomics approaches to analyze HCMV microRNAs, alterations in cellular microRNA and gene expression profiles, and global defects in host alternative splicing in infected and uninfected pNSC-derived NPCs. We also analyzed our infected NPC RNA-seq database for differences in host mRNA polyadenylation patterns and found that over a hundred transcripts were significantly altered in terms of their 3' end cleavage site preference, with the majority of these events resulting in shortened 3' UTRs. One of our most striking findings was that there was strongly enhanced expression of three miRNAs that play a critical role in auditory development. Other genes involved in cochlear development were also dysregulated by infection. These results implicate a novel molecular mechanism of damage to the developing inner ear of congenitally infected children, based on altered developmental gene regulation. These findings coupled with our success in inducing differentiation of human ES into otic progenitors that can be further differentiated to hair cell-like cells and immature auditory neurons have provided a strong foundation to pursue in depth HCMV infection of auditory progenitor cells, with the goal of determining how infection compromises the gene expression and function of human ES-derived inner ear cells and to use this information to develop new strategies for the treatment and prevention of hearing loss in congenitally infected children. Regrettably, we are not able to continue these highly important studies, as this CIRM grant ended and a new proposal to CIRM was not funded. This was very disappointing because there is a gap in the portfolio of grants awarded by CIRM, which is a lack of attention to important problems relating to Child Health. One of the most important areas in stem cells that have been neglected is congenital sensorineural hearing loss. Only 3 grants relating to hearing loss have ever been awarded by CIRM. Yet the incidence of just congenital hearing loss (not including hearing loss from other causes or associated with aging) is 400 in 100,000 newborns. Moreover, the disability will last for life, causing a significant burden to the patient and family and a high economic cost to society. There is no drug or vaccine to prevent congenital hearing loss due to CMV, and thus it is essential develop new therapeutic strategies, including stem cells, gene targeting, and drug discovery. Unfortunately, there is no accepted mechanism by which HCMV infection leads to hearing loss, and a lack of public awareness regarding the serious medical problems resulting from congenital HCMV Infection has made it difficult to garner support for studies to identify an etiology. We appreciate the support CIRM has provided and hope that in the future there will be sufficient public awareness of the devastating effects of congenital HCMV infection to bring pressure upon funding agencies to recognize and support this important research.