Sparing of the ipsilateral retina from virus infection after uniocular AC inoculation of the KOS strain of HSV-1 has been shown to be due, at least in part, to the presence of T cells.
4 9 10 In T-cell–depleted mice, virus spreads to the contralateral SCN of the hypothalamus earlier than in euthymic mice, and virus infects the optic nerve and retina of the ipsilateral injected eye, resulting in retinitis in the injected eye. In the injected eye, natural killer cells have been shown to play a role in preventing direct anterior-to-posterior spread of HSV-1.
11 12 The present study focused on the role of PMNs in the acute ocular inflammatory reaction that occurs after uniocular AC inoculation of HSV-1. In these studies, fulminant HSV-1 infection of the retina of the HSV-1–inoculated eye was observed in neutrophil-depleted mice. There are two routes by which HSV might infect the retina of the inoculated eye. One route would be by direct anterior-to-posterior spread of HSV-1 in the injected eye, whereas the other route would be from the contralateral SCN in the hypothalamus to the ipsilateral optic nerve and retina. Earlier and increased virus replication in the contralateral SCN in neutrophil-depleted mice would allow virus to infect the optic nerve and retina of the ipsilateral injected eye resulting in retinitis.
After HSV-1 inoculation in the AC of nondepleted mice, early infiltration of neutrophils was noted in the limbus region. The number of neutrophils increased rapidly during the first 3 to 4 days pi in the inoculated eye in control antibody–treated mice, and most of the neutrophils were HSV-1
+. As expected, in nondepleted mice, HSV-1 infection was limited to the anterior segment. In contrast, in neutrophil-depleted mice, inflammation of the anterior segment was reduced presumably due to the lack of these critical first-line defense cells. The lack of neutrophils correlated with slow spread of HSV-1 from the anterior to the posterior segment. In Gr-1 antibody–treated mice as well as in nondepleted mice, virus spread from the injected eye via the previously described neuronal route.
8 The timing of virus spread from the anterior segment to the brain in neutrophil-depleted mice was identical with that observed in the nondepleted group, and in both groups, the ipsilateral SCN was HSV-1
+ on day 5 pi. However, depletion of neutrophils correlated with more rapid spread of HSV-1 from the ipsilateral SCN to the contralateral SCN and in neutrophil-depleted mice, the contralateral SCN was HSV-1
+ by day 6 pi, whereas in nondepleted mice, virus was not detected in the contralateral SCN until day 7 pi.
In Gr-1–depleted mice, increasingly positive HSV-1 staining was detected in the ipsilateral optic nerve from days 6 to 8 pi. At day 7 pi, patchy HSV-1 staining was noted in the central part of the retina, and it spread to involve all the retina by day 8 pi. This pattern of HSV staining indicated retrograde spread of HSV-1 from the contralateral SCN to the optic nerve and to the retina of the injected (ipsilateral) eye in Gr-1–depleted mice. In contrast, HSV-1 staining was not observed in the ipsilateral optic nerve of nondepleted mice and the retina of the injected eye was not virus infected.
Observation of early virus infection in the area of the pars plana in Gr-1–depleted mice suggests that PMNs may play an earlier role than NK cells (which are not depleted by the Gr-1 antibody)
16 in controlling direct anterior-to-posterior spread of virus after uniocular AC inoculation of HSV-1. This idea is supported by previous studies showing NK cell cytotoxicity at day 3 after AC HSV-1 inoculation,
12 whereas in the studies reported herein, neutrophil phagocytosis of HSV-1–infected cells (as shown by HSV-1
+ neutrophils) was detected at day 1 to 2 after HSV-1 AC inoculation.
To study the influence of neutrophils in the proliferation and replication of HSV-1, neutrophils and monocytes were isolated from the peripheral blood and infected with HSV-1. HSV-1–infected Vero cells were used as the control. From 0 to 8 hours pi, there was no difference in virus recovery among the three types of cells, while at times later than 8 hours pi, replicating virus could only be recovered from Vero cells. These results suggest that although neutrophils and monocytes could not support HSV-1 replication, infectious virus could be recovered for at least 2 days from neutrophils and monocytes exposed to the virus. By extension, it is possible that virus-carrying neutrophils and monocytes may be able to spread virus in vivo.
Although neutrophils have historically been classified as nondividing cells,
22 23 24 recent investigations have indicated that PMNs have the ability to secrete iNOS as well as immunomodulatory factors such as IL-4, IL-12, IFNγ, and TNFα.
18 25 26 In the current studies, neutrophils were observed in the contralateral SCN of nondepleted mice at days 6 to 7 pi. The reason that HSV-1 does not spread from the contralateral SCN to the ipsilateral optic nerve and retina after uniocular AC injection of HSV-1 in BALB/c mice is not well understood. The results from the studies presented herein support the idea that neutrophils play a role in preventing spread of virus from the contralateral SCN to the ipsilateral optic nerve and retina, perhaps by direct engulfment and killing of virus or virus-infected cells or by secreting one or more of the above-mentioned immunomodulators, which would attract more inflammatory cells to the site of the infection and would, in turn, amplify the inflammatory response.
Neutrophils are classified as innate immune cells
22 27 28 —that is, cells that are the first to reach a site of inflammation and that recognize pathogens through invariant receptors. Neutrophils have also been shown to augment the adaptive immune response. Recent studies have shown that a subpopulation of mammalian neutrophils expresses a T-cell receptor,
22 indicating that neutrophils may use both innate and adaptive immune mechanisms for pathogen recognition. This recent finding may help to explain the role of neutrophils in the HSV-1–injected eye. First, neutrophils may function as innate immune cells to engulf the virus and/or virus-infected cells and prevent the virus from spreading to the retina of the injected eye. Second, neutrophils may function as T cells to kill HSV-1–infected cells, either directly or by secretion of cytokines. The dual function of neutrophils with properties of both NK cells and T cells would help to prevent the direct HSV spreading from the anterior segment to the posterior segment and would also assist in blocking or reducing the spread of HSV-1 in neurons synaptically connected to one or both optic nerves and retinas.
Although it is possible that NK cells and/or T cells compensate for the lack of neutrophils in the HSV-1–injected, Gr-1 antibody–treated mice, the timing of these studies supports the idea that these cells did not play a role in virus spread. In previous studies from our laboratory,
12 NK cell cytotoxicity was not observed until day 3 pi, whereas in the studies reported herein, the effect of neutrophils on direct spread of the virus was observed as early as day 1 pi. Results reported by Reading et al.
29 indicated that NK cells contribute to the early clearance of HSV-1 from the lung, but that these cells are unable to control replication of HSV-1 in the central nervous system. Other investigators have shown that activated CD4 and CD8 T cell effectors against HSV-1 infection are not generated until 7 to 8 days pi.
30 Therefore, it is unlikely that NK cells, T cells, or both played a significant role in these results; however, without additional double depletion studies, a contribution by one or both of these cell types cannot be completely ruled out. Smith et al.
31 reported that neutrophils participated in antibody-dependent cellular cytotoxicity (ADCC) against HSV-1–infected corneal cells. ADCC could be another compensatory mechanism in neutrophil-depleted mice; however, since anti–HSV-1 antibody is made later (on day 5 pi and after),
32 it is unlikely that ADCC plays a major role in controlling virus spread within the injected eye.
In addition to binding to mature neutrophils, RB6-8C5 has been reported to cross-react with the Ly-6C allele found on some CD8
+ T cells and monocytes.
33 34 Tumpey et al.
16 reported that treatment with RB6-8C5 resulted in a 96% reduction of neutrophils with no significant reduction in CD4
+ T cells, B cells, NK cells, or F4/80
+ macrophage populations. This finding was in accordance with our results for CD8
+ T cells, which showed a reduction of approximately 50% in both spleen and peripheral blood samples on day 5 pi. Our previous studies showed that either CD4 or CD8 T cells can protect the retina of the injected eye after uniocular AC inoculation of HSV-1.
10 Therefore partial depletion of CD8 T cells by administration of Gr-1 antibody may also contribute to the ability of virus to spread from the contralateral SCN to the optic nerve and retina in Gr-1 antibody–treated mice.
In summary, the results of these studies implicate PMNs in control of HSV-1 in the injected eye and in preventing virus spread from the brain to the optic nerve and retina of the injected eye. However, they do not provide information about how these cells contribute to the unique pattern of virus infection after uniocular AC inoculation of HSV-1. Further studies are needed to elucidate the mechanism(s) by which PMNs control virus spread in the eye and also from the brain back to the optic nerve and retina of the eye after uniocular AC inoculation of HSV-1.
The authors thank Jeanene Pihkala and Babak Baban for their assistance with flow cytometry.