Characterization of adenovirus hexons by their epitope composition

Adenoviruses associated with acute gastroenteritis in hospitalized and community children up to 5 years old in Rio de Janeiro and Salvador, Brazil

Acute gastroenteritis is a major source of morbidity and mortality among young children in developed and developing countries. Human adenoviruses (HAdVs), and in particular species F, are related to childhood diarrhoea worldwide. This study presents the results obtained during an investigation of HAdVs causing acute gastroenteritis in children hospitalized in Rio de Janeiro, RJ, Brazil, from April 1996 to September 2003, as well as in children with diarrhoea living in the slums of Salvador, BA, Brazil, from October 2001 to September 2003. A total of 3060 stool samples was analysed by an enzyme immunoassay for rotavirus and adenovirus (EIARA) and 61 (2%) were found to be positive. HAdV presented with low prevalence throughout the year, with a slight but not significant increase in incidence in late summer and early autumn. Children up to 2 years of age were the most frequently affected (79% of all positive samples). All positive samples were analysed further by generic and species-specific HAdV PCR protocols, confirming 100% specificity of this rapid and inexpensive EIARA. Species F was the most prevalent (65%), despite the occurrence of species A (12%), C, D and co-infection F/D (5% each) and species B and co-infections F/A, F/C and B/D (2% each). In order to type the species F strains as HAdV-40 or -41, generic PCR and a HinfI restriction digest were performed. HAdV-40 and -41 were found to represent 62% (23/37) and 38% (14/37), respectively. These results demonstrated that a combination of generic and species-specific PCRs is useful and reliable for HAdV species and type identification directly from faecal specimens. The results confirmed the endemism of human adenoviruses, mainly species F, in children as aetiological agents of diarrhoea, although the limited sensitivity of EIARA as a screening method may have underestimated their prevalence.

Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease

Adenovirus (AdV) infection in the course of allogeneic stem cell transplantation (SCT) is associated with high transplant-related morbidity and mortality. Disseminated AdV disease is lethal in most instances. Early detection of AdV infection and identification of patients carrying a high risk of disseminated disease therefore remain a major challenge. In view of the large number of existing AdV types, we have established real-time polymerase chain reaction (PCR) assays permitting sensitive detection and quantification of all 51 currently known human AdV serotypes. In a series of 132 consecutive pediatric patients undergoing SCT, more than 5000 samples derived from peripheral blood (PB), stool, urine, and throat were screened for adenovirus infection by PCR during the posttransplantation period. Thirty-six patients (27%) tested positive by PCR, revealing AdV types of the subgenera A, B, C, D, and F. Except for enteritis in some patients with AdV positivity in stool, detection of the virus at sites other than PB was not associated with clinical signs of virus disease, and transplant-related mortality was not significantly different from AdV-negative patients. By contrast, 82% of patients who had detectable AdV in PB died from infectious complications (P <.001). Monitoring of PB specimens by real-time PCR permitted early diagnosis of invasive AdV infection in all instances. In patients who developed disseminated AdV disease, detection of the virus in PB preceded onset of clinical symptoms by a median of more than 3 weeks. The observation of AdV in peripheral blood may therefore serve as a basis for early initiation of preemptive antiviral treatment.

Recombinant adenovirus vectors for gene therapy and clinical trials

In the last decade adenovirus (AdV) vectors have emerged as promising technology in gene therapy. They have been used for genetic modification of a variety of somatic cells in vitro and in vivo. They have been widely used as gene delivery vectors in experiments both with curative and preventive purposes. AdV vectors have been used in the experimental and in some extent in the clinical gene therapy of a variety of cancers. The combination of recombinant AdV technology with chemotherapy (pro drug system) seems to be promising, too. AdV vectors offer several advantages over other vectors. Replication defective vectors can be produced in very high titers (10(11) pfu/ml) thus allowing a substantially greater efficiency of direct gene transfer; they have the capacity to infect both replicating and nonreplicating (quiescent) cells from a variety of tissues and species. Several important limitations of adenovirus mediated gene transfer are also known, such as the relatively short-term (transient) expression of foreign genes, induction of the host humoral and cellular immune response to viral proteins and viral infected cells, which may substantially inhibit the effect of repeated treatment with AdV vectors, the limited cloning capacity and the lack of target cell specificity. However, the well-understood structure, molecular biology and host cell interactions of AdV-s offer some potential solutions to these limitations.

In vivo dose threshold effect of adenovirus-mediated factor VIII gene therapy in hemophiliac mice

While much is known about adenovirus biology from its development as a therapeutic gene delivery vehicle, an important question remains regarding the appropriate in vivo vector dose. We describe here an in vivo dose threshold effect with an adenoviral vector expressing human Factor VIII (FVIII) in hemophiliac mice. Upon administration of vector doses between 6 x 10(10) and 2 x 10(10) vector particles per mouse, FVIII was expressed linearly, whereas a dose of 1 x 10(10) vector particles per mouse did not result in detectable levels of FVIII activity. In contrast, in vitro transduction studies demonstrated linear transgene expression over 2 to 3 log units. To further define this dose threshold effect, a vector-mixing study was performed. Mice were injected with a total vector dose of 6 x 10(10) particles containing admixtures of FVIII vector plus a control vector lacking a transgene (null vector). With the admixture, FVIII activity was detected in mice that received 1 3 1010 particles of the FVIII vector, indicating that maintenance of the total viral input at 6 x 10(10) particles per mouse circumvented the threshold dose effect. This threshold dose effect could not be attributed to dose-dependent differences in liver toxicity nor to dose-dependent induction of cellular and humoral immune responses. Southern blot analysis of livers revealed that mice receiving the vector admixture contained FVIII DNA, accounting for the observed FVIII expression, whereas mice receiving 1 x 10(10) particles of FVIII vector had barely detectable FVIII DNA. These results suggest that the threshold effect is an in vivo phenomenon that will have important implications in defining the therapeutic window of adenoviral vectors for clinical applications.

PCR and restriction endonuclease analysis for rapid identification of human adenovirus subgenera

Subgenus identification of adenoviruses is of clinical importance and is as informative as identification by serotype in most clinical situations. A PCR-based identification of adenovirus subgenera A, B, C, D, E, and F and sometimes serotypes is described. The PCR uses nonnested primer pair ADRJC1-ADRJC2, which targets a highly conserved region of the adenovirus hexon gene, has a sensitivity of 10 to 40 copies of adenovirus type 2 (Ad2) DNA, and generates 140-bp PCR products from adenovirus serotypes representative of all the subgroups. The PCR products of all subgroups can be differentiated on the basis of the restriction fragment patterns produced by a total of five restriction endonucleases. In addition, serotypes Ad40 and Ad41 (subgroup F) and important serotypes of subgroup D (Ad8, Ad10, Ad19, and Ad37) can easily be differentiated, but serotypes within subgroups B and C cannot. The method was assessed by blind subgenus identification of 56 miscellaneous clinical isolates of adenoviruses. The identities of these isolates at the subgenus level by the PCR correlated 91% (51 of 56) with the results of serotyping by the neutralization test, and 9% (5 of 56) of clinical isolates produced discordant results.

Rapid identification of subgenera of human adenovirus by serological and PCR assays

Bacterially expressed recombinant protein IX (pIX) of human adenovirus serotype 2 (Ad2) and 3 (Ad3) was evaluated for use as a subgenus-specific antigen by enzyme-linked immunosorbent assay (ELISA) and Western blotting. Patients sera positive by ELISA for the genus-specific adenovirus hexon antigen recognized the recombinant pIX of Ad2 and Ad3 in a subgenus-specific manner by both assays. Polyclonal rabbit serum raised against the recombinant Ad2pIX reacted strongly by indirect immunofluorescence assay, with Adl, 2 and 5 (subgenus C) but not with serotypes representing other subgenera. In a similar way, anti-Ad3pIX reacted with Ad3, 7, 11 and 14 (subgenus B), but not with serotypes representing other subgenera. A polymerase chain reaction showed that the complete pIX gene could be amplified in a subgenus specific fashion using primers specific for Ad3 (subgenus B), Ad2 (subgenus C), or Ad40/41 (subgenus F). The pIX gene from the available isolates of subgenus A, D and E was not amplified with these primers. The use of pIX-based serological assays is useful for subgenotyping as a primary screen of anti-Ad sera. It is much more rapid than the currently used neutralization assay or hemagglutination inhibition test. The application of anti-pIX sera by immunofluorescence and a pIX gene-based PCR are rapid methods which will improve subgenus identification of adenoviruses.