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Vibholm LK, Nielsen SSF, Pahus MH, Frattari GS, Olesen R, Andersen R, Monrad I, Andersen AHF, Thomsen MM, Konrad CV, Andersen SD, Højen JF, Gunst JD, Østergaard L, Søgaard OS, Schleimann MH, Tolstrup M. SARS-CoV-2 persistence is associated with antigen-specific CD8 T-cell responses. EBioMedicine 2021; 64:103230. [PMID: 33530000 PMCID: PMC7847186 DOI: 10.1016/j.ebiom.2021.103230] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/05/2021] [Accepted: 01/15/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Upon SARS-CoV-2 infection, most individuals develop neutralizing antibodies and T-cell immunity. However, some individuals reportedly remain SARS-CoV-2 PCR positive by pharyngeal swabs weeks after recovery. Whether viral RNA in these persistent carriers is contagious and stimulates SARS-CoV-2-specific immune responses is unknown. METHODS This cohort study was conducted between April 3rd-July 9th 2020, recruiting COVID-19 recovered individuals that were symptom-free for at least 14 days. We collected serum for SARS-CoV-2-specific total Ig, IgA and IgM detection by ELISA, pharyngeal swabs (two time points) for ddPCR and PBMCs for anti-SARS-CoV-2 CD8 T-cell dextramer analyses. FINDINGS We enrolled 203 post-symptomatic participants with a previous RT-PCR-verified SARS-CoV-2 infection. At time point 1, a median of 23 days (range 15-44) after recovery, 26 individuals (12⋅8%) were PCR positive. At time point 2, 90 days (median, range 85-105) after recovery, 5 (5⋅3%) were positive. There was no difference in SARS-CoV-2 antibody levels between the PCR negative and positive group. The persistent PCR positive group however, had SARS-CoV-2-specific CD8 T-cell responses of significantly increased breadth and magnitude. Assisted contact tracing among persistent PCR positive individuals revealed zero new COVID-19 diagnoses among 757 close contacts. INTERPRETATION Persistent pharyngeal SARS-CoV-2 PCR positivity in post-symptomatic individuals is associated with elevated cellular immune responses and thus, the viral RNA may represent replicating virus. However, transmission to close contacts was not observed indicating that persistent PCR positive individuals are not contagious at the post-symptomatic stage of the infection.
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Affiliation(s)
- Line K Vibholm
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark.
| | | | - Marie H Pahus
- Dept. of Clinical Medicine, Aarhus University, Denmark
| | | | - Rikke Olesen
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Rebecca Andersen
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Ida Monrad
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark
| | | | | | | | | | - Jesper F Højen
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Jesper D Gunst
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark; Dept. of Clinical Medicine, Aarhus University, Denmark
| | - Lars Østergaard
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark; Dept. of Clinical Medicine, Aarhus University, Denmark
| | - Ole S Søgaard
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark; Dept. of Clinical Medicine, Aarhus University, Denmark
| | | | - Martin Tolstrup
- Dept. of Infectious Diseases, Aarhus University Hospital, Denmark; Dept. of Clinical Medicine, Aarhus University, Denmark
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2
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Andersen AHF, Nielsen SSF, Olesen R, Mack K, Dagnæs-Hansen F, Uldbjerg N, Østergaard L, Søgaard OS, Denton PW, Tolstrup M. Humanized NOG Mice for Intravaginal HIV Exposure and Treatment of HIV Infection. J Vis Exp 2020. [PMID: 32065160 DOI: 10.3791/60723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Humanized mice provide a sophisticated platform to study human immunodeficiency virus (HIV) virology and to test antiviral drugs. This protocol describes the establishment of a human immune system in adult NOG mice. Here, we explain all the practical steps from isolation of umbilical cord blood derived human CD34+ cells and their subsequent intravenous transplantation into the mice, to the manipulation of the model through HIV infection, combination antiretroviral therapy (cART), and blood sampling. Approximately 75,000 hCD34+ cells are injected intravenously into the mice and the level of human chimerism, also known as humanization, in the peripheral blood is estimated longitudinally for months by flow cytometry. A total of 75,000 hCD34+ cells yields 20%-50% human CD45+ cells in the peripheral blood. The mice are susceptible to intravaginal infection with HIV and blood can be sampled once weekly for analysis, and twice monthly for extended periods. This protocol describes an assay for quantification of plasma viral load using droplet digital PCR (ddPCR). We show how the mice can be effectively treated with a standard-of-care cART regimen in the diet. The delivery of cART in the form of regular mouse chow is a significant refinement of the experimental model. This model can be used for preclinical analysis of both systemic and topical pre-exposure prophylaxis compounds as well as for testing of novel treatments and HIV cure strategies.
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Affiliation(s)
- Anna H F Andersen
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital;
| | - Stine S F Nielsen
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital
| | - Rikke Olesen
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital
| | | | | | - Niels Uldbjerg
- Department of Clinical Medicine, Aarhus University; Department of Gynecology and Obstetrics, Aarhus University Hospital
| | - Lars Østergaard
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital
| | - Ole S Søgaard
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital
| | - Paul W Denton
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital; Department of Biology, University of Nebraska at Omaha
| | - Martin Tolstrup
- Department of Clinical Medicine, Aarhus University; Department of Infectious Diseases, Aarhus University Hospital
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Andersen AHF, Olesen R, Jønsson KL, Højen JF, Krapp C, Mack K, Thomsen MK, Østergaard L, Tolstrup M, Dagnaes-Hansen F, Jakobsen MR, Denton PW. cAIMP administration in humanized mice induces a chimerization-level-dependent STING response. Immunology 2019; 157:163-172. [PMID: 30919991 DOI: 10.1111/imm.13061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/20/2019] [Accepted: 03/23/2019] [Indexed: 12/15/2022] Open
Abstract
It is well understood that the STING signalling pathway is critical for generating a robust innate immune response to pathogens. Human and mouse STING signalling pathways are not identical, however. For example, mice lack IFI16, which has been proven important for the human STING pathway. Therefore, we investigated whether humanized mice are an appropriate experimental platform for exploring the human STING signalling cascade in vivo. We found that NOG mice reconstituted with human cord blood haematopoietic stem cells (humanized NOG mice) exhibit human STING signalling responses to an analogue of the cyclic di-nucleotide cGAMP. There was an increase in the proportions of monocytes in the lungs of mice receiving cGAMP analogue. The most robust levels of STING expression and STING-induced responses were observed in mice exhibiting the highest levels of human chimerization. Notably, differential levels of STING in lung versus spleen following cGAMP analogue treatment suggest that there are tissue-specific kinetics of STING activation and/or degradation in effector versus inductive sites. We also examined the mouse innate immune response to cGAMP analogue treatment. We detected that mouse cells in the immunodeficient NOG mice responded to the cGAMP analogue and they do so with distinct kinetics from the human response. In conclusion, humanized NOG mice represent a valuable experimental model for examining in vivo human STING responses.
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Affiliation(s)
- Anna H F Andersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Rikke Olesen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
| | | | - Jesper F Højen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Christian Krapp
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Katharina Mack
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
| | | | - Lars Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Martin Tolstrup
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
| | | | | | - Paul W Denton
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
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Frich CK, Krüger F, Walther R, Domar C, Andersen AHF, Tvilum A, Dagnæs-Hansen F, Denton PW, Tolstrup M, Paludan SR, Münch J, Zelikin AN. Non-covalent hitchhiking on endogenous carriers as a protraction mechanism for antiviral macromolecular prodrugs. J Control Release 2018; 294:298-310. [PMID: 30552954 DOI: 10.1016/j.jconrel.2018.12.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/26/2018] [Accepted: 12/11/2018] [Indexed: 12/23/2022]
Abstract
Albumin is a highly successful tool of drug delivery providing drastically extended body and blood residence time for the associated cargo, but it only traffics single drug copies at a time. In turn, macromolecular prodrugs (MP) are advantaged in carrying a high drug payload but offering only a modest extension of residence time to the conjugated drugs. In this work, we engineer MP to contain terminal groups that bind to albumin via non-covalent association and reveal that this facile measure affords a significant protraction for the associated polymers. This methodology is applied to MP of acyclovir, a successful drug against herpes simplex virus infection but with poor pharmacokinetics. Resulting albumin-affine MP were efficacious agents against herpes simplex virus type 2 (HSV-2) both in vitro and in vivo. In the latter case, sub-cutaneous administration of MP resulted in local (vaginal) antiviral effects and a systemic protection. Presented benefits of non-covalent association with albumin are readily transferrable to a wide variety of MP in development for drug delivery as anticancer, anti-inflammatory, and anti-viral measures.
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Affiliation(s)
| | - Franziska Krüger
- Institute of Molecular Virology, Ulm University Medical Center, 89081 Ulm, Germany
| | - Raoul Walther
- Department of Chemistry, Aarhus University, 8000 Aarhus C, Denmark
| | - Cecilie Domar
- Department of Chemistry, Aarhus University, 8000 Aarhus C, Denmark
| | - Anna H F Andersen
- Department of Infectious Diseases, Aarhus University Hospital, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, 8000 Aarhus N, Denmark
| | - Anne Tvilum
- Department of Chemistry, Aarhus University, 8000 Aarhus C, Denmark
| | | | - Paul W Denton
- Department of Infectious Diseases, Aarhus University Hospital, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, 8000 Aarhus N, Denmark
| | - Martin Tolstrup
- Department of Infectious Diseases, Aarhus University Hospital, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, 8000 Aarhus N, Denmark
| | - Søren R Paludan
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Jan Münch
- Institute of Molecular Virology, Ulm University Medical Center, 89081 Ulm, Germany.
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Andersen AHF, Riber CF, Zuwala K, Tolstrup M, Dagnæs-Hansen F, Denton PW, Zelikin AN. Long-Acting, Potent Delivery of Combination Antiretroviral Therapy. ACS Macro Lett 2018; 7:587-591. [PMID: 35632936 DOI: 10.1021/acsmacrolett.8b00179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Antiretroviral therapy (ART) has revolutionized HIV treatment, yet grand challenges remain: (i) short blood and body residence time of the antiviral drugs, (ii) relative poor antiretroviral drug penetrance into key tissue reservoirs of viral infection, namely, the spleen and lymph nodes, and (iii) obstacles in different pharmacokinetics of the necessary combination drugs. We present a novel drug delivery approach that simultaneously overcomes these limitations. We designed albumin-polymer-drug conjugates where albumin ensures long body residence time as well as lymphatic accumulation of the conjugate. The polymer enabled the delivery of combinations of drugs in precise ratios affording potency superior to the individual antiretroviral drugs and strong protection from HIV infection in primary human T cells.
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Affiliation(s)
- Anna H. F. Andersen
- Department of Chemistry, Aarhus University, Aarhus 8000, Denmark
- Department of Infectious Diseases and Department of Clinical Medicine, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Camilla F. Riber
- Department of Chemistry, Aarhus University, Aarhus 8000, Denmark
| | - Kaja Zuwala
- Department of Chemistry, Aarhus University, Aarhus 8000, Denmark
- Department of Infectious Diseases and Department of Clinical Medicine, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Martin Tolstrup
- Department of Infectious Diseases and Department of Clinical Medicine, Aarhus University Hospital, Aarhus 8200, Denmark
| | | | - Paul W. Denton
- Department of Infectious Diseases and Department of Clinical Medicine, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Alexander N. Zelikin
- Department of Chemistry, Aarhus University, Aarhus 8000, Denmark
- iNano Interdisciplinary Nanoscience Centre, Aarhus University, Aarhus 8000, Denmark
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6
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Zuwala K, Riber CF, Løvschall KB, Andersen AHF, Sørensen L, Gajda P, Tolstrup M, Zelikin AN. Macromolecular prodrugs of ribavirin: Polymer backbone defines blood safety, drug release, and efficacy of anti-inflammatory effects. J Control Release 2018; 275:53-66. [PMID: 29432822 PMCID: PMC7114659 DOI: 10.1016/j.jconrel.2018.02.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/02/2018] [Accepted: 02/08/2018] [Indexed: 12/18/2022]
Abstract
Macromolecular (pro)drugs hold much promise as broad-spectrum antiviral agents as either microbicides or carriers for intracellular delivery of antiviral drugs. Intriguing opportunity exists in combining the two modes of antiviral activity in the same polymer structure such that the same polymer acts as a microbicide and also serves to deliver the conjugated drug (ribavirin) into the cells. We explore this opportunity in detail and focus on the polymer backbone as a decisive constituent of such formulations. Fourteen polyanions (polycarboxylates, polyphosphates and polyphosphonates, and polysulfonates) were analyzed for blood pro/anti coagulation effects, albumin binding and albumin aggregation, inhibitory activity on polymerases, cytotoxicity, and anti-inflammatory activity in stimulated macrophages. Ribavirin containing monomers were designed to accommodate the synthesis of macromolecular prodrugs with disulfide-exchange triggered drug release. Kinetics of drug release was fast in all cases however enhanced hydrophobicity of the polymer significantly slowed release of ribavirin. Results of this study present a comprehensive view on polyanions as backbone for macromolecular prodrugs of ribavirin as broad-spectrum antiviral agents.
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Affiliation(s)
- Kaja Zuwala
- Department of Infectious Diseases, Aarhus University Hospital, 8200, Denmark; Department of Chemistry, Aarhus University, 8000, Denmark
| | | | | | - Anna H F Andersen
- Department of Infectious Diseases, Aarhus University Hospital, 8200, Denmark; Department of Chemistry, Aarhus University, 8000, Denmark
| | - Lise Sørensen
- Department of Chemistry, Aarhus University, 8000, Denmark
| | - Paulina Gajda
- Department of Infectious Diseases, Aarhus University Hospital, 8200, Denmark
| | - Martin Tolstrup
- Department of Infectious Diseases, Aarhus University Hospital, 8200, Denmark
| | - Alexander N Zelikin
- Department of Chemistry, Aarhus University, 8000, Denmark; iNano Interdisciplinary Nanoscience Centre, Aarhus University, 8000, Denmark.
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7
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Schandock F, Riber CF, Röcker A, Müller JA, Harms M, Gajda P, Zuwala K, Andersen AHF, Løvschall KB, Tolstrup M, Kreppel F, Münch J, Zelikin AN. Macromolecular Antiviral Agents against Zika, Ebola, SARS, and Other Pathogenic Viruses. Adv Healthc Mater 2017; 6. [PMID: 28945945 PMCID: PMC7161897 DOI: 10.1002/adhm.201700748] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/07/2017] [Indexed: 01/08/2023]
Abstract
Viral pathogens continue to constitute a heavy burden on healthcare and socioeconomic systems. Efforts to create antiviral drugs repeatedly lag behind the advent of pathogens and growing understanding is that broad‐spectrum antiviral agents will make strongest impact in future antiviral efforts. This work performs selection of synthetic polymers as novel broadly active agents and demonstrates activity of these polymers against Zika, Ebola, Lassa, Lyssa, Rabies, Marburg, Ebola, influenza, herpes simplex, and human immunodeficiency viruses. Results presented herein offer structure–activity relationships for these pathogens in terms of their susceptibility to inhibition by polymers, and for polymers in terms of their anionic charge and hydrophobicity that make up broad‐spectrum antiviral agents. The identified leads cannot be predicted based on prior data on polymer‐based antivirals and represent promising candidates for further development as preventive microbicides.
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Affiliation(s)
- Franziska Schandock
- Institute of Molecular Virology; Ulm University Medical Center; Meyerhofstrasse 1 89081 Ulm Germany
| | | | - Annika Röcker
- Institute of Molecular Virology; Ulm University Medical Center; Meyerhofstrasse 1 89081 Ulm Germany
| | - Janis A. Müller
- Institute of Molecular Virology; Ulm University Medical Center; Meyerhofstrasse 1 89081 Ulm Germany
| | - Mirja Harms
- Institute of Molecular Virology; Ulm University Medical Center; Meyerhofstrasse 1 89081 Ulm Germany
| | - Paulina Gajda
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus 8000 Denmark
| | - Kaja Zuwala
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus 8000 Denmark
| | - Anna H. F. Andersen
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus 8000 Denmark
| | | | - Martin Tolstrup
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus 8000 Denmark
| | - Florian Kreppel
- Institute of Molecular Virology; Ulm University Medical Center; Meyerhofstrasse 1 89081 Ulm Germany
| | - Jan Münch
- Institute of Molecular Virology; Ulm University Medical Center; Meyerhofstrasse 1 89081 Ulm Germany
| | - Alexander N. Zelikin
- Department of Chemistry; Aarhus University; Aarhus 8000 Denmark
- iNano Interdisciplinary Nanoscience Centre; Aarhus University; Aarhus 8000 Denmark
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Danial M, Andersen AHF, Zuwala K, Cosson S, Riber CF, Smith AAA, Tolstrup M, Moad G, Zelikin AN, Postma A. Triple Activity of Lamivudine Releasing Sulfonated Polymers against HIV-1. Mol Pharm 2016; 13:2397-410. [DOI: 10.1021/acs.molpharmaceut.6b00156] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | - Anna H. F. Andersen
- Department
of Clinical Medicine, Aarhus University Hospital, Aarhus N 8200, Denmark
| | - Kaja Zuwala
- Department
of Clinical Medicine, Aarhus University Hospital, Aarhus N 8200, Denmark
| | - Steffen Cosson
- CSIRO Manufacturing, Clayton, VIC 3168, Australia
- Tissue
Engineering and Microfluidics Laboratory, Australian Institute for
Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, QLD 4072, Australia
| | | | | | - Martin Tolstrup
- Department
of Clinical Medicine, Aarhus University Hospital, Aarhus N 8200, Denmark
| | - Graeme Moad
- CSIRO Manufacturing, Clayton, VIC 3168, Australia
| | - Alexander N. Zelikin
- Department
of Chemistry, Aarhus University, Aarhus C 8000, Denmark
- iNANO
Interdisciplinary Nanoscience Centre, Aarhus University, Aarhus C 8000, Denmark
| | - Almar Postma
- CSIRO Manufacturing, Clayton, VIC 3168, Australia
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