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Orthohantaviruses are rodent-borne pathogens distributed all over the world, which do not cause visible disease in their reservoir host. Puumala orthohantavirus (PUUV) causes most human hantavirus disease cases in Europe and is transmitted by the bank vole (Clethrionomys glareolus). Hantaviruses have a tri-segmented genome consisting of the large (L) segment, coding for the RNA-dependent RNA polymerase (RdRP), the medium (M) segment, encoding the glycoproteins, and the small (S) segment. The S-segment contains two major overlapping open reading frames (ORF) coding for the nucleocapsid (N) protein and a non-structural (NSs) protein, a putative type I interferon (IFN-I) antagonist. To date, pathogenesis and reservoir host adaptation of hantaviruses are poorly understood due to missing adequate cell culture and animal models.
In contrast to previous studies, in this work, data from spring and summer 2019 indicated a high vole abundance, a high PUUV prevalence in voles and high human incidence for some endemic regions in Germany, but elsewhere values were low to moderate. Regional and local human health institutions need to be aware about the heterogeneous distribution of human PUUV infection risk.
For a better understanding of virus-host associations, two novel cell lines from bank voles and common voles each were generated and their susceptibility and replication capacities for a variety of zoonotic and non-zoonotic viruses were analyzed. The PUUV strain Vranica/Hällnäs showed efficient replication in a new bank vole kidney cell line, but not in four other cell lines of bank and common voles. Vice versa, Tula orthohantavirus (TULV) replicated in the kidney cell line of common voles, but was hampered in its replication in other cell lines. Several viruses, such as Cowpox virus, Vaccinia virus, Rift Valley fever virus, and Encephalomyocarditis virus 1 replicated in all four cell lines. West Nile virus, Usutu virus, Sindbis virus and Tick-borne encephalitis virus replicated only in a part of the cell lines. These results indicate a tissue or species specific tropism for many of the tested viruses and the potential value of vole cell lines to address such questions in detail.
Using one of these new cell lines, the first German PUUV strains were isolated from bank voles caught in the highly endemic region around Osnabrück. Complete genomes were determined by target-enrichment-mediated high-throughput sequencing from original lung tissue, after isolation and after additional passaging in VeroE6 cells and a bank vole-derived kidney cell line. Different single amino acid substitutions were observed in the RdRP of the two stable PUUV isolates. The PUUV strain isolated on VeroE6 cells showed a lower titer when propagated on bank vole cells compared to VeroE6 cells. Additionally, glycoprotein precursor (GPC)-derived virus-like particles of a German PUUV strain from the same region allowed the generation of monoclonal antibodies that reacted with the isolated PUUV strains.
To investigate the role of PUUV and other vole-borne hantavirus NSs proteins, the evolution of the NSs and N encoding sequences was investigated by a field study in bank voles and the NSs sequences were characterized in vitro for their inhibitory effect on the human interferon-β promoter. Analysis of blood and lung samples of 851 bank voles trapped during 2010-2014 in Baden-Wuerttemberg and North Rhine-Westphalia resulted in detection of 27.8% PUUV-specific antibody positive bank voles, whereas in 22.3% PUUV-specific RNA was detected. In the hantavirus outbreak years 2010 and 2012 PUUV prevalence in bank voles was higher compared to 2011, 2013 and 2014. Sequences of the S segment of all positive bank voles showed amino acid and nucleotide sequence types of the NSs-ORF with temporal and/or local variation, whereas the N-ORF was highly conserved. One sequence type persisted over the whole observation period in both regions. The NSs coding sequence was highly divergent among regional bank vole populations in the outbreak year 2012.
Transfection experiments resulted in the detection of different products of the NSs-ORF of PUUV, TULV, Prospect Hill and Khabarovsk orthohantaviruses, due to translation initiation at different methionine codons along the coding sequence. Using luciferase reporter assays, the NSs proteins of PUUV, TULV, Prospect Hill and Khabarovsk orthohantaviruses showed inhibition of IFN-I induction of up to 70%, whereas Sin Nombre and Andes orthohantavirus NSs proteins showed a reduced effect compared to the other NSs proteins. The first 20 amino acids of the N-terminal region of PUUV NSs were found to be crucial for IFN-I promoter inhibition.
In conclusion, the newly established cell lines, antibodies, reporter assays and PUUV isolates are highly valuable tools for future hantavirus research. The activity of PUUV NSs protein in human cells contributes to our understanding of virus-host interactions and highlights the importance of corresponding future reservoir host studies. Hantavirus surveillance studies showed the necessity for timely information of the potential human PUUV infection risk to public health institutions in endemic areas to initiate appropriate actions.
Hantaviruses are enveloped viruses with a single-stranded RNA genome of negative polarity. The genome consists of three segments: small (S), medium (M) and large (L). As zoonotic pathogen, hantaviruses are worldwide responsible for 150,000 to 200,000 human disease cases per year. Two forms of human disease are currently distinguished: In the Americas the hantavirus cardiopulmonary syndrome (HCPS) and in Europe and Asia the hemorrhagic fever with renal syndrome (HFRS). Since the introduction of the German Protection against Infection Act in 2001 until now a total of 10,082 disease cases have been reported. As a result, hantavirus infections currently rank as the fifth frequent notifiable disease in Germany. More than 80% of these infections were caused by the hantavirus species Puumala virus (PUUV), transmitted by the bank vole Myodes glareolus. Besides temporal oscillations, an unequal geographical distribution of human PUUV cases was noticed in Germany and in other countries of Central Europe. This is reflected in the presence of endemic and non-endemic regions as well as of so-called outbreak years. Therefore, the overall objective of this study was to find out possible reasons for the inhomogeneous distribution of PUUV in Central Europe, in particular in Poland, Germany and certain districts of Baden-Wuerttemberg. The basic working hypothesis was that PUUV spread in Central Europe after the last glaciation with different evolutionary lineages of the bank vole and that the current emergence of PUUV in bank vole populations is determined by local geographical and ecological factors. Very little was known about the presence of PUUV in Poland. Earlier studies were based exclusively on serological detection of PUUV, but a molecular detection with subsequent phylogenetic investigation was missing so far. Therefore, 45 bank voles from the northeastern part of Poland were investigated by serological and molecular assays. In three animals from a forest region close to the city of Miko³ajki PUUV-reactive antibodies and/or PUUV RNA were detected. Phylogenetic analysis indicated the presence of a Latvian (LAT) PUUV strain. Viral RNA was detected in one bank vole of the Eastern evolutionary lineage and two animals of the Carpathian lineage. Thereby it could be demonstrated for the first time that the distribution of the LAT PUUV lineage ranges from Latvia south-west to the northeastern part of Poland. An inhomogeneous spatial distribution of human disease cases has been observed even for Baden-Wuerttemberg, a long time known endemic federal state of Germany. Therefore 660 bank voles were trapped during the outbreak and non-outbreak years 2012 and 2013 in four districts with high incidences (H) and in four districts with low incidences or lacking PUUV cases (L). During the outbreak year 2012 PUUV-positive bank voles were detected by serological and molecular investigations in seven of eight districts. In contrast, in the following year only in one district PUUV infected bank voles were detected. Furthermore, it was demonstrated that after a beech mast, i.e., a massive fructification of beech trees, in H districts with a higher percentage of beech forest coverage a higher number of human cases was notified, but not in L districts with a lower percentage of beech forest coverage. For the future development of early warning modules it is therefore necessary to have a long-term bank vole monitoring established that incorporates beech mast data and information on beech forest coverage. High endemic regions for PUUV are mainly located in the southern and western parts of Germany, whereas in the eastern and northern parts only low numbers or even no human cases are recorded. To find out possible reasons for this inhomogeneous distribution, 1,774 bank voles from different regions of Germany were investigated for PUUV infections and in parallel for the corresponding bank vole evolutionary lineage (Western, Eastern, Carpathian). The PUUV investigations indicated positive voles in the known endemic regions with an easternmost and northernmost occurrence in western Saxony-Anhalt, western Thuringia and in Osnabrück. In the northern and eastern part of Germany none of the 1,210 investigated bank voles showed a PUUV infection. In the southern and western parts of Germany only the Western bank vole lineage was identified, whereas the Eastern lineage was exclusively found in the eastern and northern part and the Carpathian lineage in the South-East and North-East of Germany. PUUV infections were found almost exclusively in bank voles of the Western lineage. Individuals of the other two vole lineages were found to be PUUV infected only in regions with sympatric occurrence of the Western lineage. The previously described contact zone of the different bank vole phylogroups ranges from Poland to the entire northern part of Germany. In conclusion, the results of this investigation indicate two potential major reasons for the inhomogeneous distribution of PUUV in Germany: First, PUUV of the CE lineage seems to be associated with the Western bank vole lineage. The current geographical distribution of virus and host might be explained by a post-glacial northern expansion of the bank vole starting at the western refuge. Second, the missing detection of PUUV in bank voles of the Western lineage in areas close to high endemic regions might be explained by the extinction of the virus due to a limited winter survival of infected animals during long and harsh winters. The virus stability outside the host or ecological barriers, such as isolated forest areas or broad rivers, might also influence the distribution of PUUV in bank vole populations.