Long Macrophage Pathology
Long Macrophage Pathology
Long Macrophage Pathology
DOI: 10.1007/s00408-004-2535-y
1
Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA;
2
Esperion Therapeutics, Inc., 3621 S. State St., 695 KMS Place, Ann Arbor, Michigan 48108, USA;
3
Division of Pediatric Infectious Diseases, University of Michigan, Ann Arbor, Michigan 48109, USA;
4
Department of Microbiology and Immunology, SUNY Upstate Medical University,
750 East Adams St., Syracuse New York 13210, USA
Abstract. The purpose of this study was to examine the lung pathogenesis of
murine gammaherpesvirus (MHV-68) infection in mice that lack CC chemo-
kine receptor CCR2, an important receptor for macrophage recruitment to
sites of inflammation. BALB/c and CCR2)/) mice were inoculated intranasally
(i.n.) with MHV-68 and samples were collected during acute infection (6 dpi)
and following viral clearance (12 dpi). Immunohistochemistry was used to
determine which cells types responded to MHV-68 infection in the lungs. Lung
pathology in infected BALB/c mice was characterized by a mixed inflammatory
cell infiltrate, necrosis, and increased alveolar macrophages by 12 dpi.
Immunohistochemistry showed intense positive staining for macrophages.
CCR2)/) mice showed greater inflammation in the lungs at 12 dpi than did
BALB/c mice, with more necrosis and diffuse neutrophil infiltrates in the
alveoli. Immunohistochemistry demonstrated much less macrophage infiltra-
tion in the CCR2)/) mice than in the BALB/c mice. These studies show that
CCR2 is involved in macrophage recruitment in response to MHV-68 infection
and illustrates how impairments in macrophage function affect the normal
inflammatory response to this viral infection.
*Current address: Laboratory Animal Health Sciences, The Jackson Laboratory, 600 Main St.,
Bar Harbor, Maine
**Current address: Kent County Health Department, Grand Rapids, Michigan
Correspondence to: R. Rochford; email: rochforr@upstate.edu
240 J. M. Cadillac et al.
Introduction
The lung is often the site of entry for viruses because of the large bronchial and
alveolar surface area. Although many viral infections are rapidly resolved, evi-
dence is accumulating that is a subset of viral infections is associated with chronic
lung disease. For example, herpesvirus infections have been shown to be associ-
ated with the development of idiopathic pulmonary fibrosis [33] and primary
pulmonary hypertension [7]. Understanding how viral infections induce immu-
nopathology in the lungs is critical to development of prevention and treatment of
chronic lung diseases.
Challenge of mice with a variety of respiratory viruses has proven to be a
useful model system to elucidate many of the host factors involved in immune
response in the lung. Infection of mice with murine gammaherpesvirus (MHV)-68
serves as a model to study the effects of viral infection on lung pathology. MHV-68
is a naturally occurring rodent pathogen which, following intranasal (i.n.) inocu-
lation in mice, replicates in the lungs [1, 5, 22, 24, 27, 29, 31, 32]. Viral latency is
established predominantly in the mediastinal lymph nodes (MLN) and in the
spleen [5, 29], but there is also evidence that viral DNA can persist in the lungs of
infected mice [28, 37] suggesting that this virus could also contribute to a sustained
immune response in the lungs.
Chemokines are chemotactic cytokines that orchestrate the movement of
leukocytes along a concentration gradient into and out of sites of inflammation
[18, 25, 34]. They are increasingly recognized as key mediators of inflammation
and leukocyte recruitment in response to inflammatory stimuli including viral
infections [18, 25]. Viral respiratory infection induces the production of chemo-
kines critical to the host inflammatory response [9, 10, 13, 20, 36].
Early descriptions of lung inflammation following MHV-68 infection noted
cellular infiltrates lasting up to 30 days post inoculation (dpi) [2, 30]. We and
others have described a sustained chemokine response, including monocyte
chemoattractant protein-1 (MCP-1), to lung infection with MHV-68 [26, 38]
suggesting that these chemokines contribute to lung inflammation. Chemokine
receptors are expressed on a number of cells, including monocytes, macrophages,
T lymphocytes, eosinophils, and basophils [18]. MCP-1, now termed chemokine
ligand 2 [35, 39], and its receptor CCR2 are potent monocyte and lymphocyte
chemoattractants important in the pathogenesis of several inflammatory diseases,
including atherosclerosis, idiopathic pulmonary fibrosis, and multiple sclerosis [8,
15--18]. Deficiency of CCR2 results in delayed or failed macrophage recruitment,
which in turn causes a reduction in phagocytosis with prolonged influx of and/or
increased numbers of neutrophils and eosinophils and resultant tissue damage [4,
8, 15, 16].
To determine the role of macrophages in MHV-68 infection of the lung,
BALB/c and CCR2)/) mice were infected with MHV-68 and examined histo-
logically. The kinetics of pathologic lesions in the lungs following MHV-68
infection is described. Our data suggest that MHV-68 infection is a useful model
for viral-induced pathology in the lungs and that in the absence of CCR2 there is
increased inflammation.
Macrophages Mediate Viral Lung Pathology 241
Animals
Four--six-week-old male BALB/c mice were purchased from Harlan Sprague Dawley, Inc.
(Indianapolis, IN). Six--eight-week-old CCR2)/) mice (BALB/cCmkbr2tm1Kuz) of both genders were a
kind gift from Dr. Gary Hufmagle (University of Michigan, Ann Arbor, MI). All mice were main-
tained in specific-pathogen-free housing and acclimated in the animal facility for 4--7 days before
infection occurred. The mice were housed in accordance with Animal Welfare Act regulations and the
Guide for the Care and Use of Laboratory Animals, under a protocol approved by the University of
Michigan Committee on Use and Care of Animals.
Virus Infection
Generation of MHV-68 stocks was done as previously described [5]. Mice were lightly anesthetized
with isoflurane (AErrane; Baxter, Deerfield, IL) and inoculated i.n. with 4 · 104 plaque-forming units
(PFUs) of virus, diluted in 20 ll of sterile phosphate buffered saline (PBS; GibcoBRL, Grand Island,
NY). Control mice (mock infected) were inoculated with 20 ll of supernatant from mock virus
preparation at an equivalent dilution in PBS. BALB/c and CCR2)/) mice were euthanized with iso-
flurane at 6 and 12 dpi. Additional BALB/c mice were also euthanized at 16, 20, and 31 dpi.
RNA was extracted from tissues as described [6, 24]. MHV-68 gene expression was determined using
the c-7 riboprobe template, as previously described [24]. All riboprobe syntheses were driven by T7
bacteriophage RNA polymerase with [a-32P]UTP (Amersham, Arlington Heights, IL) as the labeling
nucleotide [14]. The ribonuclease protection assay (RPA) was done as described [24]. Bands were
visualized by autoradiography (XAR film, Kodak, Rochester, NY) and were quantified by using the
Storm PhosphorImager and ImageQuant software (Molecular Dynamics, Sunnyvale, CA). Volume
measurements with rectangular objects were used to generate PhosphorImager (PI) counts, which are
presented as a percentage of the internal housekeeping gene signal (i.e., L32) present in each lane.
Histopathology
The left lung was resected, inflated with O.C.T. (Tissue-Tek, Torrance, CA), placed in freezing
embedding medium (O.C.T.), and snap-frozen on dry ice with ethyl alcohol. Frozen tissue was stored
at )80C until sectioning. Serial sections, 4--8 lm thick, were stained with hematoxylin and eosin
(H&E) or prepared for immunohistochemistry.
Upon initial blind evaluation of slides, it was determined that histology findings in uninfected and
mock-infected mice were identical. In both groups, lungs demonstrated minimal focal or no inflammation
and no necrosis or hemorrhage. Consequently, for comparison purposes, lung histology in these two
groups was considered as baseline regarding subsequent evaluation and scoring of infected mice. A score
of 0 reflects no remarkable change. A score of 1 indicates a minimal increase in cells or observation of
necrosis in at least two locations. A score of 2 indicates a mild increase in cell numbers, with at least three
inflammatory cells per high-powered field and/or at least three necrotic cells near a given airway or vessel.
A score of 3 indicates moderate inflammation, with a large contiguous population of cells (30+ cells) and/
or areas of necrosis with at least ten necrotic cells near a given airway or vessel. A score of 4 indicates
marked inflammation, with a high number of inflammatory cells forming clumps, filling the alveoli.
242 J. M. Cadillac et al.
Statistics
Group means were compared by two-sample t-test. Statistical significance was set at p < 0.05.
Results
variable numbers of monocytes [3]. There was also no alveolar macrophage re-
sponse over baseline and no hemorrhage or necrosis present at 31 dpi.
To quantify the inflammatory response to the virus, H&E-stained sections of
infected lungs at 6 dpi (peak of viral infection) and 12 dpi (following viral
clearance) were evaluated for pathology. Specific criteria were chosen to allow
repeatable scoring based on counting of either inflammatory cells or hemorrhagic
or necrotic foci. Slides were evaluated in six categories: (1) perivascular and
peribronchial inflammation, (2) perivascular necrosis, (3) perivascular hemor-
rhage, (4) increased neutrophils in the alveoli, (5) increased number of alveolar
macrophages, and (6) alveolar necrosis. Each slide was evaluated blindly and was
scored semiquantitatively on a scale from 0 to 4 based on severity of lung
pathology (see the Methods section for scoring explantation). With the exception
of mean neutrophil numbers, mean scores of inflammation, necrosis, and hem-
orrhage increased between 6 and 12 dpi (Fig. 2A).
The lungs of infected BALB/c mice had intense positive staining for mono-
cytes and macrophages with the macrophage markers MOMA-2 (Fig. 3A) and
Mac3 (data not shown) at 6 dpi and light positive staining by 12 dpi. These
immunohistochemistry results confirm the presence of monocytes and macro-
phages in MHV-68 infection during both acute and recovered infection as noted
by histologic analysis.
To verify viral infection of the mice, RNA was analyzed by RPA to measure
expression of viral transcripts. We observed high-level viral gene expression at 6
dpi (Fig. 4) consistent with our previous observations that 6 dpi corresponds to
the acute phase of viral infection in the lung [38]. No viral gene expression was
observed at the later time points (Fig. 4 and data not shown) verifying that virus
was cleared from the lungs by 12 dpi.
CCR2 is the receptor for the monocyte chemoattractant protein-1 (MCP-1) [39].
Infection of mice deleted of CCR2 (CCR2)/) mice) results in reduced macrophage
recruitment in the lungs following viral infection [16]. To determine if the absence
of CCR2 would impact the pathogenesis of MHV-68 infection, CCR2)/) mice
were infected i.n. with MHV-68 and lungs were processed for histology or for
RNA extraction. We observed a robust pattern of viral gene expression in the
CCR2)/) infected mice at 6 dpi as determined by RPA analysis (Fig. 4). Viral
gene expression was no longer detectable by 12 dpi in the CCR2)/) mice, indi-
cating that the virus was cleared by this time point. No significant differences in
the pattern of viral gene expression were observed following infection of BALB/c
or CCR2)/) mice (Fig. 4B).
In the CCR2)/) infected mice, inflammation was characterized most com-
monly by a mixed infiltrate of neutrophils, lymphocytes, and plasma cells. Peri-
vascular inflammation and peribronchial inflammation were minimal in CCR2)/)
mice at 6 dpi (Fig. 5A, B), and the mean score for alveolar macrophage accu-
mulation was less than 1 (Fig. 2A). By 12 dpi, scores for all six evaluation cate-
244 J. M. Cadillac et al.
Fig. 1. Characterization of lung pathology following intranasal infection with MHV-68 in the lungs of
BALB/c mice. All sections are prepared from frozen tissue and stained with H&E. (A) Acute infection
(6 dpi) characterized by a mild mixed-cell inflammatory infiltrate which caused an increased lung
cellularity; scale = 200 lm. Inset shows accumulation of neutrophils (arrowheads) and lymphocytes.
(B) By 12 dpi, a moderate mixed-cell inflammatory response is seen with an increased alveolar mac-
rophage population; scale = 200 lm. Inset shows neutrophils (arrowheads) and alveolar macro-
phages (arrows). (C) At 16 dpi, the mixed-cell infiltrate is most severe, characterized by multifocal
dense accumulations of inflammatory cells; scale = 200 lm. Inset shows cellular infiltrates in the
peribronchial regions. (D) By 20 dpi, the inflammatory response has greatly decreased compared with
the earlier time points; scale = 200 lm. (E) At 31 dpi, a diffuse lymphocytic infiltrate is seen; sca-
le = 200 lm. Inset shows dense accumulation of lymphocytes (arrows). Original magnifications: · 200
(A--E); insets · 400 (A, B, E), · 800 (C).
Macrophages Mediate Viral Lung Pathology 245
Fig. 3. Evaluation of the inflammatory response to MHV-68 infection in the lungs of BALB/c and
CCR2)/) mice using immunohistochemistry on frozen sections. (A) MOMA-2 positive staining of
alveolar macrophages (arrows) at 6 dpi in a BALB/c mouse, showing numerous macrophages. (B) Few
macrophages are seen at 6 dpi in a CCR2)/) mouse, as expected with a deficiency in CCR2. Original
magnifications: · 400.
gories (Fig. 2C) were increased from the prior time point (Fig. 2B). Overall his-
tology scores for BALB/c and CCR2)/) mice show a trend of increasing
inflammation from 6 dpi to 12 dpi. At 12 dpi (Fig. 2C), there is a significant
difference between the BALB/c mice and the CCR2)/) mice when comparing
perivascular necrosis and diffuse alveolar neutrophil infiltrates (p < 0.05).
CCR2)/) mice at both time points had lower mean alveolar macrophage scores
(i.e., less macrophage accumulation) when compared with BALB/c mice.
By 12 dpi (Fig. 5C), the CCR2)/) mice showed increased perivascular
necrosis and increased numbers of neutrophils in the alveoli that were significantly
greater when compared with those of the BALB/c mice (p < 0.05). Perivascular
and peribronchial regions of hemorrhage were observed in both the BALB/c and
the CCR2)/) mice, associated with regions of severe perivascular and peribron-
chial necrosis and inflammation. Necrosis of the alveolar epithelial cell lining was
a rare finding, noted only in CCR2)/) animals (one mouse at 6 dpi and one mouse
at 12 dpi).
At 6 and 12 dpi, lungs of CCR2)/) mice showed light positive staining for
monocytes and macrophages with MOMA-2 (Fig. 3B) and Mac3 (data not
shown). These results support the histologic observations that there were a de-
creased number of alveolar macrophages present in the CCR2)/) mice compared
with the BALB/c mice.
b
Fig. 4. (A) Viral gene expression in lungs of CCR2)/) mice infected with MHV-68. RNA was har-
vested at 6 and 12 dpi, and 5 lg of RNA was analyzed for expression of MHV-68 transcripts by RPA
with the c-7 probe set. Shown is a representative phosphorimage. Each lane represents RNA extracted
from a single mouse. (B) Quantitation of MHV-68 gene expression following infection of BALB/c or
CCR2)/) mice. PI counts were obtained for protected probe fragments and the data are presented as a
percentage of the internal housekeeping signal L32. Means ± SEM are shown for each time point for
balb/c and CCR2-/- mice.
Discussion
Fig. 5. Inflammatory response to MHV-68 in lungs of CCR2)/) mice. Frozen sections were stained,
with H&E. (A) Perivascular inflammation and hemorrhage in the lungs of a CCR2)/) mouse at 6 dpi,
scale = 200 lm. Inset shows numerous lymphocytes (arrows) and alveolar macrophages (arrow-
heads). An area of hemorrhage is present between the two labeled macrophages. Several cells in the
vessel wall are necrotic. (B) Higher magnification of a CCR2)/) mouse at 6 dpi showing several
picnotic cells which characterize perivascular and alveolar wall necrosis (arrows); scale = 50 lm.
There are multiple neutrophils also identified. (C) Perivascular infiltrates and necrosis in a CCR2)/)
mouse at 12 dpi; scale = 200 lm. Lung interstitium and alveolar spaces are highly cellular. Area
between arrows has increased numbers of neutrophils and alveolar macrophages with numerous
lymphocytes also present. Original magnifications: ·400 (A, C), · 700 (B).
Acknowledgments. This work was supported in part by NIH/NCRR T32 RR07008 (J.C.), NICHD
grant HD28820 (J.W.), and NIA AG908692 (R.R.). The authors would like to thank the Martin
Philbert laboratory for use of their cryostat, Thomas Komorowski for his technical assistance, and Dr.
Ken Guire, University of Michigan, and Dr. Weidong Zhang, The Jackson Laboratory, for advice on
statistical analysis. The authors also thank Elizabeth Horn and Mark Deming from Pathology Pho-
tography for their technical assistance. The authors are especially grateful to the personnel at Diane
Robins Laboratory for their support.
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Accepted for publication: January 3 2005