| Literature DB >> 35106511 |
Bernhard Neumann1,2, Klemens Angstwurm1, Ralf A Linker1, Gertrud Knoll3, Lisa Eidenschink3, Dennis Rubbenstroth4, Kore Schlottau4, Martin Beer4, Patrick Schreiner5, Erwin Soutschek5, Merle M Böhmer6,7, Benedikt M J Lampl8,9, Matthias Pregler8, Alexander Scheiter10, Katja Evert10, Saida Zoubaa11, Markus J Riemenschneider11, Benedikt Asbach12, André Gessner3,12, Hans Helmut Niller3,12, Barbara Schmidt3,12, Markus Bauswein3.
Abstract
Borna disease virus 1 (BoDV-1) causes rare but often fatal encephalitis in humans. Late diagnosis prohibits an experimental therapeutic approach. Here, we report a recent case of fatal BoDV-1 infection diagnosed on day 12 after hospitalization by detection of BoDV-1 RNA in the cerebrospinal fluid. In a retrospective analysis, we detect BoDV-1 RNA 1 day after hospital admission when the cell count in the cerebrospinal fluid is still normal. We develop a new ELISA using recombinant BoDV-1 nucleoprotein, phosphoprotein, and accessory protein X to detect seroconversion on day 12. Antibody responses are also shown in seven previously confirmed cases. The individual BoDV-1 antibody profiles show variability, but the usage of three different BoDV-1 antigens results in a more sensitive diagnostic tool. Our findings demonstrate that early detection of BoDV-1 RNA in cerebrospinal fluid and the presence of antibodies against at least two different viral antigens contribute to BoDV-1 diagnosis. Physicians in endemic regions should consider BoDV-1 infection in cases of unclear encephalopathy and initiate appropriate diagnostics at an early stage.Entities:
Keywords: Borna disease virus 1; ELISA; antibodies; diagnostics; encephalitis; encephalopathy; humoral immune response; recombinant protein; zoonosis
Mesh:
Substances:
Year: 2022 PMID: 35106511 PMCID: PMC8784767 DOI: 10.1016/j.xcrm.2021.100499
Source DB: PubMed Journal: Cell Rep Med ISSN: 2666-3791
Figure 1Time course of disease
A 71-year-old individual without significant past medical history living in an endemic area in southern Germany developed unspecific symptoms of BoDV-1 infection 2 weeks prior to hospitalization. The x axis shows days after hospital admission. Leucocyte count (cells/μL) in cerebrospinal fluid (CSF) is represented on the left y axis, and RNA copies (copies/mL) in CSF obtained through qRT-PCR of two target regions are represented on the right y axis. The diagnosis was made by qRT-PCR from CSF on day 12. Workup of other infectious or autoimmune causes of encephalitis remained negative. The individual died on day 15 after admission.
BoDV-1 qRT-PCR from post mortem tissue samples of the affected individual
| Sample | BoDV-1 RNA (copies/mL organ homogenate) | |
|---|---|---|
| Mix 1 | Mix 6 | |
| Frontal cortex | 1.50E10 | 2.65E8 |
| Optical nerve | 3.05E9 | 7.15E7 |
| Brachial plexus | 6.15E6 | 9.80E5 |
| Femoral nerve | 3.30E4 | 1.90E4 |
| Sural nerve | 1.35E9 | 4.90E7 |
| Sartorius muscle | <3E2 | <3E2 |
| Heart muscle | <3E2 | <3E2 |
| Blood (post mortem) | <3E2 | <3E2 |
| Lung | <3E2 | <3E2 |
| Cervical lymph node | <3E2 | <3E2 |
| Spleen | <3E2 | <3E2 |
| Liver | <3E2 | <3E2 |
| Kidney | <3E2 | <3E2 |
| Urine (post mortem) | <3E2 | <3E2 |
| Stool (post mortem) | <3E2 | <3E2 |
Two targets were analyzed. Tissue samples were homogenized in approximately 1 mL 0.9% sodium chloride.
Figure 2Silver staining and western blots of purified recombinant BoDV-1 proteins
For silver staining, proteins were separated by SDS-PAGE using a 15% polyacrylamide gel. Lanes were loaded with 200 ng His-tagged Np40, 200 ng GST-tagged Xp10, and 100 ng His-tagged Pp23 protein. For western blots, lanes were loaded with 100 ng Np40, 200 ng Xp10, and 100 ng Pp23. Proteins were separated by SDS-PAGE using a 12% polyacrylamide gel and then blotted onto a 0.2 μm nitrocellulose membrane. Selected samples of 8 confirmed BoDV-1-infected individuals were diluted 1:100. Time of sample collection is expressed as days post admission (dpa) to hospital. Asterisks mark specific bands with the expected molecular weight expressed in kDa. All experiments were carried out once.
Figure 3BoDV-1 IgG-ELISA
Three ELISA systems for the detection of IgG antibodies against BoDV-1 nucleoprotein (N), accessory protein X, and phosphoprotein (P) were developed. All samples were diluted 1:100 prior to testing. Dots represent serum/plasma samples (green: anti-BoDV-1-N-IgG; red: anti-BoDV-1-X-IgG; blue: anti-BoDV-1-P-IgG), and squares represent CSF samples (light green: anti-BoDV-1-N-IgG; magenta: anti-BoDV-1-X-IgG; light blue: anti-BoDV-1-P-IgG). The x axis shows days after hospital admission, and the y axis shows optical density (OD). Cutoffs for each ELISA system are indicated by horizontal lines (green: anti-BoDV-1-N ELISA; red: anti-BoDV-1-X ELISA; blue: anti-BoDV-1-P ELISA). A vertical yellow line indicates the time of death. Black arrows point to corresponding indirect immunofluorescence assay (iIFA) results. iIFA titers in CSF are indicated in italics.
(A) Determination of cutoffs as the sum of arithmetic mean (black horizontal line) plus 6 standard deviations (error line) of 24 samples, which had been characterized as negative via iIFA. Green, red, and blue horizontal lines represent cutoffs.
(B) Reactivity against BoDV-1 N, X, and P antigens in samples of affected individuals with suspected tick-borne encephalitis. Horizontal lines represent cutoffs.
(C) Time course of BoDV-1 antibodies in the current case.
(D) ELISA results for another seven confirmed and recently published BoDV-1-infected individuals. All experiments were carried out once. Interassay variabilities were calculated for N, X, and P antigens in five runs of one sample of individual 7, resulting in 30%, 10%, and 5%, respectively.
Figure 4BoDV-1 IgM-ELISA
(A) Cutoffs for each ELISA system are indicated by horizontal lines (green: anti-BoDV-1-N ELISA; red: anti-BoDV-1-X ELISA; blue: anti-BoDV-1-P ELISA). A vertical yellow line indicates the time of death. Cutoffs were determined by 24 characterized negative samples as the sum of arithmetic mean (black horizontal line) plus 6 standard deviations (error line) Green, red and blue horizontal lines represent cutoffs.
(B and C) ELISA results for the current individual and another 7 recently published confirmed BoDV-1-infected individuals. All experiments were carried out once. Interassay variabilities were calculated for N, X, and P antigens in three runs of one sample of individual 2, resulting in 42%, 15%, and 15%, respectively.
| REAGENT or RESOURCE | SOURCE | IDENTIFIER |
|---|---|---|
| Cy3 AffiniPure Goat Anti-Human IgG (H+L) | Jackson ImmunoResearch | Cat# 109-165-003; RRID: |
| Cy3 AffiniPure Goat Anti-Rabbit IgG (H+L) | Jackson ImmunoResearch | Cat# 111-165-003; RRID: |
| Polyclonal Rabbit Anti-Human IgG/HRP antibody | Agilent | Cat# P021402-2; RRID: |
| Polyclonal Rabbit Anti-Human IgM/HRP antibody | Agilent | Cat# P021502-2; RRID: |
| Goat Anti-Rabbit IgG (H+L)-HRP Conjugate antibody | Bio-Rad | Cat# 172-1019; RRID: |
| BoDV-1, 2 strains isolated from human CNS tissue | Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Germany | N/A |
| Plasma samples of 2 BoDV-1 infected rabbits. The animal experiments were evaluated and approved by the ethics committee of the State Office of Agriculture, Food safety, and Fishery in Mecklenburg – Western Pomerania (LALLF M-V: LVL MV/TSD/ 7221.3-2-010/18). | Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald – Insel Riems, Germany | N/A |
| Plasma samples of VSBV-1 infected rabbits. The animal experiments were evaluated and approved by the ethics committee of the State Office of Agriculture, Food safety, and Fishery in Mecklenburg – Western Pomerania (LALLF M-V: LVL MV/TSD/ 7221.3-2-010/18). | Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald – Insel Riems, Germany | N/A |
| BoDV-1 nucleocapsid Np40 protein, His-tagged | Mikrogen | N/A |
| BoDV-1 phosphoprotein Pp23, His-tagged | Mikrogen | N/A |
| BoDV-1 X protein Xp10, GST-tagged | Mikrogen | N/A |
| PBS | GIBCO | Cat# 14190-094 |
| Tween 20 | Caelo | Cat# 3472 |
| Fat free milk powder | Heirler | N/A |
| RF Absorbent | Virion/Serion | Cat# Z200 |
| Mikrogen TMB | Mikrogen | Cat# 12003 |
| Mikrogen Stopp (24.9% H3PO4) | Mikrogen | Cat# 12004 |
| TRIS buffer with Tween 20, pH 8.0 | Sigma-Aldrich | Cat# T9039-10PAK |
| TaqPath™1-Step RT-qPCR Master Mix, CG | Applied Biosystems | Cat# A15299 |
| NxtScript Reaction Mix | Roche/Penzberg | Cat# 07368372103 |
| NxtScript RT 85U/μL | Roche/Penzberg | Cat# 07371527103 |
| ROX-Reference Dye | Life technologies | Cat# 12223-012 |
| RNase free DEPC water | Roth | Cat# 143.3 |
| PageRuler Prestained Protein Ladder | Thermo Fisher Scientific | Cat# 26617 |
| Roti-Block | Roth | Cat# A151.2 |
| EZ1 Virus Mini Kit v2.0 | QIAGEN | Cat# 179799 |
| Dataset uploaded to Mendeley | This study | |
| Vero cells | Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Germany | N/A |
| BoDV-1 Mix 1 (target: x/p gene): | Metabion; (Schlottau et al. | N/A |
| • BoDV1-1288-F (TAGTYAGGAGGC | ||
| • BoDV-1-1449-R (GTCCYTCAGGA | ||
| • BoDV-1-1346-FAM (FAM-AAGAAG | ||
| BoDV-1 Mix 6 (target: m/g gene): | Metabion; (Schlottau et al. | N/A |
| • BoDV-1-2262-F (CAATYAATGCAG | ||
| • BoDV-1-2336-R (GAATGTCYGGG | ||
| • BoDV-1-2316-FAM (FAM-CCARCA | ||
| MS2: | Metabion; | N/A |
| • MS2 forward primer | Metabion; | |
| • MS2 reverse primer | Applied Biosystems; | |
| • MS2 So VIC/Tamra | (Dreier et al., 2005) | |
| GraphPad Prism V9.2.0 | GraphPad | |
| Nunc Maxisorp Plates | Thermo Fisher Scientific | Cat# 446469 |
| μ-Plate 96 Well Black | Ibidi | Cat# 89626 |
| Nitrocellulose western blotting membrane Amersham Protran Premium 0.2 μm | Thermo Fisher Scientific | Cat# 15279794 |