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Copyright Traffic 2004; 5: 643–650 Blackwell Munksgaard # Blackwell Munksgaard 2004 doi: 10.1111/j.1600-0854.2004.00209.x Review Retroviral Spread by Induction of Virological Synapses Clare Jolly* and Quentin J. Sattentau* The Sir William Dunn School of Pathology, The University of Oxford, South Parks Road, Oxford OX1 3RE *Corresponding authors: Quentin J. Sattentau, Quentin.Sattentau @pathology.ox.ac.uk Clare Jolly, [email protected] Cells of the immune system communicate via the formation of receptor-containing adhesive junctions termed immunological synapses. Recently, retroviruses have been shown to subvert this process in order to pass directly from infected to uninfected immune cells. Such cell–cell viral dissemination appears to function by triggering existing cellular pathways involved in antigen presentation and T-cell communication. This mode of viral spread has important consequences for both the virus and the host cells in terms of viral pathogenesis and viral resistance to immune and therapeutic intervention. This review summarises the current knowledge concerning virological synapses induced by retroviruses. Key words: adhesion molecules, CD4, CXCR4, HIV-1, HTLV-1, immunological synapse, viral pathogenesis, viral receptors, virological synapse Received 12 May 2004, revised and accepted for publication 26 May 2004 Cell–Cell Contact and Synapses The ability of cells to interact in a co-ordinated manner is integral to many biological processes. Communication often occurs by establishing sites of cell–cell contact that direct secretion from one cell to another. This type of cellular teamwork is particularly important in the complex functioning of the nervous and immune systems (reviewed in this issue (1)). Cells regulate the distribution of receptors in the plasma membrane via targeting to specific microdomains (such as lipid rafts) and/or by cytoskeleton-driven movement in response to external stimuli. Some cells, such as epithelial cells, are naturally polarised, whereas others can be induced to polarise receptors in response to soluble factors (such as chemokines), transcriptional activation or direct cell–cell contact. Cells of many different lineages often contact other cell types during their lifetime. What makes neuronal and immune cells different is that upon contact, a characteristic arrangement of molecules forms at the cell–cell junction, which has been termed a synapse. A synapse has been defined as ‘a stable adhesive junction across which information is relayed by directed secretion’ (2). Cell contact promotes outside-in signalling that directs actin-mediated recruitment of receptors to the interface. The neurological and immunological synapses (IS) differ in the receptors that are recruited to the contact site, but they share a number of similarities that define them as synapses (2): the plasma membranes of interacting cells show points of contiguity but are not continuous and the cells remain independent and do not fuse; * cell–cell recognition is mediated in part by professional adhesion molecules and the synapse is stable; * * there is directed secretion from one cell towards the other. Immune Cells and Synapses The adaptive immune response is dependent on cell contact to detect and respond effectively to antigenic challenge. T-lymphocytes are central to this and perform a variety of functions, from direct killing of infected cells by cytotoxic T-cells, to providing T-cell help by secreting cytokines and chemokines that recruit and activate other cells and assist in antibody production. Formation of an IS facilitates much of this. One of the best-characterised synapses is that between antigen presenting cells (APC) and T-cells (3,4). Most T-lymphocytes are naı̈ve or resting memory cells and must first become activated themselves. T-cell activation is mediated largely by T-cell receptor (TCR) binding to peptide that is associated with major histocompatibility complex (pMHC) displayed on the surface of an APC. If recognised by the T-cell expressing the receptor specific for that antigen-MHC complex, TCR cross-linking transduces signals that cause transcriptional up-regulation and cell proliferation. T-cell activation requires a threshold of pMHC–TCR interactions, estimated to be between 50 and 300 (3,5) and this helps ensure that high-affinity antigen-specific T-cells respond appropriately. The synapse gains stability through co-receptor interactions such as the integrin Lymphoctye Function-associated Adhesion molecule (LFA-1) on the T-cell binding to its cognate ligand Intercellular Adhesion Molecule-1 (ICAM1) on the opposing cell, and CD28 interacting with B7 (6). It 643 Jolly and Sattentau appears that the initial contact between a T-cell and an APC is antigen-independent and adhesion molecule binding precedes the specific pMHC–TCR interactions (7). Signal transduction by the TCR/CD3 complex and costimulation by CD28 and LFA-1 directs cytoskeletal remodelling in the synaptic T-cell (3,8,9). This in turn recruits more receptors to the synapse, increasing stability and amplifying activation signals. A series of elegant studies have demonstrated the complexity of molecular arrangements at the IS (3,10,11). At the earliest stages the supramolecular activation cluster (SMAC) consists of a central core of LFA-1-ICAM, which is surrounded by a ring of TCR-pMHC molecules. In the space of minutes this inverts and the TCR-pMHC becomes central (cSMAC), surrounded by adhesion molecules at the periphery (pSMAC). In this mature synapse, the microtubule organising centre (MTOC) is positioned proximally and other accessory proteins, such as the adaptor protein talin and protein tyrosine kinases including Lck, ZAP-70 and PKCy are also recruited (10–12) (also see Figure 1). In addition to transcriptional activation in the T-cell, the IS facilitates the transfer of molecules between cells by directed secretion into the synaptic cleft. Cytotoxic CD8þ T-cells use the IS to direct target cell killing by exocytosis of lytic granules and perforin (13) whereas CD4þ T-cells can secrete activating cytokines such as interleukin-5 across the synapse (14). What is a Virological Synapse? In order to initiate infection, viruses must adhere to surface receptors on target cells, and then traverse the plasma membrane to gain access to the host cell replicative machinery. The classic model of virus entry describes cell-free virion binding and entry with little, if any, active contribution to infection by the target cell. Some viruses, Figure 1: Generalised molecular interactions taking place between cells in the immunological synapse (top) and the virological synapse (bottom). Some of the interactions are probably shared between the two types of synapse, such as LFA-1-ICAM-1 and LFA-1talin-actin, whereas others are specific for each type of synapse. 644 Traffic 2004; 5: 643–650 Retroviruses and the Virological Synapse however, move by direct passage between infected and uninfected cells (15), a process that may be particularly important in tissues where cells are in close contact, such as within epithelial and endothelial surfaces, lymphoid organs and neuronal axons. Although this process is poorly understood, direct cell–cell transmission has a number of probable advantages for viruses. Firstly, it allows more rapid replication kinetics than free virus infection by speeding up or obviating a rate-limiting step in replication–viral attachment. Secondly, it may allow the virus to evade aspects of the humoral immune response such as neutralising antibody and complement. Retroviruses, including the Human T-cell Leukaemia Virus type-1 (HTLV-1) and the Human Immunodeficiency virus type-1 (HIV-1) can spread by direct cell–cell transfer. HTLV-1 appears to use this process as its primary mode of spread between and within hosts (16), whereas the relative contributions of cell–cell vs. cell-free dissemination in HIV-1 infection is unknown. Both of these viruses infect T-cells that are able to form IS contacts. The existence of synapse-like structures serving to facilitate HIV-1 dissemination had been suggested in the past (15,17), and there were hints that HIV-1 might require a functional actin cytoskeleton during virus infection or HIV-1-mediated fusion (18,19). However, no detailed evidence had been put forward to support the concept of a retrovirally driven synapse. Over the past year, three papers have shed light on how these two viruses may exploit interactions taking place between immune cells resulting in the formation of a ‘virological synapse’ (20–22). Based on these studies we tentatively define the virological synapse (VS) as a cytoskeletondependent, stable adhesive junction across which virus is transmitted by directed transfer. The VS forms in response to contact between virally infected (effector) and permissive, uninfected (target) immune cells, and contains viral antigens and cellular receptors colocalised at the conjugate interface (see Figure 1). In the case of HIV-1 (21), viral receptors and adhesion molecules are recruited into the target cell-side of the synapse in a cytoskeleton-dependent manner. In the effector cell, the core proteins (Gag) are focussed at the synapse and antigen rapidly transfers across the synaptic junction into the target cell, in a microtubule-dependent manner. The HIV-1 DC-T Cell VS HIV-1 is the cause of AIDS and currently infects approximately 40 million people worldwide. Although the predominant mode of transmission is via sexual contact, meaning that the mucosae and associated tissues are the initial targets of infection, the major source of virus production in HIV-1-infected individuals is CD4þ T-lymphocytes. Permissive T-cells express the HIV-1 entry receptors CD4 and a chemokine receptor (CKR); either or both CCR5 and CXCR4 (23). HIV-1 engages these receptors in a two-step process via the viral surface glycoprotein (Env) Traffic 2004; 5: 643–650 subunit gp120 (24). CD4-gp120 engagement induces CKR binding, which in turn activates the Env transmembrane subunit gp41, promoting fusion of the Env-containing and target cell membranes. The viral core is then released into the cytoplasm for subsequent steps including reverse transcription and proviral integration into the host cell genome. CKR usage defines the cellular tropism of HIV: CCR5-using viruses infect monocytes/macrophages and activated and memory CD4þ T-cells, whereas CXCR4-using isolates infect predominantly naı̈ve CD4þ T-cells that are the major CD4þ subset circulating in the periphery. Macrophages and dendritic cells (DC) are also targets for HIV-1 uptake and infection (25,26). DC can be divided into mature and immature subsets; HIV can enter and replicate efficiently in immature DC but can be captured by, but replicate only inefficiently in, mature DC (27). Productive infection of DC by HIV-1 is mediated by Env–CD4/CCR5 interactions (27), but virus uptake can also take place via cognate recognition of adhesion molecules in the virus envelope (28) or glycans on gp120 by lectins, most notably the C-type lectin DC-SIGN (29). A prominent model for sexual transmission of HIV-1 is that DC acquire HIV-1 in the mucosae and transmit the virus to T cells in the secondary lymphoid tissue (30). Infection of CD4þ T-cells in trans by DC-captured HIV-1 was found to be more efficient than infection with cell-free virus (30). Until recently it was not clear how DC acquired and transmitted HIV-1, but recent results show that both lectinmediated acquisition (31) and infection (25) can lead to efficient infection of T-cells. As mentioned above, DC interact intimately with T-cells in both antigen-dependent and independent ways, resulting in cytoskeleton-dependent receptor recruitment to the cellular interface (7). A significant advance in our understanding of the role of DC in transmitting HIV-1 infection was made by McDonald and colleagues (22), who first described an HIV-1-induced synapse. The synapse in this study was referred to as an ‘infectious synapse’ but for consistency in this review we shall use the term virological synapse. Using fluorescent (GFP)-tagged HIV-1 virions, it was observed that in response to contact between an HIV-1-pulsed (effector) DC and a (target) T-cell, the DC rapidly recruited virus to the conjugate interface. CD4, CCR5 and LFA-1 were partially polarised to the interface on the T-cell and transfer of HIV-1 into the target cell took place across the synapse. HIV-1 recruitment to the synapse in the DC was resistant to protease treatment, indicating that the virions were within an intracellular compartment, which was trafficked to the synapse. Although the DC intracellular compartment containing HIV-1 has not been formally identified, recent work suggests that the virus localises within multivesicular bodies (MVB) for translocation to the synapse (T. Hope, personal communication). MVB are intracellular compartments consisting of membrane-bound vesicles that perform a number of endosomal functions, including transport of cytosolic protein and membrane out of the cell via exocytosis (32). This result is consistent with reports that 645 Jolly and Sattentau HIV-1 budding into MVB followed by exocytosis may be the principal mode of viral egress from macrophages (33,34). Given the shared monocytic lineage between macrophages and the monocyte-derived (mDC) used in the McDonald study, it is likely that a similar mechanism pertains to mDC. The idea that HIV-1 in DC may be using vesicular transport is supported by data showing that monomeric gp120 is not present in the same vesicles as whole virus within pulsed DC and that HIV may alter endolysosomal trafficking to avoid degradation by lysosomes (26). The HIV-1 T Cell VS The rapid kinetics of HIV-1 infection of target T-cells via direct transfer from infected T-cells is well-established (35–37), although the molecular details of this process had not been elucidated. The movement of viral antigens and genomic RNA between cells followed by the de novo synthesis of viral DNA and protein in the target cell testify to the rapid kinetics and productive nature of this mode of viral spread (35,38). Some time ago we observed that CD4 and Env rapidly cocluster at the site of target-effector T-cell contact (39). We have recently followed this up and describe the formation of an HIV-1-induced VS between T-cells (21). We observed that if a T-cell line (Jurkat) infected with a CXCR4-using strain of HIV was incubated with uninfected primary CD4þ/CXCR4þ T-cells negatively enriched from peripheral blood, there was rapid recruitment to the cell–cell contact surface of CD4, CXCR4, talin, actin and LFA-1 on the target cell (Figure 2). This was concomitant with recruitment of Env and Gag to the site of cell contact in the effector cell. Kinetic studies showed that LFA-1 and viral receptor recruitment in the target cell was rapid (recruitment in 50% of conjugates in < 30 min) and so perhaps required active transport of receptors to the interface, as opposed to relying on passive diffusion. Confirmation of a role for cytoskeletal mobilization of receptors came from studies demonstrating enrichment of F-actin in the target cell at the interface and inhibition of receptor recruitment when the target cells were treated with inhibitors of actin remodeling or myosinmotor protein function. In the infected T-cell, Env and Gag Figure 2: Schematic diagram of the virological synapse formed between a retrovirally infected (effector) and an uninfected (target) T-cell. The cell–cell contact zone contains tight junctions and, in the case of the HIV-1 VS, a synaptic cleft into which virions are released from the effector cell. The HTLV-1 VS may differ from the HIV-1 VS: there is no evidence for HTLV-1 virion budding or release or of a synaptic cleft (C. Bangham, unpublished results). The MTOC is polarised towards the site of cell–cell contact and viral Gag may be associated with, and be transported along, microtubules. Figure based on results presented in (20–22). 646 Traffic 2004; 5: 643–650 Retroviruses and the Virological Synapse recruitment appears to be induced in response to cell–cell contact and to require components of the actin and tubulin cytoskeleton ((21) and our unpublished results). The T-cellT-cell VS facilitated transfer of HIV-1 into the previously uninfected target cell by promoting directed budding of virus into the synaptic cleft, probably followed by fusion of virions with the target cell plasma membrane. Polarised budding of HIV-1 in cell–cell conjugates has been previously observed by electron microscopy, and implies a mechanism for targeting virus to the site of cell contact (17,40,41). Unlike DC–T-cell clustering, which is frequently observed under normal, uninfected conditions, CD4þ T-cells do not often form stable antigen-independent contacts with each other. Although weak cell–cell contacts may form randomly between T-cells, a specific trigger is probably required to enhance and stabilise adhesion. To test the hypothesis that the trigger may be engagement of CD4 and CXCR4 on the surface of a target cell by Env on the effector cell, we tested the effects of blocking antibodies and pharmacological inhibitors on the VS. Antibody and drug-mediated inhibition of Env-CD4 and Env-CXCR4 binding blocked VS formation and reduced conjugates forming between T-cells. These two studies (21,22) confirm the general concept of a viral synapse, and are important for our understanding of the earliest stages of transmission, dissemination and immune evasion by HIV-1. Since DC are one of the first cells to encounter incoming virus at the mucosal surface, where most HIV-1 transmission occurs, the VS would help protect the virus from immune surveillance and allow it to rapidly and efficiently gain access to the major target of HIV-1 infection, the CD4þ T-cell. Synaptic transfer of HIV-1 between T-cells would likewise help the virus spread efficiently within secondary lymphoid tissue. Moreover, this model may help explain an interesting paradigm in HIV pathogenesis – the preferential infection of virus-specific CD4þ T-cells by HIV-1 (42). The HTLV-I T Cell VS A detailed description of a VS was first published in the context of HTLV-I infection (20). HTLV-I is an oncogenic human retrovirus that infects 10–20 million people worldwide. Although only rarely associated with disease, approximately 2–3% of infected individuals develop an adult T-cell leukaemia and another 2–3% suffer from chronic inflammatory syndromes. Like HIV-1, HTLV-I is also T-cell-tropic but infects both CD4þ and CD8þ T-cells and spread between and within individuals is primarily by infected lymphocytes with little, if any, contribution from cell-free virus (16). Igakura and workers (20) described a VS that forms during contact between an HTLV-I infected and an uninfected T-cell. Similar to the HIV-1 VS, cell–cell contact promoted Traffic 2004; 5: 643–650 clustering of HTLV-1 Env and Gag within the effector cell and talin within the target cell to the site of cell–cell contact. In unconjugated infected cells the HTLV-1 core proteins Gag p19 and p15 are arranged in clusters near the plasma membrane and Env is uniformly distributed on the cell surface. Target–effector cell interactions induced rapid (< 30 min) polarization of Gag and Env to the cell–cell junction and transfer of Gag into the target cell within 2 h. Fluorescence in situ hydridisation studies showed that Gag movement into the target cell was coordinated with transfer of the HTLV-1 RNA genome. Similar to the formation of an IS between a CD8þ CTL and its target (13), MTOC polarisation towards the synapse also occurs in the effector cell in the HTLV-1 VS. Igakura et al. (20) point out that MTOC movement is not triggered by specific T-cell receptor recognition of HTLV-1 antigen in the infected cell and does not represent a T-cell IS, but a VS. However, similar to a T-cell IS, there is a higher order level of structure to the HTLV-1 VS. The actin adaptor protein talin is recruited in a percentage of VS conjugates into a ring-like structure reminiscent of a pSMAC in the IS (20). Recently, the glucose transport protein GLUT-1 has been identified as an entry receptor for HTLV-1 (43) and it will now be interesting to examine the role of the target cell in VS formation. By analogy with the HIV-1 T-cell synapse, it might be expected that the Env clustering in the effector cell will be mirrored by enrichment of GLUT-1 in the target cell at the interface. Indeed, preliminary results suggest that this is the case (D. Brighty, personal communication). What Directs VS Formation? VS formation requires the active participation of the cell cytoskeleton. A major unanswered question is what triggers VS formation and is it a mechanism common to both HIV-1 and HTLV-1-induced synapses and DC and T-cells? Let us first look at the target cell. In the IS the signalling cascade that directs receptor recruitment has been well studied. TCR/CD3-pMHC binding leads to lck-mediated phosphorylation of the cytoplasmic tail of CD3 and subsequent recruitment of activated ZAP-70. This in turn phosphorylates other adaptors and the signalling cascade culminates in recruitment of actin, actin-anchored receptors and the MTOC to the site of cell–cell contact. CD4 signalling by p56lck contributes to IS formation (3) and costimulation by LFA-1 can also reorganise F-actin and recruit additional high-affinity adhesion molecules to the synapse (9). It is unlikely that TCR signalling plays a determinant role in the VS since the TCR was not actively recruited into the HIV-1 T-cell synapse (21) and the frequent realignment of the MTOC in HTLV-1-infected cells is not consistent with antigen-specific recognition by a TCR (20). However, TCR-mediated recognition of target cells should not be ruled out as a ‘cofactor’ to VS formation 647 Jolly and Sattentau since both HIV-1 and HTLV-1 preferentially infect virusspecific T-cells (42,44,45). Env-receptor engagement is central to the HIV-1 VS since blocking these interactions with inhibitors abrogated VS assembly ((21) and unpublished results). Whether this is because VS formation requires signals to be transduced through CD4 and/or the CKR in response to Env binding, or Env-receptor binding simply mediates sufficiently tight conjugate formation to allow other proteins to interact and elaborate a synapse is unclear. Signal transduction by CD4 (via p56lck) and CKRs is well documented and evidence exists that gp120 engagement of these receptors can initiate signalling cascades (46–48). CKRs are G-protein coupled receptors and can transduce signals in a G-protein-dependent or -independent manner and this is necessary for cellular polarization and chemotaxis (49). Interestingly, CKR-mediated signalling can activate integrins by inducing conformational changes that force a switch from a low-affinity to a highaffinity state (50) and this is necessary for efficient ligand binding. Moreover, integrin activation modifies its association with the cytoskeleton, and the increase in lateral mobility facilitates rapid integrin clustering (51) and subsequent integrin-mediated actin remodelling (9). Integrin activation is a particular requirement for naı̈ve and resting T-cells, which express the low-avidity, low-affinity form in the absence of stimulation. This suggests that LFA-1 and/or other integrins may both initiate and require triggering of actin remodelling and recruitment of other receptors. In this respect, integrins appear to be a common link between the IS and VS. Integral to HIV-1 VS assembly is the actin-mediated recruitment of CD4 and CKRs. Association of CD4 (52) and CXCR4 (53) with actin has been documented, suggesting that they may be recruited directly by F-actin polarising to the site of cell–cell contact. Alternatively, these receptors may be recruited via their association with detergent insoluble lipid microdomains (DIMs). We have observed coalescence of GM1-rich domains to the HIV-1 VS in target T-cells (unpublished results). Both CD4 and CXCR4 are at least partially compartmentalised within DIMs (54,55), and there is evidence to support a link, via annexin-II, between DIMs and the actin cytoskeleton (56). Future studies will investigate the role of signalling via CD4, CKRs and integrins in the HIV-1 VS and GLUT-1 and integrins in the HTLV-1 VS. Initiation of events relating to VS formation within the effector cell is obscure. Intracellular HIV particles were recruited to the site of cell–cell contact in DC–T-cell conjugates (22), and HIV-1 and HTLV-1 Env and Gag polarise to the VS in infected T-cells (20,21). It appears that the infected cell is able to detect cell–cell contact and traffic viral antigens to the VS, but the trigger for this is unknown. One speculative pathway might be via signalling associated with a tyrosine motif located within the cytoplasmic tail of HIV-1 gp41: mutation of this motif reduced polarisation of p24 and directed virus budding in the cell and interfered with cell–cell spread (40). Tyrosine-based motifs in retroviral transmembrane 648 glycoproteins have been shown to signal in infected cells, making this a plausible hypothesis (57). Ligation of plasma membrane-associated Env by receptors on the target cell might trigger such a pathway. For the DC-T-cell viral synapse it is becoming clearer that this probably involves re-routing of HIV-1-containing intracellular vesicles, potentially MVB, through the exocytosis pathway. As mentioned above, it seems likely that the virus is subverting a normal intercellular vesicular communication pathway to facilitate its own dissemination between cells. Whether there is a role for the exocytic pathway in transporting HIV proteins to the T-cell viral synapse is untested and cannot be excluded, but HIV-1 is not thought to bud into intracellular vesicles in T-cells, but to assemble under and bud out directly from the plasma membrane. In this model, Env is trafficked to the plasma membrane via the secretory pathway and is enriched in lipid rafts (40,58). Viral components then assemble under the patches of Env, ultimately resulting in foci of nascent virions budding through rafts. The recruitment of viral Gag to the site of assembly may be along microtubules; this concept is supported by reorientation of the MTOC proximal to the VS in a high frequency of conjugates ((20) and our unpublished results). CD4þ T-cells are not usually polarised but they can become so after activation during chemotaxis or in response to cell–cell contact (59) and this appears to impact on sites of viral release. In summary, polarised virus assembly and budding at the T-cell VS may require both virus-specific signals and normal cellular responses to synapse elaboration. It will be interesting to investigate whether the recently described cellular machinery that assists in viral budding, termed the ESCRT pathway (60–62), plays a role in polarised HIV-1 exit from T-cells. Understanding the role of the effector cell in the VS is perhaps the most exciting challenge in this area because of the potential to provide new targets for antiviral therapies. Conclusions Many intracellular pathogens including viruses, bacteria and parasites are able to hijack elements of the host cell cytoskeleton to assist in entry, exit and cytoplasmic trafficking. What then are the special features of the VS? Because viruses are obligate intracellular parasites, they appear to be able to manipulate the infected cell cytoskeleton from within to promote and polarise viral egress. If the infected cells are already polarised, such as in epithelial monolayers, then the direction of virus movement will be predetermined. When the cells involved are members of the immune system, the machinery for communication between them pre-exists, but is not activated. It appears that in the case of viruses that infect immune cells such as HIV-1 and HTLV-1, a combination of virus–receptor interactions and cognate immune receptor interactions are required to activate and regulate cell–cell movement of virus. Traffic 2004; 5: 643–650 Retroviruses and the Virological Synapse Acknowledgments We thank Charles Bangham, Tom Hope and David Brighty for critical reading of the manuscript and permission to cite unpublished results. 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