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Poxviruses: Their Impact on Human Health, History, and Research Don Gammon March 18, 2011 What is a Virus? What is a Virus? • Formal definition: “an ultramicroscopic infectious agent that replicates itself only within cells of hosts; consisting of a piece of DNA or RNA wrapped in a coat of protein” • Some viruses also have lipid membranes surrounding them (called envelopes) • Poxviruses consist of a double-stranded DNA genome, proteins, and one or more lipid membranes IMAGE FROM: Discovery of antivirals against smallpox.Harrison SC, Alberts B, Ehrenfeld E, Enquist L, Fineberg H, McKnight SL, Moss B, O'Donnell M, Ploegh H, Schmid SL, Walter KP, Theriot J.Proc Natl Acad Sci U S A. 2004 Aug 3;101(31):1117892 Poxviruses • >60 poxviruses have been described • Infect a wide range of hosts • Cause acute diseases that range from benign to fatal IMAGE FROM: Poxvirus tropism.McFadden G.Nat Rev Microbiol. 2005 Mar;3(3)Review. Size DOES Matter: Poxviruses are the largest of the Mammalian Viruses Animal Virus (genome size, Kb) Parvo (~5) DNA polyme rase host RNA polyme rase host Papova (~5-8) host host Adeno (~36) viral host Herpes (~120-200) viral host Pox (~130-300) viral viral Mimi (~300-1,200)* viral viral Bacteriophage (genome size, Kb) DNA polyme rase X174 (5.4, ssDNA) host RNA polyme rase host Poxvirus “Firsts” Poxviruses were the first animal viruses to be: • Seen microscopically • Propagated in tissue culture • Physically purified ~400 nm VACV virions • Shown to regulate gene expression • Shown to produce inhibitors of host defence Smallpox: a Tale of Tragedy & Triumph • Variola virus causes Smallpox • Most infamous poxvirus • Probably originated in Fertile Crescent (Iran & Iraq) and Nile Valley ~10,000 BC • Deadliest viral disease in human history • Mortality rates ~10-30% but many survivors remain disfigured Ramses V (died 1157 BC) IMAGE FROM: http://www.microbiologybytes.com/virology/Poxviruses.html Recovery Symptomatic Period Incubation Period Smallpox Pathology http://www.who.int/emc/diseases/smallpox/slideset/ Image adapted from: http://whqlibdoc.who.int/smallpox/9241561106_chp3.pdf Smallpox and the Age of Exploration Smallpox and Spanish Domination of Mexico, Central & S. America Cortés & Aztec Empire (1519-1521) http://www.ucalgary.ca/applied_history/tutor/eurvoya/azte c.html Pizzaro & Inca Empire (1524-1532) http://www.ucalgary.ca/applied_history/tutor/ eurvoya/inca.html Plague upon Plague The destruction of Central and S. American civilization Arrival dates • • • • • Smallpox, 1518 Measles, 1530 Typhus? 1546 Influenza? 1558 Yellow fever, 1648 Diego Rivera By mid-17th century the population was ~1/20th that in 1492 North America • Encounters with explorers and trappers created an expanding wave of smallpox • Alexander Mackenzie (1793) discovered villages “destroyed by its pestilential breath” • Smallpox arrives in Victoria BC in 1862 and then spreads along the coast north to Alaska A. Mackenzie Why did European settlers find a seemingly empty land? Smallpox Eradication: Killing a Killer Smallpox becomes the first and only infectious disease ever to be eradicated 1965 1802 1096-1291 1796 10th Century 1979-80 1718 1977 Timeline image taken from: Smallpox: anything to declare?Smith GL, McFadden G.Nat Rev Immunol. 2002 Jul;2(7):521-7 Vaccinia virus (VACV) • Host unknown • Used as a Smallpox vaccine • Encodes ~200 proteins • Dozens of immunomodulators ~400 nm VACV virions • “Core” enzymes/proteins (Ex. DNA polymerase) Why Do We Still Care About Smallpox? • Despite eradication of variola by 1979, threat of accidental or intentional release lingers • Variola virus an ideal bioweapon because: Highly transmissible by aerosol route High proportion of susceptible persons (no vaccination) High morbidity and mortality (10-30%) Diagnosis of disease difficult- last seen over 30 years ago No licensed drugs for smallpox 1. 2. 3. 4. 5. Mahy (2003) Further Challenges: Immunosuppression • Dec. 9th, 1979- WHO declares smallpox eradicated • Reports of disseminated vaccinia in HIV-infected individuals Complications of vaccination • • • • • Inadvertent inoculation Generalized vaccinia Eczema vaccinatum Progressive vaccinia Postvaccinial encephalitis IMAGE FROM: Pathogenesis and potential antiviral therapy of complications of smallpox vaccination.Bray M.Antiviral Res. 2003 Apr;58(2):101-14. Review Emerging Threats: Monkeypox Mortality rates: 1-10 % 2003 Outbreaks: USA & DRC See: Human monkeypox: an emerging zoonotic disease.Parker S, Nuara A, Buller RM, Schultz DA.Future Microbiol. 2007 Feb;2(1):17-34. Review. Research Projects 1. Antiviral Drugs 2. Basic Virology 3. Viral Immunology Poxvirus Replication & Pathogenesis; Therapeutic Development 4. Oncolytic Virotherapy Cidofovir-a “New” Anti-Poxvirus Drug • De clercq et al. (1987)-cidofovir (CDV) introduced • Analog of dCMP • Shown to be inhibitory to wide range of DNA viruses • 1996 licensed for herpesvirus infections (AIDS patients) dCMP CDV How Does CDV Inhibit VACV Replication? GAGXA CTCGTCT 5’ Slow 5’-to-3’ elongation “X” = CDV GAGXA CTCGTCT 5’ GAGG CTCXTCT 5’ Removal of drug residue by 3’-to-5’ exonuclease (proofreading) Second round replication Conclusions: CDV impedes DNA synthesis and is resistant to removal by viral DNA polymerase For more information see: Mechanism of inhibition of vaccinia virus DNA polymerase by cidofovir diphosphate.Magee WC, Hostetler KY, Evans DH.Antimicrob Agents Chemother. 2005 Aug;49(8):3153-62. The 3'-to-5' exonuclease activity of vaccinia virus DNA polymerase is essential and plays a role in promoting virus genetic recombination.Gammon DB, Evans DH.J Virol. 2009 May;83(9):4236-50. Does CDV Resistance Develop in Poxviruses? •G. Andrei isolated CDV-resistant (CDVR) VAC in tissue culture •A314T and A684V a.a. substitutions identified in viral DNA polymerase gene (E9L) Dr. G. Andrei NH2 COOH 1006 a.a A314T CDVR A684V CDVR VACV DNA Polymerase Hypothesis: A314T and/or A684V substitutions are responsible for CDVR phenotype Plaque Reduction Assay Crystal violet staining Virus No drug Drug Drug Cultured cells 1. Culture (days) 2. Fix and stain 3. Count plaques Typical Plaque Reduction Assay Increasing drug concentration Decreasing plaque numbers Recombinant virus are resistant to CDV [CDV] (µM) 0 30 60 100 1000 Wild-type Vaccinia Virus CDVR (A314T + A684V) Conclusion: A314T and A684V substitution mutations in the VACV DNA Polymerase cause resistance to CDV D. Gammon, unpublished data CDVR VACV Can Still Be Treated With CDV *Infection with CDVR Virus Cidofovir IMAGE FROM: Cidofovir resistance in vaccinia virus is linked to diminished virulence in mice.Andrei G, Gammon DB, Fiten P, De Clercq E, Opdenakker G, Snoeck R, Evans DH.J Virol. 2006 Oct;80(19):9391-401. Research Projects 1. Antiviral Drugs 2. Basic Virology 3. Viral Immunology Poxvirus Replication & Pathogenesis; Therapeutic Development 4. Oncolytic Virotherapy Poxvirus Replication Intermediate mRNA DNA polymerase Early mRNA Intermediate transcription factors Late transcription factors Late mRNA RNA polymerase Growth factors Late enzymes Immune defense molecules Early transcription factors Structural proteins Adapted from Moss. Fundamental Virology, 2001 Pox, Dyes, and Videotape GFP-Cro-Expressing Cells Nucleus GFP-Cro mRNA GFP-Cro Viral factories Research Projects 1. Antiviral Drugs 2. Basic Virology 3. Viral Immunology Poxvirus Replication & Pathogenesis; Therapeutic Development 3. Oncolytic Virotherapy Poxviruses: Masters of Deception & Manipulation IMAGE FROM: Poxvirus immunomodulatory strategies: current perspectives.Johnston JB, McFadden G.J Virol. 2003 Jun;77(11):6093-100. Review Research Projects 1. Antiviral Drugs 2. Basic Virology 3. Viral Immunology Poxvirus Replication & Pathogenesis; Therapeutic Development 4. Oncolytic Virotherapy Understanding Virus-Host Interactions May Lead to New Therapeutics • Myxoma virus does not replicate in normal human cells Normal Cell Cancer Cell • Myxoma can replicate in human cells lacking IFN response Adapted IMAGE FROM: Poxvirus tropism.McFadden G.Nat Rev Microbiol. 2005 Mar;3(3)Review. *Cancer cells often lack a functional IFN pathway Oncolytic Virotherapy with Poxviruses No Treatment Myxoma Virus Treatment Tumor Volume Tumour size 2500 No Treatment Myxoma Virus Treatment Tumor Volume (mm3) 2000 1500 1000 500 0 0 5 10 15 20 25 30 35 Day Tumour signal (luciferase) ~ 10 days after implantation C. Irwin, unpublished data Summary • Poxviruses are some of the largest and most complex DNA viruses known • Despite the eradication of Smallpox they continue to affect human health as they have done for thousands of years • New drug strategies are needed to treat poxvirus infections in humans • Basic research with poxviruses has furthered our understanding of our own immune system • In the future, poxviruses may be used to treat other diseases such as cancer Poxvirus Resources • Poxvirus tutorial: http://www.microbiologybytes.com/virology/Poxviruses.html • General Virology Information: http://www.virology.net/