Electrostatic interactions at the five-fold axis alter heparin-binding phenotype and drive enterovirus A71 virulence in mice

PLoS Pathog. 2019 Nov 15;15(11):e1007863. doi: 10.1371/journal.ppat.1007863. eCollection 2019 Nov.

Abstract

Enterovirus A71 (EV-A71) causes hand, foot and mouth disease epidemics with neurological complications and fatalities. However, the neuropathogenesis of EV-A71 remains poorly understood. In mice, adaptation and virulence determinants have been mapped to mutations at VP2-149, VP1-145 and VP1-244. We investigate how these amino acids alter heparin-binding phenotype and shapes EV-A71 virulence in one-day old mice. We constructed six viruses with varying residues at VP1-98, VP1-145 (which are both heparin-binding determinants) and VP2-149 (based on the wild type 149K/98E/145Q, termed KEQ) to generate KKQ, KKE, KEE, IEE and IEQ variants. We demonstrated that the weak heparin-binder IEE was highly lethal in mice. The initially strong heparin-binding IEQ variant acquired an additional mutation VP1-K244E, which confers weak heparin-binding phenotype resulting in elevated viremia and increased virus antigens in mice brain, with subsequent high virulence. IEE and IEQ-244E variants inoculated into mice disseminated efficiently and displayed high viremia. Increasing polymerase fidelity and impairing recombination of IEQ attenuated the virulence, suggesting the importance of population diversity in EV-A71 pathogenesis in vivo. Combining in silico docking and deep sequencing approaches, we inferred that virus population diversity is shaped by electrostatic interactions at the five-fold axis of the virus surface. Electrostatic surface charges facilitate virus adaptation by generating poor heparin-binding variants for better in vivo dissemination in mice, likely due to reduced adsorption to heparin-rich peripheral tissues, which ultimately results in increased neurovirulence. The dynamic switching between heparin-binding and weak heparin-binding phenotype in vivo explained the neurovirulence of EV-A71.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Brain / metabolism
  • Brain / pathology
  • Brain / virology*
  • Capsid Proteins / chemistry
  • Capsid Proteins / genetics
  • Capsid Proteins / metabolism*
  • Enterovirus / chemistry
  • Enterovirus / genetics*
  • Enterovirus A, Human / genetics*
  • Enterovirus Infections / epidemiology
  • Enterovirus Infections / metabolism
  • Enterovirus Infections / virology*
  • Heparin / chemistry
  • Heparin / metabolism*
  • Host-Pathogen Interactions
  • Humans
  • Mice
  • Mice, Inbred ICR
  • Mutation
  • Phenotype
  • Static Electricity
  • Tumor Cells, Cultured
  • Virulence
  • Virulence Factors / chemistry
  • Virulence Factors / genetics
  • Virulence Factors / metabolism*
  • Virus Replication

Substances

  • Capsid Proteins
  • Virulence Factors
  • Heparin

Grants and funding

YFC was supported by grants from the Ministry of Education, FRGS-FP012-2018A and ER017-2013A. HKT was supported in parts by MyBrain15 scholarship and salary from Newton Advanced Fellowship granted to YFC. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.