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Journal of Clinical Microbiology, July 2005, p. 3267-3272, Vol. 43, No. 7
0095-1137/05/$08.00+0 doi:10.1128/JCM.43.7.3267-3272.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina
Received 3 September 2004/ Returned for modification 16 January 2005/ Accepted 3 March 2005
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Laboratory studies of dengue virus are difficult because the virus does not grow to high titers in cell culture and assays for titrating virus and measuring virus neutralization are time-consuming. These problems are exacerbated when working with primary clinical isolates of virus. Standard methods for titrating DENV and measuring the ability of antisera to neutralize the virus are based on plaque assays which require 5 to 7 days to complete. Some isolates, especially among primary clinical isolates, do not form clear plaques on cell monolayers. Better methods for titrating the virus and measuring the ability of antisera to neutralize dengue need to be developed. Within the past 10 years, fluorescence-activated cell sorter (FACS)-based methods have been developed to follow infection and determine titers of viruses such as human immunodeficiency virus, herpesvirus, measles virus, influenza virus, Epstein-Barr virus, and rabies virus (1, 4, 12, 13, 16). FACS has also been used to detect DENV in clinical samples and to measure the ability of the virus to infect a variety of cells (2, 3, 7, 8, 11, 17). Here we report on a FACS-based assay for titrating DENVs and for characterizing the ability of antisera to neutralize the virus.
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The viruses used in this study included prototype DENV2 virus (New Guinea C strain), prototype DENV3 (H87 strain), and prototype DENV4 (H241) (gifts from Robert Shope, University of Texas at Galveston), one DENV1 high-passage clinical isolate (16007; gift from Robert Putnak, Walter Reed Army Institute of Research), one DENV1 clinical isolate from Sri Lanka (UNC 1002), three DENV3 clinical isolates from Sri Lanka (UNC 3001, UNC 3009, and UNC 3011), and two DENV3 clinical isolates from Nicaragua (UNC 3017 and UNC 3018; gifts from E. Harris, University of California, Berkeley). All experiments with the clinical virus isolates, unless otherwise stated, used stocks from viruses that had been passaged in cell culture fewer than four times. Viral stocks were obtained by inoculating a monolayer of C6/36 cells in a 75-cm2 tissue culture flask with 200 µl of virus diluted in 1 ml of EMEM-2% FBS. After 1 h, 14 ml of EMEM supplemented with 2% FBS was added and the cells were cultured for 10 days at 28°C in 5% CO2. The supernatant was removed from the cells and centrifuged for 5 min at 2,000 x g to pellet cellular debris. The supernatant was aliquoted and stored at 80°C. DENV1 (16007) was grown and passaged in Vero cells, whereas DENV4 (H241) was grown in C6/36 cells as described above and passaged one time in Vero cells.
The flavivirus group-reactive monoclonal antibody 4G2 (6) was purchased from the American Type Culture Collection, Rockville, MD.
FACS titration assay.
C6/36 cells were seeded in six-well plates and incubated at 28°C in 5% CO2 until cells were approximately 90 to 95% confluent (
1 x 106 cells/well). Medium was removed from cells, and 10-fold serial dilutions of virus diluted in EMEM with 2% FBS to a final volume of 200 µl were added to the cells. The cells were incubated at 28°C in 5% CO2 for 1 h, and plates were rocked every 15 min. The medium was removed, and the cells were washed in 1x phosphate-buffered saline (PBS). Two milliliters of EMEM with 2% FBS was added to each well, and the cells were incubated for 24 h at 28°C in 5% CO2. After 24 h the medium was removed and the cells were washed and scraped from the well and resuspended in PBS. An aliquot of cells from each well was counted using a hemocytometer. The remaining cells were centrifuged at 1,000 x g for 5 min and resuspended in 200 µl of Cytofix/Cytoperm solution (BD Biosciences, San Jose, CA) and incubated on ice for 20 min in the dark. All subsequent steps were performed in Cytoperm/Cytowash solution. The cells were centrifuged at 1,000 x g for 5 min and washed two times before resuspending in 50 µl of fluorescein isothiocyanate (FITC)-labeled 4G2 monoclonal antibody for 1 h on ice. The cells were washed two times and resuspended in the Cytoperm/Cytowash solution. The samples were analyzed on a FACScan flow cytometer using Summit software. For each sample at least 100,000 events were collected. The linear range of the assay under the tested parameters was determined to be between 0.20% and 25% infected cells in a well (between
2,000 and 250,000 infected cells per well), and sample wells outside this range were not used for determining final titers. The titer of the virus was determined using the following formula: FACS infectious units/ml = [(% of infected cells) x (total number of cells in well) x (dilution factor)]/(volume of inoculum added to cells). Samples with a titer below 1 x 104 infectious particles/ml cannot be analyzed with the FACS assays, as this titer is below the level of detection.
Vero plaque assay. Vero plaque assays were performed using a modified protocol from Wu et al. (18). Briefly, Vero cells were seeded in six-well plates at a density of 2.5 x 105 cells/well and incubated overnight. Fifty microliters of DENV stock was added to 450 µl of diluent containing 1% bovine albumin in DMEM-F-12 medium supplemented with penicillin and streptomycin. The virus mixture was serially diluted using 10-fold dilutions. Two hundred microliters of each dilution of virus was added to each well of Vero cells in duplicate. The plates were incubated at 37°C in 5% CO2 for 1 h, rocking plates every 15 min. Four milliliters of primary nutrient agar overlay (1% Seakem LE agarose, 20% Earle's balanced salt solution 10x, 7% yeast extract-lactalbumin hydrolysate, 4% FBS, 0.5% sodium bicarbonate, 1% gentamicin [50 mg/ml]) and 0.2% Fungizone (12.5 µg/ml) was added to each well, and the cells were incubated at 37°C in 5% CO2 for 5 to 7 days. Next, 2 ml of a secondary nutrient agar overlay (primary nutrient overlay containing 1% neutral red) was added to each well and the cells were incubated overnight at 37°C in 5% CO2 before counting plaques and calculating viral titers. The viral titers were expressed as PFU/ml, calculated as [(number of plaques per well) x (dilution)]/(inoculum volume).
Endpoint titration assay. Endpoint titration assays were performed using a modified protocol from Schoepp et al. (15). Briefly, C6/36 cells were seeded in a 96-well plate at a density of 1.3 x 105 cells/well in 225 µl and incubated overnight at 28°C in 5% CO2. Twenty-five microliters of virus was added to the first well, and the virus was serially diluted using 10-fold dilutions. The plates were incubated at 28°C in 5% CO2 for 5 days. To fix the plates, 50 µl of a 3:1 acetone-PBS mixture was added to each well, and the plates were incubated at 20°C for 20 min. The plates were air dried and washed with 1x PBS. The plates were blocked with 5% FBS-PBS-0.05% NaN3 for 15 min at room temperature. Each well was resuspended in 50 µl of FITC-labeled 4G2 monoclonal antibody diluted in blocking buffer and incubated for 1 h at 4°C. The plates were analyzed using an inverted fluorescence microscope. Wells were scored for the presence or absence of infection with either a positive or a negative symbol. Replicates of 10 were performed for each virus. We calculated the 50% tissue culture infectious dose (TCID50) of each virus using the Reed-Muench formula, based on immunofluorescence: TCID50 (expressed as 10x/ml) = (dilution where % of infected wells is >50%) + [(% of infected wells above 50%) 50%]/[(% of infected wells above 50%) (% of infected wells below 50%)] x log1010.
Plaque reduction neutralization test. The plaque reduction neutralization tests were performed using modified protocols from Russell et al., Kochel et al., and Wu et al. (9, 14, 18). Vero cells were seeded in six-well plates at a density of 2.5 x 105 cells/well and incubated overnight. The test serum was heat inactivated at 56°C for 30 min. The serum was serially diluted twofold in diluent containing 1% bovine albumin in DMEM-F-12 medium supplemented with penicillin and streptomycin. DENV was diluted such that each well would be infected with 40 to 60 PFU. An equal volume of virus was added to the diluted serum and incubated at 37°C in 5% CO2 for 1 h. The virus and antibody mixtures were added to the Vero cells for 1.5 h. Four milliliters of primary nutrient agar overlay, as described above, was added to each well and the cells were incubated at 37°C in 5% CO2 for 6 days. Next, 2 ml of a secondary nutrient agar overlay (primary nutrient agar overlay containing 1% neutral red) was added to each well and the cells were incubated overnight at 37°C in 5% CO2 before counting plaques and calculating viral titers. Each antibody concentration was tested in triplicate. The numbers of plaques in each well were counted and the percent reduction was determined as follows: % reduction = [(average number of control plaques average number of plaques for each dilution)/(average number of control plaques)] x 100. The plaque reduction neutralization titers of serum equaled the reciprocal of the serum dilution in which either 50% (PRNT50) or 80% (PRNT80) plaque reductions were observed.
FACS neutralization test (FNT). Vero cells were seeded in six-well plates at a density of 2.5 x 105 cells/well and incubated overnight. Human serum to be tested was heat inactivated at 56°C for 30 min. The serum was serial diluted twofold in diluent containing 1% bovine albumin in DMEM-F-12 medium supplemented with penicillin and streptomycin. DENV was resuspended in diluent such that each well would receive a multiplicity of infection (MOI) of 0.1. An equal volume of virus was added to the diluted serum and incubated at 37°C in 5% CO2 for 1 h. The virus and antibody mixture was added to the Vero cells. Each antibody dilution was assayed in triplicate. The plates were incubated at 37°C in 5% CO2 for 1 h, rocking plates every 15 min. Two milliliters of DMEM-F-12 containing 10% FBS was added to each well, and the plates were incubated at 37°C in 5% CO2 for 24 h. Each well was washed with 1 ml of trypsin-EDTA. Next, 0.2 ml of trypsin-EDTA was added to each well and incubated at 37°C for 5 min. One milliliter of chilled 1x PBS containing 10% FBS was added to each well to inactivate the trypsin. The cells were pipetted to breakup any clumps and centrifuged at 1,000 x g for 5 min. The PBS was removed, and the cells were fixed and stained for FACS as described above. Approximately 100,000 to 200,000 cells were analyzed for each sample. The percent reduction in the number of infected cells was calculated for each serum dilution. The number of infected cells in the wells infected with virus only was used to calculate the percent reduction. The titers were expressed as the reciprocal of the serum dilution that inhibited 50% (FNT50) or 80% (FNT80).
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FIG. 1. Time course of DENV2 and DENV3 infection of C6/36 insect cells. C6/36 cells grown in six-well plates were infected with DENV2 strain NGC and DENV3 strain H87 at an MOI of 0.05. One well was mock infected to serve as a negative control. Cells were harvested from duplicate wells on days 1, 2, 3, 5, and 7 and processed for FACS. The cells were fixed and permeabilized using the Cytofix/Cytoperm kit from BD Biosciences and stained for FACS using monoclonal antibody 4G2, which cross-reacts with all four DENV serotypes. Cells were gated according to their size and granularity (x axis, side-scattered cells; y axis, forward-scattered cells) to identify intact, single cells. The gated cells were displayed on dot plots in which the x axis is the forward scatter and y axis is fluorescence (FITC) intensity. The dot plot was divided into four quadrants based on including 99.9% of the uninfected control cells in the lower left quadrant. The percentage of DENV-infected cells was determined by counting the number of cells in the upper left quadrant and dividing this number by the total number of cells in the dot plot.
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Titration of DENV by FACS. Ideally, a cell line for determining the titer of dengue virus by FACS should be highly permissive for infection and infected by different strains of virus with similar efficiencies. Otherwise, titers obtained for different strains may reflect differences in interactions between the viruses and cell line and may be a poor measure of the absolute number of infectious particles. We chose the C6/36 mosquito cell line because the available evidence indicates no dramatic differences in interactions between different strains or serotypes of virus with this mosquito cell line. C6/36 cells were infected with prototype DENV3 and clinical isolates of DENV3 (MOI, 0.01), and the infection was monitored daily for 7 days by FACS. The different strains of virus displayed similar growth kinetics, indicating that this cell line was suitable for titrating DENV (Fig. 2). The DENV2 prototype strain NGC displayed growth kinetics similar to the DENV3 isolates in the C6/36 cell line (data not shown).
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FIG. 2. Infection of C6/36 cells by different strains of DENV. The DENV3 prototype strain H87 as well as four primary DENV3 clinical isolates were used to infect C6/36 cells at an MOI of 0.01. Cells were harvested at 24-h intervals for 7 days, and infected cells were detected by FACS.
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FIG. 3. Time course of cell-to-cell spread of DENV2-infected C6/36 insect cells. C6/36 cells grown in six-well plates were infected with DENV2 strain NGC at an MOI of 2. Cells and supernatants were harvested from wells at 9, 18, 24, 26, 30, and 46 h postinfection. The cells were fixed and permeabilized using the Cytofix/Cytoperm kit from BD Biosciences and stained for FACS using monoclonal antibody 4G2 to determine the percentage of infected cells; the results are expressed as a continuous line with a closed circle. The amount of virus in the supernatant at each time point was determined by plaque assay on Vero cells and is expressed as a dashed line with a closed square.
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FIG. 4. Titration of dengue virus using FACS. C6/36 cells were infected with 10-fold serial dilutions of prototype strains and a clinical isolate. At 24 hpi, cells were harvested, fixed, and stained for FACS analysis. (A) Contour dot plots for DENV2- and DENV3-infected cells were obtained from FACS analysis of infected C6/36 cells at 24 h postinfection. C6/36 cells grown in six-well plates were infected for 24 h using 10-fold serial dilutions of prototype strains NGC and H87. One well served as a mock-infected control. The percentage of DENV-infected cells was determined by counting the number of cells in the upper left quadrant and dividing this number by the total number of cells in the dot plot. At 24 h postinfection, the cells in the upper left quadrant are likely a measure of the input virus, because this time point is too early for cell-to-cell spread of newly assembled virus. The dot plots shown above represent one experiment out of three and one out of six experiments for DENV2 and DENV3, respectively. (B) C6/36 cells grown in six-well plates were infected for 24 h using 10-fold serial dilutions of prototype strains NGC and H87 and clinical isolates UNC 3001, UNC 3017, and UNC 3018.
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2,000 and 25,000 infected cells per well). When the signal was below 0.2%, the assay was not sensitive and displayed high variability (data not shown). When more than 25% of the cells were infected, the assay was no longer linear, presumably because the C6/36 cells became limiting in the assay (data not shown). When titers for several strains of DENV1, DENV2, DENV3, and DENV4 were determined by FACS, plaque assay, and endpoint dilution assay, similar titers were obtained with the different assays for DENV1 (strains 16007 and UNC 1002), DENV2 (NGC), DENV3 (strains UNC 3001, UNC 3009, and UNC 3011), and DENV4 (H241) (Table 1). For DENV3 strain H87, the titers obtained with the different assays varied more than the titers of the other viruses analyzed (Table 1).
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FIG. 5. Comparison of FACS titration and plaque assay methods for estimating DENV2 titers. A stock of DENV2 (1 x 107 PFU/ml) was serially diluted fivefold, and each dilution was titrated on Vero cells by plaque assay and on C6/36 cells by FACS. The lower limit of detection by FACS is 10,000 infectious units per milliliter of inoculum. The lower limit of detection by plaque assay is 50 PFU/ml.
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TABLE 1. DENV titers determined by FACS, plaque assay, and and point dilution
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TABLE 2. Antibody neutralization titers determined by FACS and PRNT assaysa
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The current method for measuring the ability of antisera to neutralize DENV is the PRNT assay. The PRNT assay is subject to the same drawbacks as the plaque titration assay. We report here that the FACS assay can also be adapted to measure the ability of antisera to neutralize the virus. When two human dengue virus immune sera were tested with the FACS and plaque neutralization assays, similar neutralization titers were obtained with both assays. Further studies are needed to validate the FACS neutralization assay. Specifically, experiments need to be done with reference sera to determine if the FACS neutralization assay can be used to identify the infecting serotype of DENV and to distinguish between primary and secondary infections. A major advantage to a FACS neutralization assay is that it could be used to measure neutralization of DENV isolates, irrespective of their ability to form plaques. Compared to existing methods for studying dengue virus, which work best with laboratory-adapted strains, we hope the FACS-based methods described here will greatly facilitate studies with primary clinical isolates of dengue virus.
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