The importance of innate, cellular and humoral immunity components on fighting Orthopoxvirus' infections has been demonstrated in several studies. The depletion of macrophages in mice results in their inability to control infection by vaccinia virus [14]. Likewise, the decline of NK cells levels in C57BL/6 mice culminates in increased ectromelia virus (ECTV) titters and disease severity [15, 16]. Complement-deficient mice developed more severe disease when infected with cowpox virus [17]. Evaluation of cytokines, such as IFN (I and II) and TNF also confirmed the key role of these molecules in the innate immune response against orthopoxviruses [18–21]. Both cellular and humoral responses are highly coordinated and require the combined activity of B and T lymphocytes. The primary infection of mice by ECTV cannot be controlled exclusively by TCD8 + lymphocytes [22] and production of antibodies by B lymphocytes is also essential in disease control, reinforcing the functional complementarity of the immune response to poxvirus' infections. This interaction between B and T cells is also crucial in subsequent exposures to these viruses [23]. Nonetheless, poxviruses are capable of encoding several proteins that are related to the evasion of the immune response [24, 25]. Indeed, it has been demonstrated that poxviruses infecting humans are able to significantly modulate components of host-specific immune response [26, 27]. Likewise, many studies have demonstrated the immunomodulatory ability of poxviruses in animal infections [8, 16, 25, 28]. Therefore, the viruses' ability to block, escape or subvert the essential elements of the antiviral response is essential for their replicative success in the host [24].
The Brazilian VACV isolates have been divided into two distinct groups. This classification considers characteristics such as the virulence of these isolates in a murine model, which in turn is linked to intrinsic genetic differences in their respective genomes. Analyses on how different zoonotic VACV isolates interact with their hosts, as well as other virological and biological aspects, could reinforce and support their segregation and classification into different genetic groups.
In this study, we showed how VACVs that belong to genetically different groups are able to modulate the immune response in mice in distinct patterns. Infections with VACV can lead to the appearance of clinical signs such as piloerection, weight loss, back arching, and facial edema. Nonetheless, animals infected with different VACV isolates show these signs differently [8, 29]. Ferreira and colleagues have demonstrated that infection by VACV-WR and GP1V in mice led to the appearance of signs such as piloerection, back arching, periocular alopecia and 25% weight loss. In contrast, the same study showed that animals infected with PSTV and other VACV belonging to group 1, such as the Araçatuba virus and GP2V samples, did not exhibit typical clinical signs of the infection and did not experience marked weight loss. We have replicated these experiments and observed that animals infected with GP1V and WR presented the typical symptoms of VACV infection belonging to group 2. On the other hand, mice infected with PSTV did not manifest significant symptoms after virus inoculation.
Poxviruses have an extensive capacity to infect different hosts. However, viral multiplication rates vary according to the host species, considering that it depends on host-specific antiviral mechanisms [30]. The acute infection initiated in the lung after VACV intranasal inoculation can spread to other organs of the host [29]. One hundred percent of the animals inoculated with the PSTV, GP1V and VACV-WR showed chronic interstitial pneumonia. Liver and spleen were also compromised by infection with viral samples, indicating that PSTV, GP1V and VACV-WR multiply initially in the lungs, spreading to other organs and causing systemic disease. We also found that only VACV-WR was able to cause pulmonary haemorrhage in animals. The histopathological evaluation of the samples showed that PSTV is associated with a lower degree of liver and splenic damage when compared to the other studied viruses (as shown on Fig. 3), similarly to what was described by Ferreira and collaborators [29].
As previously reported, both cellular and humoral immunity are important for controlling infections triggered by Orthopoxvirus. Cell proliferation analysis is a parameter to detect the presence of antigen-specific lymphocytes, in order to obtain information about the cellular response induced by the infection. Gomes and collaborators [9] performed cell proliferation experiments carried out with human peripheral blood mononuclear cells (PBMCs) naturally infected with zoonotic VACV. They observed that after mitogenic and antigenic stimulation, individuals naturally infected with VACV showed a significant proliferative cell response compared to uninfected individuals. Similarly, our results showed increased levels of cell proliferation, after stimulation with VACV-WR, in cells from animals infected with the WR and PSTV samples (Fig. 4).
To deceive the cellular and humoral immune response, poxviruses encode several proteins capable of modulating their hosts' immune systems. Gomes and collaborators [9] also showed a lower frequency of CD14 + and an increase in CD8 + in humans infected with VACV zoonotic viruses. The immunomodulation of these subsets of cells suggests that such cells are important in controlling primary infection, preventing viral multiplication in infected cells. Furthermore, several studies have shown that the depletion of CD4 + T lymphocytes, macrophages and NK cells leads to greater disease severity in mice inoculated with VACV [16, 18, 31]. Some authors suggest that the primary VACV infection does not appear to be controlled solely by the activity of CD8 + T lymphocytes [9, 22]. Overall, these viruses have developed specific downmodulation mechanisms for most immune cells that are important to counter the infection. Our data reflect the differences in patterns of immune responses triggered by different VACV strains and different abilities to downmodulate such responses, culminating with distinct patterns of virulence. Infections by the GP1V and WR viruses (VACV Group 2) resulted in a robust T CD8 + response, unlike the animals infected with the PSTV sample (VACV Group 1), which presented a similar immune patterns observed in the mock-infected group. In addition, a reduction in total lymphocytes, NK cells and macrophages were observed in the group infected with VACV-WR. However, once again the group infected with the sample belonging to the phylogenetic group whose virulence characteristics in mice are milder or non-existent did not show variation in these cell groups, presenting a global profile that was similar to the group of mock-infected animals. The cell activation patterns were also different when different VACV strains were inoculated into mice. VACV-WR- and GP1V-infected animals showed a tendency in CD19 + CD80 + cells downmodulation when compared to the uninfected controls. This was also observed in the study of VACV infections in humans [21]. Antibody production by B lymphocytes is essential to control infections caused by VACV [24]; therefore, it is not surprising that these viruses developed countermeasures that inhibit the activation of such cells. Mice infected with VACV-WR showed lower expression of CD28 in CD8 + T lymphocytes when compared to uninfected controls. Similarly, it has been suggested that this molecule is responsible for enhancing the activation of T cells after infection in mice with this VACV isolate [8].
Cytokines are secreted water-soluble proteins that act as mediators of immune responses, with autocrine and/or paracrine action. VACV produce virokines and viroceptors that mimic the molecules of the host's immune system, mainly affecting IFN, TNF and other cytokines [32, 33]. We also observed a reduction in IFN-γ production by CD4 + T lymphocytes in animals infected with GP1V and VACV-WR after antigen stimulation (Fig. 7A). This cytokine participates in the activation of macrophages, stimulation of inflammation and the mounting of Th1-type responses, all essential for the control of viral infections [34]. The reduction of IFN-γ production by these cells in GP1V- and VACV-WR-infected mice emphasizes the immunomodulatory capacity of these viruses as opposed to the PSTV strain. It corroborates the different virulence patterns found on the literature and observed in a murine model in this work [29].
Our data support a model in which the primary immune responses to acute Orthopoxvirus infection has the involvement of Macrophages/Monocytes and possibly CD4 + T cells, whereas the Lymphocyte-mediated response CD8 + would have a secondary role in infection control. The observation of modulation of those compartments in both humans [9] and mice, reinforces this hypothesis [11]. Finally, we demonstrated here that zoonotic vaccinia viruses belonging to different clades exhibit immunomodulation properties that are proportional to their pathogenic potential. These observations reinforce the idea that the segregation of zoonotic VACVs in two distinct clade/groups reflects not only genetic differences, but distinct virological and biological aspects as well.