Of all the viral hemorrhagic fevers, those caused by EBOV are the most severe (
14,
33). The dramatic clinical presentation in humans and nonhuman primates as well as extensive laboratory data generated in the past has led to the idea that filovirus-induced disease is as much an immune syndrome as a vascular disease (
14,
38). While the clinical picture has become clearer through in vivo experimental studies, the molecular mechanisms, particularly with respect to vascular dysregulation, remain elusive. Although vascular instability and dysregulation are thought to be disease-decisive symptoms, endothelial cells are largely considered secondary target cells during EBOV infection. Primary replication occurs within monocytes/macrophages and dendritic cells (
20,
22,
47), which become activated upon infection and produce active mediator molecules such as proinflammatory cytokines and chemokines but also release soluble viral glycoproteins, particularly sGP, which has been detected in the plasma of human patients (
34). The pathogenic role of secreted cytokines in EBOV pathogenesis has been investigated in the past (
3,
20,
22,
24,
47), but little is known regarding the role of the secreted glycoproteins in endothelial dysfunction. Nevertheless, it has long been hypothesized that the secreted glycoproteins, particularly sGP and Δ-peptide, may play an important role during EBOV pathogenesis and can function as mediators of endothelial and immune dysregulation (
13,
15,
19).
In the past several studies have morphologically described the involvement of the endothelium in experimentally infected nonhuman primates and rodent models as well as in postmortem human material (
4,
19,
31,
32,
64). Destruction of endothelial cells could be found only in postmortem human material (
64) and some nonhuman primate models (
30-
32), but all investigators concluded that endothelial cell function was impaired during infection. To investigate the influence of the soluble and transmembrane glycoproteins on endothelial cell activation and barrier function, we used immunofluorescence analyses and RT-PCR as well as impedance spectroscopy and transwell filter systems, respectively. Impedance spectroscopy is a highly sensitive biophysical assay that provides a unique possibility to study the endothelial barrier function under resting (
25) and shear stress conditions with high time resolution (
11,
42). This technique determines the TER of a cultured endothelial cell monolayer and predominantly reflects the changes in paracellular permeability (
42). Endothelial cell barrier function is frequently studied in transwell filter systems by analyzing the passage of tracer substances (
10,
12,
13). In contrast to impedance spectroscopy, which reliably detects changes in barrier function of about 2% (
42), tracer systems are limited in time resolution and sensitivity and thus allow for the detection of strong effects only.
In the present work we clarified the long-standing question as to whether the EBOV secreted glycoproteins sGP and Δ-peptide are able to influence endothelial cell functions. We determined that, in addition to its ability to induce transcriptional activation of ICAM-1 and VCAM-1 (
20), ZEBOV infection of endothelial cells resulted in surface expression of those molecules as well as of E-selectin (Fig. ). We found that, in contrast to sGP and Δ-peptide, VLP
VP40/GP, produced by transfection of VP40 and GP
1,2, and nearly identical in morphology to infectious virus particles, activated endothelial cells in culture and decreased the endothelial cell barrier function (Fig. , , and ). These effects were not observed using VLPs lacking GP
1,2 (VLP
VP40), indicating the importance of the transmembrane glycoprotein GP
1,2 in the context of a virion particle for endothelial cell activation (Fig. , , and ). The permeability-increasing effect of VLP
VP40/GP might allow for extravasation of small solutes and water and thus might contribute to the development of edema and shock observed during EBOV HF. The moderate permeability increase was confirmed by a moderate change in endothelial cell morphology following VLP
VP40/GP treatment, as indicated by largely intact VE-cadherin staining along the cell junctions but formation of actin stress fibers (Fig. ). A similar morphological change associated with permeability increase was also observed after treatment of endothelial cells with low concentrations of TNF-α (1 ng/ml) (Fig. and ). The data are in agreement with our earlier studies showing that Marburg virus infection did not enhance macromolecular permeability in a transwell filter system (
13).
Geisbert et al. (
20) recently demonstrated upregulation of mRNA transcripts of several genes associated with endothelial cell activation, including cyclooxygenase-2, inducible nitric oxide synthase, ICAM-1, and VCAM-1, following ZEBOV infection of endothelial cells. At the same time, gamma-irradiated EBOV almost failed to activate endothelial cells (only cyclooxygenase-2 mRNA transcripts were upregulated), and it was therefore proposed that endothelial cell activation was dependent on virus replication. This raises the question as to whether or not VLPs and virus subjected to gamma irradiation, a method commonly used to inactivate infectious high-containment agents, can be used interchangeably to represent replication-deficient virus particles. It is known that gamma irradiation changes structural features of proteins dramatically, particularly at high doses (
17,
21). For example, alpha-crystallin activity was reduced by 40% after a dose of 4,000 Gy, and a dose of 60,000 Gy was used to inactivate EBOV (
20). Thus, it seems reasonable to assume that the structure of glycoproteins on gamma-irradiated EBOV may be altered, resulting in insufficient binding of virus particles to endothelial cells and, in turn, insufficient activation, an explanation that still needs to be addressed experimentally.
During an EBOV infection, large amounts of proinflammatory cytokines are secreted from infected primary target cells (
20,
22,
47), with the level of TNF-α in the blood of infected patients reaching 5 to 7 ng/ml. Therefore, it is reasonable to assume that the endothelial barrier function during EBOV infection may be affected as a result of a combined action of different cellular and viral mediators. To verify this hypothesis, we studied the effect of the primary soluble glycoprotein sGP on endothelial barrier function in the presence of TNF-α (Fig. ). In order to detect potential cumulative effects on endothelial cell barrier function, we used a TNF-α concentration of 1 ng/ml, which induced an approximately 30% decrease in barrier function (Fig. ). The moderate effect of VLP
VP40/GP on endothelial barrier function was further enhanced in the presence of TNF-α, thus contributing to the severity of endothelial damage even in the absence of direct endothelial cell infection. Surprisingly, when sGP was administered simultaneously with TNF-α, it caused a recovery of endothelial cell barrier function starting after approximately 10 h (Fig. ). This finding is intriguing and suggests that sGP may have an anti-inflammatory role in the course of EBOV pathogenesis. During EBOV infection, areas of focal tissue destruction can be seen in multiple organs. Interestingly, these areas largely lack infiltration of leukocytes, although neutrophil aggregation within the vascular system is observed in infected nonhuman primates (
31,
32). This might indicate that the activation of the endothelium with the recruitment of neutrophils occurs but that the transmigration process is blocked or impaired, which could be related to the observed anti-inflammatory effect of sGP. TNF-α plays a pivotal role in establishing and orchestrating inflammatory and immune responses to infection (
1,
43). As a consequence, many viruses have evolved countermeasures, such as some of the large DNA viruses (i.e., poxviruses) that encode immunomodulatory proteins which directly inhibit or modify antiviral activities of proinflammatory cytokines (
7,
41). Future studies will have to address the mechanism behind the potential anti-inflammatory action of sGP. In particular, it must be clarified whether the effect is specific for TNF-α and, if so, whether sGP directly interferes with TNF-α or components of the TNF signaling pathway. In this study we used a TNF-α concentration (1 ng/ml) lower than that observed in vivo during infection, but the effect of TNF-α on endothelial cells in vivo can be less pronounced. It was shown that under shear stress, which resembles in vivo physiological conditions, endothelial cells are less responsive to TNF-α (
44,
61). Thus, it would also be of interest to determine the effect of sGP in vivo.
In conclusion, we demonstrated that neither of the two major EBOV secreted glycoproteins, sGP and Δ-peptide, was responsible for endothelial cell activation and/or reduced endothelial cell barrier function. In contrast, VLPs containing the EBOV transmembrane glycoprotein GP1,2 were potent activators of endothelial cells and also induced changes in endothelial cell barrier function, indicating that the transmembrane glycoprotein GP1,2 in the context of a virus particle is an important pathogenic determinant. Interestingly, sGP was found to modulate the endothelial cell inflammatory response, a phenomenon that might play a critical role in EBOV pathogenesis.