Because there is no DNA phase during the replication of negative-sense RNA viruses, there is no danger that the viral genome will integrate into the host genome when influenza virus is used as a viral vector.
26 This would provide for a dramatic increase in safety as compared with other viral vectors with the potential to integrate their viral DNA into the host genome. Moreover, the RNA genome of the influenza virus is a potent trigger of innate immunity and can stimulate RIG-I and induce IFN-β production.
27 It may also be possible that influenza virus, when used as a viral vector, could help to induce strong humoral and cellular immune response after immunization as will be discussed in later sections. Thus, it was a great milestone when the reverse genetics of the negative-stranded virus was successfully developed. Many important achievements were produced by using this novel virus rescue system, including studies with influenza viruses. Scientists can now mutate specific nucleotides in the viral genome to explore the functions of the proteins or amino acid domains, or elucidate the nature of regulatory sequences. Furthermore, the influenza virus reverse genetics system may also be a very important tool in generating influenza vaccines. Of significance, a cold-adapted, seasonal influenza vaccine which stimulates potent humoral and T cell immune responses was created for human use.
28 Influenza virus reverse genetics may also be used to produce effective vaccines to prevent influenza pandemics.
29,30 In addition, influenza viral vectors have several potential advantages against various disease pathogens. These advantages include the ability for large-scale production of influenza virus in embryonated chicken eggs. Since influenza HA and NA surface antigens continuously evolve,
31 another advantage of influenza virus-vectored vaccines is that they may be used frequently for immunization.
32 Moreover, as a major respiratory system disease pathogen, influenza virus stimulates potent mucosal and systemic immune responses.
33 Finally, as we have discussed in earlier sections, highly efficient, reverse genetic systems of influenza virus have been established.
The majority of studies on the use of influenza virus as a vaccine vector are centered on modifying an influenza virus to incorporate a heterologous gene. Several influenza gene segments can be modified in the process of producing recombinant influenza viruses by inserting a foreign gene into a gene segment of the influenza viral genome. Such a rescued influenza virus was reported in 1994, and expressed a conserved epitope ELDKWA from gp41 ectodomain of HIV-1. The epitope was inserted into the loop of antigenic site B of influenza HA. This was the first study to generate a chimeric influenza virus carrying a heterologous amino acid epitope.
34 Intranasal immunization with this chimeric virus induces a significant mucosal antibody response and induces strong immune responses in the respiratory, vaginal, and intestinal tracts. Sustained levels of secretory immunoglobulin A (sIgA) were detectable for more than 1 y after immunization.
35 In another study,
Bacillus anthracis protective antigen (PA) domain 1 and domain 4 were inserted into the C-terminal flank of the HA signal peptide or into the HA1 subunit of HA. Both chimeric proteins show similar HA function to that of wild-type HA. Furthermore, immunization with the plasmids encoding the chimeric proteins and the recombinant virus induce immune responses against both HA and PA. Genes encoding exogenous protein domains can also be inserted into the HA gene segment of recombinant influenza virus without decreasing the function of HA.
36,37 Intranasal immunization with live influenza expressing the receptor domain of
Bacillus anthracis protective antigen (PA) or the lethal and edema factor binding domain (domain 1) induce strong and specific immune responses. To reduce the possibility of recombination of the rescued influenza virus with natural influenza virus, Hai et al. generated a recombinant influenza B virus to express the ectodomain of influenza A virus HA protein. Immunization of mice with these viruses protected mice against lethal influenza virus infection.
38Besides the influenza virus HA gene segment, the NA gene segment may also be modified to express heterologous amino acids. In fact, Castrucci and colleagues inserted a cytotoxic T lymphocyte epitope specific to the lethal lymphocytic choriomeningitis virus (LCMV) nucleoprotein into the NA stalk region and found that as many as 58 amino acids could be inserted into the NA stalk region without obvious effects on the function of NA.
39 In contrast, Mishin et al. generated a NA-deficient mutant influenza A virus by replacing the NA stalk region with an enhanced derivative of green fluorescent protein (GFP), also known as eGFP. The results from this study in ferrets suggested that NA stalk region-lacking mutants can be used as either a live attenuated influenza virus vaccines or as viral vectors.
40 Moreover, Efferson et al. generated a recombinant influenza virus expressing the immunodominant HER-2 CTL epitope KIF (E75) in the stalk region of NA protein. It was the first report that demonstrated a live attenuated recombinant influenza vector carrying the immunodominant HER-2 CTL E75 could induce human epitope-specific CTLs against a tumor-associated antigen.
41 These results suggest that influenza virus may be used as anti-tumor viral vector. In another study, a recombinant influenza virus containing an HIV-1 epitope in the NA stalk region induced strong, durable immune responses in female mice when administered to the mucosa of the vaginal tract.
42 Finally, recombinant viruses with eGFP insertions that do not cause loss of NA function have been created as tools for tracing and deciphering the steps involved in infection and replication of influenza viruses.
43,44In addition, the non-structural (NS) gene segment can also tolerate insertions of up to 250 amino acids.
45 The NS gene segment is the smallest segment, encoding two proteins, NS1 and NS2. NS1 is an important factor for effective influenza virus replication and serves as an IFN α/βantagonist.
45 NS2 mRNA is synthesized via alternative splicing of NS1 mRNA and functions in influenza virus transcription and replication, including nucleocytoplasmic export of viral RNPs.
46 Different approaches may be utilized for genetic manipulation of the NS gene segment. Several studies report the expression of full-length exogenous proteins in influenza virus via the insertion of an internal ribosomal entry site (IRES) into the recombinant RNA gene segment to generate a bicistronic vRNA.
47 Another method used to generate multicistronic vectors is to introduce a short 2A cleavage site. These 2A cleavage sites have been identified in several RNA viruses, including foot and mouth disease virus, equine rhinitis A virus and porcine teschovirus.
48 The 2A peptide facilitates co-translational cleavage of large viral polyproteins at a single site, but can also mediate co-translational cleavage in synthetic polyproteins.
49Furthermore, as a determinant of influenza virus pathogenesis, the NS gene segment is the most popular gene for modification. Attenuated influenza A and B viruses can be produced via alteration of the NS gene segment as Talon and colleagues first reported.
50 In a later study, Ferko and colleagues generated a hyper-attenuated recombinant influenza virus containing 137 C-terminal amino acid residues of human immunodeficiency virus type-1 Nef protein within the NS gene. Animal experiments show that this hybrid influenza virus can induce strong Nef and influenza-specific CD8
+-T cell responses.
51 The attenuated influenza viruses with altered NS genes markedly increase the safety of a live influenza vaccine.
Specific modifications of the NS gene segment can also be used to improve the immunogenicity of live influenza vaccines. In one study, the NS gene segment was modified to express human interleukin-2 (IL-2) in an attenuated, cold-adapted influenza virus.
52 Intranasal immunization of mice with this modified influenza virus dramatically enhanced mucosal and cellular immune responses compared with its wild-type counterpart. In another study, Wolschek et al. replaced the interferon antagonist NS1 of influenza A viral vector with human IL-2, human interleukin-24 (IL-24), or human CCL20.
53 Kittel et al. also generated a recombinant influenza virus expressing biologically active human interleukin-2 from within the NS1 open reading frame. An insertion of an overlapping UAAUG stop-start codon cassette into NS gene gives this bicistronic influenza vector the ability to replicate in mouse lungs and secrete biologically functional interleukin-2.
26 These influenza virus vectors expressing cytokines are potential viral vectors for cancer treatments.
Reporter influenza viruses have also been produced by inserting a tetracysteine
54 or GFP
45 tag into the NS gene segment. Use of the tetracysteine tag allowed for the real-time visualization of NS1 protein transport in infected cells by Li et al.,
54 while Kittel al suggested that their GFP-expressing virus construct could be used in the future to track viral infection in animals and for rapid screening of drugs against influenza virus.
45 In addition, Takasuka et al. inserted the chloramphenicol acetyltransferase (CAT) reporter gene into the NS gene segment and demonstrated that their recombinant virus generated a respiratory immune response against CAT in mice with intranasal inoculation.
55As a respiratory disease pathogen, live attenuated influenza virus may be considered as a potential vector against other respiratory pathogens, such as
Mycobacterium tuberculosis and respiratory syncytial virus. Indeed, an attenuated influenza virus has been generated to express the
M. tuberculosis secretory antigenic target protein within the influenza NS segment. This construct provides potent protection against challenge with tuberculosis to mice and guinea pigs when administered via the intranasal route. Moreover, protection by this influenza virus is similar to that induced by the
Mycobacterium bovis Bacillus Calmette-Guérin strain (BCG), and has a synergistic effect when used with chemotherapy.
56,57It is also possible to express full-length foreign proteins through an additional gene segment. Using reverse genetics techniques, Gao et al. generated a recombinant A/PR/8/34/ with a ninth gene segment encoding GFP or the HA gene of A/Hong Kong/1/68.
58 This ninth gene segment can be used further to generate bivalent attenuated influenza vaccines against other pathogens.