Increased Susceptibility of WHIM Mice to Papillomavirus-induced Disease is Dependent upon Immune Cell Dysfunction

Abstract

Warts, Hypogammaglobulinemia, Infections, and Myelokathexis (WHIM) syndrome is a rare primary immunodeficiency disease in humans caused by a gain of function in CXCR4, mostly due to inherited heterozygous mutations in CXCR4. One major clinical symptom of WHIM patients is their high susceptibility to human papillomavirus (HPV) induced disease, such as warts. Persistent high risk HPV infections cause 5% of all human cancers, including cervical, anogenital, head and neck and some skin cancers. WHIM mice bearing the same mutation identified in WHIM patients were created to study the underlying causes for the symptoms manifest in patients suffering from the WHIM syndrome. Using murine papillomavirus (MmuPV1) as an infection model in mice for HPV-induced disease, we demonstrate that WHIM mice are more susceptible to MmuPV1-induced warts (papillomas) compared to wild type mice. Namely, the incidence of papillomas is higher in WHIM mice compared to wild type mice when mice are exposed to low doses of MmuPV1. MmuVP1 infection facilitated both myeloid and lymphoid cell mobilization in the blood of wild type mice but not in WHIM mice. Higher incidence and larger size of papillomas in WHIM mice correlated with lower abundance of infiltrating T cells within the papillomas. Finally, we demonstrate that transplantation of bone marrow from wild type mice into WHIM mice normalized the incidence and size of papillomas, consistent with the WHIM mutation in hematopoietic cells contributing to higher susceptibility of WHIM mice to MmuPV1-induced disease. Our results provide evidence that MmuPV1 infection in WHIM mice is a powerful preclinical infectious model to investigate treatment options for alleviating papillomavirus infections in WHIM syndrome. AUTHOR SUMMARYMice carrying the same gain-of-function mutation in the gene CXCR4 that is present in human patients suffering from the Warts, Hypogammaglobulinemia, Infections, and Myelokathexis (WHIM) syndrome were previously created to understand the biology underlying this syndrome and to develop better means for treating WHIM patients. WHIM mice display neutropenia and lymphopenia symptoms as do WHIM patients. One of the key features of the WHIM syndrome in humans is increased susceptibility to infections by human papillomaviruses (HPV) with the majority of WHIM patients experiencing persistent warts and some developing anogenital cancers, both caused by HPVs. In this study we use a mouse papillomavirus, MmuPV1, which is a model for HPV infection in humans, to ask if the WHIM mice are more susceptible to infection and to understand why. We demonstrate that WHIM mice are more susceptible to MmuPV1-induced disease and that correcting the neutropenia and lymphopenia by bone marrow transplantation was effective at decreasing susceptibility to MmuVP1 induced disease. Our data support WHIM mice as a disease model for WHIM syndrome for future investigations on curative treatment options.