Differential susceptibility of neuronal neurotransmitter phenotypes to HHV6 infection
Authors: Bahramian E , Furr M , Wu JT , Ceballos RM 
Published: January 2021

Within the familyHerpesviridae, sub-familyβ-herpesvirinae, and genusRoseolovirus, there are only three human herpesviruses that have been discovered and described: HHV-6A, HHV-6B, and HHV-7. Initially, HHV-6A and HHV-6B were considered to be simply two variants of the same virus (i.e., HHV6). Despite high overall genetic sequence identity (~90%), HHV-6A and HHV-6B are now recognized as two distinct viruses of the genus. Limited sequence identity (e.g., <70%) in key coding regions as well as significant differences in physiological and biochemical profiles (e.g., preferential use of different receptors for viral entry into susceptible hosts) underscore the conclusion that HHV-6A and HHV-6B are distinct virus species. Likewise, each virus appears to differentially contribute as putative etiologic agents to a variety of neurological disorders, including: multiple sclerosis, epilepsy, and chronic fatigue syndrome. Despite being implicated as causative agents in nervous system dysfunction, mechanisms of action and relative contributions of each virus to neural disorders remain elusive. Unresolved questions regarding: cell receptor use and binding affinity (i.e., CD49 versus CD134); cell tropism; the role of HHV-7 superinfection; and, relative virulence between HHV-6A versus HHV-6B – prevent a complete characterization. Although it has been demonstrated that both HHV-6A and HHV-6B can infect glia and, more recently, cerebellar Purkinje cells, cell tropism of HHV-6A versus HHV-6B for different nerve cell types remains vague. In this study, we demonstrate that both HHV-6A and HHV-6B can infect different nerve cell types (i.e., glia versus neurons) and different neuronal neurotransmitter phenotypes derived from the differentiation of human neural stem cells. We further show that both HHV-6A and HHV-6B induce cytopathic effects (CPEs) in susceptible nerve cells. However, the time-course and severity of CPEs appear to differ between HHV-6A versus HHV-6B infections and are dependent upon multiplicity of infection (MOI). As demonstrated by immunofluorescence, although both the HHV-6A and HHV-6B viruses productively infected VGluT1-containing cells (i.e., glutamatergic neurons) and dopamine-containing cells (i.e., dopaminergic neurons), neither HHV-6A nor HHV-6B challenge resulted in the productive infection of GAD67-containing cells (i.e., GABAergic cells). The reason underlying the apparent resistance of GABAergic cells to HHV-6A and HHV-6B infection remains unclear. Morphometric and image analyses of neurite extension and retraction dynamics as well as the time-course of cell aggregation phenomena (e.g., syncytia formation) during infection also indicate that HHV-6A induces more severe CPEs than HHV-6B at the same time-point and MOI. These data suggest that HHV-6A is more virulent than HHV-6B on susceptible human neural stem cells (HNSCs) differentiated into neuronal phenotypes, while neither virus is able to infect GABAergic cells. If thesein vitrodata holdin vivo, theinhibitory interneuron dysfunction hypothesisfor HHV6-driven seizures may be ruled out as a potential mechanism for HHV6-induced epileptogenesis.