Ion transport basis of norovirus diarrhea in a neonatal mouse model
Authors: Griggs Theodor , Natarajan Anbazhagan Arivarasu , Jayawardena Dulari , Kapoor Shaunik , Tyagi Sangeeta , Dudeja Pradeep 
Published: May 2023

Background: Human Norovirus (HuNoV) is the leading cause of infectious gastroenteritis and food-borne outbreaks, responsible for over 220K deaths annually. Given difficulties studying HuNoV, Murine Norovirus (MNV) has been used as a model for norovirus (NoV) pathophysiology. A major barrier to understand how NoV causes diarrhea is the absence of diarrhea in adult wild-type (WT) mice, which have asymptomatic MNV infections. While several KO mouse strains (e.g., STAT1) have been employed to recapitulate disease, these mice often have exaggerated, systemic, and lethal disease courses that imperfectly match human disease. Very recently, a new model of MNV that appears to recapitulate symptomatic HuNoV infection has been established. This model involves the oral gavage of three- or four-day-old (d.o.) WT BALB/c mice with high-concentrations of MNV resulting in a diarrheal phenotype. Current studies were undertaken to understand the ion transport basis of MNV diarrhea using this novel model. Methods: Three to four d.o. BALB/c pups were gavaged with either 1x108 plaque-forming units (PFU) of MNV-1 (CW3) or PBS alone followed by sacrifice at 48 hours-post-gavage (hpg). Small and large intestines were harvested for RNA and immunofluorescence (IF) analysis of multiple ion transporters that have been linked to diarrhea in other disease models. Results: MNV-gavaged pups had loose, orange stools, consistent with a diarrheal phenotype observed previously with this model. MNV RNA was detectable in small and large intestinal tissue for CW3-gavaged vs mock-gavaged pups (p-values <0.05) demonstrating successful infection with MNV. MNV infection had no significant effect on transcript levels of various electrolyte and nutrient transporters including DRA, NHE3, PAT-1, Na-K-ATPase, or SGLT-1. However, we found significant increases in CFTR and Vasoactive intestinal peptide receptor 1 (VPAC1) transcripts (p <0.05 and 0.01, respectively) and a significant increase in CFTR IF staining in frozen sections of the SI over mock (p<0.01). We did not find a significant increase in VIP transcript, VPAC1 protein expression or immunofluorescent staining, nor nuclear localization of pCREB in SI frozen sections. Conclusion: Using this novel neonatal WT BALB/c MNV mouse model to evaluate the effect of infection on gene transcription, and protein expression and localization of ion transporters commonly implicated in diarrhea, we observed significant increases in CFTR and VPAC1 SI gene expression in CW3-gavaged pups with negligible changes in transcription of all other transporters examined in this study. In addition, apical and total CFTR staining increased significantly without changes in VPAC1 or pCREB nuclear localization in frozen SI sections of CW3-gavaged pups compared to mock, suggesting that MNV causes a CFTR-mediated secretory diarrhea in the absence of changes in VPAC1 protein expression, localization, or activation. These studies were supported by the Department of Veterans Affairs, Veterans Heath Administration, Office of Research and Development, Biomedical Laboratory Research and Development: Merit Review Award: BX002011 (PKD), and VA Senior Research Career Scientist Award:1IK6BX005242 (PKD). The studies were also supported by NIH/NIDDK grants, R01 DK54016 and DK92441 (PKD). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.