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Clinical and Diagnostic Laboratory Immunology, March 2002, p. 236-242, Vol. 9, No. 2
1071-412X/02/$04.00+0 DOI: 10.1128/CDLI.9.2.236-242.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Changes in CD4+, CD8+, CD4+ CD8+, and Immunoglobulin M-Positive Peripheral Blood Mononuclear Cells of Postweaning Multisystemic Wasting Syndrome-Affected Pigs and Age-Matched Uninfected Wasted and Healthy Pigs Correlate with Lesions and Porcine Circovirus Type 2 Load in Lymphoid Tissues
Laila Darwich,1* Joaquim Segalés,1,2 Mariano Domingo,1,2 and Enric Mateu1,2
Departament de Sanitat i d'Anatomia Animals, Facultat de Veterinària,1
Centre de Recerca en Sanitat Animal, Universitat Autònoma de Barcelona, Bellaterra, Spain2
Received 30 July 2001/
Returned for modification 25 October 2001/
Accepted 18 December 2001

ABSTRACT
Forty-one 8- to 12-week-old wasted pigs were selected from several
conventional farms with histories of postweaning multisystemic
wasting syndrome (PMWS) and classified into two groups according
to their porcine circovirus type 2 (PCV2) infection status,
as determined by in situ hybridization (ISH). Twenty-four pigs
tested positive for PCV2 (PCV2-positive group), while 17 pigs
tested negative for PCV2 (PCV2-negative group). In addition,
eight uninfected healthy pigs from an experimental farm were
used as controls. Heparinized blood samples were taken to obtain
peripheral blood mononuclear cells. The CD4
+, CD8
+, CD4
+ CD8
+ (double-positive [DP]), and immunoglobulin M-positive (IgM
+)
cell subsets were analyzed by flow cytometry with appropriate
monoclonal antibodies. Histopathological studies were done to
evaluate the apparent degrees of lymphocyte depletion in different
lymphoid organs (superficial inguinal and mesenteric lymph nodes,
Peyer's patches, tonsils, and spleen) and to determine the viral
load of the PCV2 genome by using an ISH technique. Animals of
the PCV2-positive group showed a significant downshift of the
CD8
+ and DP cell subsets compared to the other groups (
P <
0.05). Moreover, in PCV2-positive pigs, the amount of PCV2 genome
in lymphoid tissues was related to the degree of cell depletion
in those tissues (
P < 0.05) as well as to the relative decrease
in IgM
+ and CD8
+ cells in peripheral blood. These data support
the notion that PCV2-positive pigs might have an impaired immune
response.

INTRODUCTION
Since its first description in 1996 by Clark and Harding (Abstr.
Proc. West Can. Assoc. Swine Pract., abstr. 21 to 25, 1996),
postweaning multisystemic wasting syndrome (PMWS) has been reported
worldwide (
2,
4,
9,
11,
13,
22; S. C. Kyriakis, S. Kennedy,
K. Saoulidis, S. Lekkas, C. C. Miliotis, G. C. Balkamos, and
P. A. Papoutsis, Abstr. 16th Int. Pig Vet. Soc. Congr., p. 633,
2000). This syndrome, which affects weaned and fattening pigs
(
8), is characterized by progressive weight loss or unthriftiness,
dyspnea, enlarged lymph nodes, and, less frequently, pallor,
jaundice, and diarrhea (
5,
8). Viral detection techniques and
nucleotide sequence analyses have shown an association between
porcine circovirus type 2 (PCV2) and the presence of a characteristic
histopathologic pattern of PMWS (
7,
8,
12).
Nowadays, PCV2 is included with Chicken anemia virus, Beak and feather disease virus, and PCV1 in the family Circoviridae. Members of this family are small, nonenveloped viruses characterized by circular, single-stranded-DNA genomes (6, 16, 24). Infections caused by circoviruses have been associated with damage to lymphoid tissues resulting in extensive lymphocyte depletion (18, 25). For instance, chicken anemia virus infects the hemocytoblasts in the bone marrow and precursor T lymphocytes in the thymus (25), and beak and feather disease virus infects macrophages and causes atrophy of lymphoid tissue in the thymus and bursa of Fabricius (25). Particularly, PMWS-affected pigs show histiocytic infiltration and lymphocyte depletion of both follicle centers and parafollicular zones, symptoms associated with the presence of PCV2 (18). Consequently, members of this viral family have been supposed to be immunosuppressive (1, 10, 14).
The effects of PCV2 on the pig immune system are not yet fully known, but it has been reported that the main target cells for PCV2 replication are the monocyte/macrophage lineage cells as well as other antigen-presenting cells such as follicular dendritic cells (18). In addition, PCV2 antigen in the nuclei of some lymphocyte subsets has been described (23). Recent studies have suggested that PCV2 infects dividing cells, macrophages, and B lymphocytes, inducing apoptosis of the B cells that leads to the depletion of the lymphoid organs (23). Moreover, studies of lymphocyte subsets showed that pigs suffering from PMWS had lower proportions of CD4+ and immunoglobulin M-positive (IgM+) cells in blood than healthy, uninfected pigs did (20). Taken together, these facts have led some to suggest that PCV2 infection might cause immunosuppression (20, 23). However, little is known regarding the immunological response of pigs suffering from PMWS and the mechanism by which PCV2 infection might result in the development of PMWS.
The aim of this study was to evaluate by means of flow cytometry the changes in lymphocyte subsets of peripheral blood of naturally PCV2-infected pigs suffering from PMWS as well as to correlate these changes with histopathological findings for lymphoid organs such as the superficial inguinal and mesenteric lymph nodes, Peyer's patches, tonsils, and spleen.

MATERIALS AND METHODS
Animals and study design.
Forty-one 8- to 12-week-old pigs were randomly selected from
those that were submitted to the Veterinary Faculty of the Universitat
Autònoma of Barcelona because of their evident chronic
wasting and unhealthy status. To be included in the study, the
pigs had to be from conventional farms with historical records
of PMWS and had to present clear signs of wasting and labored
breathing. Eight healthy PCV2-uninfected pigs obtained from
an experimental herd were also included to provide standards
for the immune parameters. Before the pigs were euthanatized,
blood samples were aseptically taken from the jugular veins,
and after the animals were killed, they were necropsied and
histopathological analyses were performed.
Postmortem and histopathological studies.
All pigs examined were euthanatized by means of a sodium pentobarbital overdose, and detailed necropsies were performed. Samples of the superficial inguinal and mesenteric lymph nodes, Peyer's patches, tonsils, and spleen were taken and fixed by immersion in 10% neutral-buffered formalin, dehydrated, embedded in paraffin wax, and sectioned at 4-µm intervals. The samples were then stained with hematoxylin and eosin (HE) in order to assess the degree of apparent lymphocellular depletion. The different lymphoid tissues were classified by a ranked scoring from no depletion (score 0) to severe depletion (score 3) (Fig. 1). The pattern of distribution of B- and T-cell-dependent areas of the examined tissues was evaluated as described previously (3). These evaluations were always done by the same pathologist, and samples were masked to ensure a blind study.
ISH technique to detect PCV2 infection.
The in situ hybridization (ISH) technique was performed according
to a previously described protocol (
17). Briefly, sections were
hybridized to a PCV2-specific, single-stranded, 40-nucleotide
DNA probe (5'-CAGTAAATACGACCAGGACTACAATATCCGTG-TAACCATG-3')
that was complementary to nucleotides 1,085 to 1,124 of open
reading frame 2 of the PCV2 genome. The DNA probe was end labeled
with digoxigenin, and the prehybridization heating was carried
out for 5 min at 105°C followed by the hybridization process
at 37°C for 60 min. Positive control samples were obtained
from pigs from Spain that had been previously diagnosed with
PMWS (
22), and negative control samples were lymph node tissues
from pigs that tested negative for PCV2 and that came from an
experimental farm with no record of PMWS. The apparent levels
of viral genome stained by ISH in the different lymphoid tissues
were evaluated as described previously (
15). Accordingly, three
categories were considered: high (Fig.
2A), low (Fig.
2B), and
absent.
IHC technique to detect PRRSV infection.
In order to detect porcine reproductive and respiratory syndrome
virus (PRRSV) infection, an immunohistochemical (IHC) technique
was carried out on lung tissue sections by using an avidin-biotin-peroxidase
method described previously (
21). Briefly, tissue sections were
placed on silane [3-(triethoxysilyl)-propylamine]-coated slides.
Endogenous peroxidase activity was inhibited by immersing the
tissue sections in a 3% solution of hydrogen peroxide in methanol
for 30 min. Antigen retrieval was done by enzymatic treatment
(protease type XIV) in Tris-buffered saline (TBS; pH 7.4) for
10 min. Blocking was carried out for 1 h with 10% normal goat
serum in TBS. Tissue sections were mounted on slides and covered
with the monoclonal antibody (MAb) anti-PRRS SDOW17 (dilution,
1:1,000 in TBS), and the slides were incubated overnight at
4°C. Then, the secondary antibody (biotinylated goat anti-mouse
linking antibody) and peroxidase-conjugated avidin were applied
(at dilutions of 1:200 and 1:100, respectively) for 1 h at room
temperature. Sections were incubated in diaminobenzidine-hydrogen
peroxide solution for 8 min, counterstained with Harris's hematoxylin,
dehydrated, covered with a coverslip, and examined microscopically.
Negative control procedures included the omission of the primary
antiserum.
Serological techniques to detect PPV.
A commercially available enzyme-linked immunosorbent assay (Ingezim PPV; Ingenasa, Madrid, Spain) was used according to the manufacturer's recommendation.
Isolation of PBMC.
Ten milliliters of blood was collected from each pig, with heparin used as an anticoagulant. Blood samples were processed to separate peripheral blood mononuclear cells (PBMC) by using gradient density centrifugation with Histopaque 1.077 (Sigma, Barcelona, Spain) at 500 x g for 30 min. Once the PBMC were recovered from the plasma-Histopaque interphase, they were washed three times with phosphate-buffered saline (PBS) and resuspended in RPMI 1640 supplemented with 10% fetal calf serum (Life technologies, Barcelona, Spain). Cells were quantified with a hemocytometer, and a trypan blue-dye exclusion test was performed to assess viability.
Flow cytometry.
Phenotypic analysis of PBMC subsets was done by flow cytometry with the following MAbs: anti-CD4 (b38c6, IgG1; Labor, Reutlingen, Germany), anti-CD8 (295/33-25, IgG2a; Labor), and anti-IgM (k52-1c, IgG1; LabGen, Barcelona, Spain). For secondary antibodies, goat F(ab')2 anti-mouse IgG2a R-phycoerythrin-conjugated antibody and goat F(ab')2 anti-mouse IgG1 fluorescein-conjugated antibody (Southern Biotechnology, Birmingham, Ala.) were used. Irrelevant isotype-matched antibodies were used as background controls. Optimal dilutions of MAbs were standardized in previous experiments (data not shown). Mononuclear cells were dispensed at 106 cells/ml, washed with PBS supplemented with 0.01% sodium azide and 1% fetal calf serum (flow cytometry buffer [PBS-Flow]), and sedimented by centrifugation at 500 x g for 4 min. After the supernatants were discarded, the remaining cell pellets were resuspended with 50 µl of MAb against CD4 or CD8 (two-color cytofluorometry) and IgM (single-color) membrane antigens and incubated in ice for 30 min. Then, 1 ml of PBS-Flow was added, and the PBMC were washed three times. In the last wash, the supernatant fluid was removed and pelleted cells were incubated with 50 µl of the corresponding conjugate for 30 min in ice and in the dark. Finally, the PBMC were washed three more times and fixed in PBS-Flow with 0.5% formaldehyde before analysis with an EPICS XL-MLC cytometer (Coulter) to an excitation wavelength of 488 nm and with 580- and 630-nm filters.
Statistical analysis.
Statistics were calculated with Statsdirect and Epi-Info V.6.01. Comparison between groups regarding the proportion of cells in each subset was done by means of the Kruskal-Wallis test. Further pairwise comparisons were done by the Conover-Inman method. Additional statistical analyses (2-by-2 tables) were calculated by using the chi-square test, and regression analyses were carried out by the method of Draper and Smith (4a) with the Epi-Info program. A P value of
0.05 was considered statistically significant.

RESULTS
ISH technique for PCV2 infection and IHC technique for PRRSV infection.
Regarding the results of the ISH, 24 wasted pigs were positive
for PCV2 (PCV2-positive group) and 17 wasted pigs were negative
(PCV2-negative group). All healthy animals were also negative
for PCV2. The IHC analysis showed that six pigs were positive
for PRRSV. Four of them were coinfected with PCV2, and the other
two animals were PCV2-negative wasted pigs. The eight healthy
pigs were also negative for PRRSV infection. The sex distributions
for the different groups were 12 males and 12 females for the
PCV2-positive group, 11 males and 6 females for the PCV2-negative
group, and 4 males and 4 females for the healthy group.
PPV status.
Eight out of 24 PCV2-positive pigs were seropositive for PPV, while 9 out of 17 PCV2-negative pigs were positive (insignificant differences). None of the healthy control pigs was seropositive.
Flow cytometry.
The relative proportions of CD4+, CD8+, CD4+ CD8+ (double-positive [DP]), and IgM+ cell subsets in PBMC were significantly different among the groups (Table 1). With regard to the CD4+ cell subset, differences were observed between wasted (PCV2-positive or -negative) and healthy animals. Thus, wasted pigs always had a lower proportion of the CD4+ cell subset than the healthy ones (P < 0.001). When the relative proportions of CD8+ or DP cells were compared among groups, a significant downshift of these cells was observed for the PCV2-positive group (P < 0.01).
The results for the IgM
+ cell subset were compared among groups.
Results for the PCV2-positive animals were significantly different
from those for the PCV2-negative animals (
P < 0.05) but did
not differ from those for the healthy animals, although the
P value was close to the significance level (
P = 0.09). However,
when the actual distribution of individual results was considered,
we found that the PCV2-positive group included a cluster of
animals with an IgM
+ cell proportion lower than 5% while the
other 13 animals in this group had IgM
+ cell proportions ranging
from 6.5 to 22.2% (Fig.
3). Comparison of these results with
the apparent level (high or low) of PCV2 genome in tissues showed
that most of the pigs with proportions of IgM
+ cells lower than
5% had high levels of PCV2 infection (
P < 0.05). Thus, data
for IgM
+ cells were analyzed again, with PCV2-positive animals
classified into two subgroups according to the ISH results.
With this analysis, it was evident that pigs with higher levels
of PCV2 had lower proportions of IgM
+ cells in their blood (mean
= 6.5%), results that were statistically different from the
IgM
+ cell proportions in the pigs in the healthy group (mean
= 12.5%;
P < 0.05). In contrast, pigs with low levels of
PCV2 were similar to the healthy ones with respect to IgM
+ cells
(Table
1). In addition, PCV2-positive pigs with lower proportions
of IgM
+ cells (<5%) also had lower proportions of CD8
+ cells
(
r = 0.43;
P < 0.05). As for DP cells, PCV2-infected animals
had lower proportions of those cells than animals in all other
groups (
P < 0.05).
Histopathological studies.
The evaluation of cellular depletion in the different lymphoid
tissues showed significant differences between groups. The PCV2-positive
group had the highest proportion of pigs with any degree of
depletion in most lymphoid tissues (Table
2), and the pigs in
this group had a more severe degree of depletion than the pigs
in the PCV2-negative group did; although there were some PCV2-negative
animals with lymphocyte depletion, that depletion was always
much slighter than that of the PCV2-positive pigs. Moreover,
PCV2-positive pigs that had moderate to severe depletions of
lymphocytes in both T- and B-cell-dependent zones of a tissue
also had similar degrees of depletion in all of the other examined
tissues (
P < 0.05). Furthermore, for PCV2-positive pigs with
moderate (score 2) or severe (score 3) depletions in B-cell-dependent
areas of a given organ, a similar score was determined for the
T-cell-dependent areas of that organ (
P < 0.05). On the other
hand, the degree of cellular depletion in superficial inguinal
lymph nodes or tonsils was inversely correlated to the IgM
+ cell proportions in blood (
P < 0.01) and was also related
to the apparent level of PCV2 genome in lymphoid tissues (
P < 0.05). Thus, the greater the amount of PCV2, the more severe
the depletion, except in periarteriolar lymphoid sheaths (
P = 0.07) (Table
3).
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TABLE 2. Distribution of pigs according to the histopathologic stage of cellular depletion in different lymphoid tissuesa
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TABLE 3. Comparison of the degrees of lymphocyte depletion of different lymphoid tissues with respect to the apparent amount of PCV2 DNA genome observed after ISH
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DISCUSSION
In our study, flow cytometric analyses showed that PCV2-infected
animals suffered a shift in the relative counts of lymphocyte
subsets in PBMC. Some of these changes have been described in
other reports (
19,
20,
23), in which the reduction of T cells
was associated with a decrease or shift in the CD4
+ cell subset
(
19,
20). In those reports, only PCV2-positive or healthy pigs
were examined. In our report, we included PCV2-positive and
PCV2-negative wasted pigs. Thus, the statistical evaluation
of our results showed that the CD4
+ cell shift occurred in both
wasted groups, regardless of whether or not the pigs were PCV2
infected. This might suggest that the changes observed for CD4
+ cells are related to the wasted state, regardless of the PCV2
status. By contrast, when the CD8
+ and DP cell subsets were
analyzed, the relative decreases in these cells were detected
only in PCV2-infected pigs. In consequence, these results might
suggest that CD8
+ and DP cells are specifically affected during
the development of PMWS. Other studies of experimental PCV2
inoculation in conventional pigs showed that animals infected
with PCV2 which did not develop clinical signs of PMWS had,
in the initial stages of infection (approximately 21 days postinfection),
a downshift of CD8
+ cells that recovered later on (L. Darwich,
J. Segalés, A. Resendes, C. Rosell, M. Domingo, M. Balasch,
J. Plana, and E. Mateu, Abstr. 6th Int. Vet. Immunol. Symp.,
abstr. 146, 2001). Since the CD8
+ cell subset is mainly responsible
for the cytotoxic responses, it would be advisable to focus
future studies on the general and virus-specific cytotoxic responses
of PMWS-affected animals.
The fact that DP cells were also downshifted is difficult to explain and deserves further study. However, DP cells are mature lymphocytes with properties of memory and effector cells (26). If that shift in DP cells represents a true decrease, it can be inferred that memory responses could also be altered.
Changes in the proportion of IgM+ cells in PBMC of PCV2-infected pigs have been reported (19, 20, 23). It was suggested that this decrease could be due to the apoptotic effect that PCV2 infection might have on B cells (23). The results of our analysis of IgM+ cell levels showed two different clusters of animals within the PCV2-positive group: pigs with proportions of IgM+ cells of <5% and pigs with proportions of >5%. Though this 5% cutoff was obviously identified after the analysis, it clearly correlates with the amount of virus in the tissues and the severity of the lesions. Thus, this proportion of 5% of IgM+ cells might be a good candidate for a marker of severe progression of the PCV2 infection, particularly since PCV2-negative wasted animals were not clinically distinguishable, while alive, from PMWS-affected pigs.
The histopathological analysis showed that the intensity of depletion in B- or T-cell-dependent areas of the examined lymphoid tissues was related to the apparent amount of viral DNA in those tissues. Also, when severe cellular depletions were found in one lymphoid organ, it became more likely that similar lesions would be found in others. We think that these results indicate that lymphoid cell depletion occurs generally in all secondary or peripheral lymphoid organs affected by PMWS. On the other hand, present knowledge supports the theory that in the pathogenesis of PMWS, the first replication of PCV2 takes place in local lymphoid organs such as the tonsils and lymph nodes (18). This is thought to cause lymphocyte damage that leads to the typical histopathological pattern of PMWSabsence of follicles and lymphoid tissue atrophy (18, 19)that we found in PCV2-infected pigs.
In relating the histopathological observations to the flow cytometry results, it is difficult to determine whether the downshift of lymphocyte subsets in the blood of PMWS-affected pigs represents a depletion or a relative change with respect to other cell types (T-
cells or monocytes) that were not examined. However, since the most severe depletions in lymphoid tissues were found in pigs with lower blood counts, we think that changes in the blood probably reflect general lymphocyte depletion. Unfortunately, we did not examine primary organs like the thymus or bone marrow, nor did we further characterize the phenotype of existing lymphocytes to ascertain whether they were naïve or effector or memory cells (LFA-3, CD45RO/RA, CD69, etc.). Thus, additional studies are needed to clarify whether these decreases are general or specific to a given type of lymphocyte subset.
The results of the present report reinforce the notion that in natural cases of PMWS, there is an evident change (absolute or relative) in the proportions of the different lymphocyte subsets. This change seems to be related to the levels of PCV2 in lymphoid tissues and to the extent of depletion in both B- and T-cell-dependent areas of these tissues. Taken together, these facts could suggest the existence of damage to the immune systems of PMWS-affected pigs. However, it remains unclear how PCV2 acts upon the immune systems of infected pigs.

ACKNOWLEDGMENTS
This work has been performed thanks to funding from Project
QLRT-PL-199900307 of the Fifth Framework Programme 1998-2002
of the European Commission, Project 2-FEDER-1997-1341 of the
I+D National Plan (Spanish Ministry of Science and Technology),
and a grant from Generalitat de Catalunya.

FOOTNOTES
* Corresponding author. Mailing address: Departament de Sanitat i d'Anatomia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain. Phone: 34 93 5811046. Fax: 34 5812006. E-mail:
Laila.Darwich{at}uab.es.


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Clinical and Diagnostic Laboratory Immunology, March 2002, p. 236-242, Vol. 9, No. 2
1071-412X/02/$04.00+0 DOI: 10.1128/CDLI.9.2.236-242.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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