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Acute murine cytomegalovirus (MCMV) infection alters the course of graft-vs-host (GVH) disease involving major histocompatibility (MHC) antigens and induces interstitial pneumonitis. F1 (B10 x B10.BR) mice given 20 x 10(6) B10.BR spleen cells and MCMV (1 x 10(5) plaque-forming units [PFU]) develop severe, diffuse pneumonitis not seen with either MCMV or GVH alone. As one index of the host immune processes operating in the lungs during MCMV/GVH pneumonitis, we examined the types of cells recovered from the lung by bronchoalveolar lavage (BAL) during pneumonitis. During MCMV/GVH pneumonitis, the total cells recovered significantly increased, due primarily to an influx of Thy 1.2 lymphocytes. Characterization of cells using multiparameter flow cytometric analysis revealed that greater than 80% of all BAL cells were Thy 1.2-positive lymphocytes of donor origin. In addition, donor Thy 1.2-positive cells were of both the L3T4+ (43% of BAL cells) and Lyt 2+ (38% of BAL cells) phenotype. Thus, MCMV infection during GVH to MHC antigens induces interstitial pneumonitis, characterized by an influx of T lymphocytes (both helper and suppressor/cytotoxic) from the donor. The antigenic specificity of these cells is not known.

The severity of the graft-versus-host (GVH) reaction, judged by splenomegaly and immunosuppression, was augmented by murine cytomegalovirus (MCMV) infection. Profound GVH-induced immunosuppression was seen in adult unirradiated MCMV-infected F1, mice even after challenge with extremely low doses of parental spleen cells. Mice receiving MCMV+GVH challenge died from days 16-21, with interstitial pneumonia being the most prominent pathological lesion. Pulmonary disease was unrelated to levels of viral replication in the lung. These results suggest that in human marrow recipients, cytomegalovirus infection may play a primary role both in provoking or accentuating GVH disease, as well as in the development of interstitial pneumonia.

In BALB/c mice, murine cytomegalovirus (MCMV) in conjunction with a single dose of cyclophosphamide (CP) induces a diffuse interstitial pneumonitis not seen with either virus or CP alone. To gain insight into the host immune mechanisms operating in the lung during interstitial pneumonitis, we examined the cells recovered in bronchoalveolar lavage (BAL) fluids of mice with MCMV with and without CP. During MCMV interstitial pneumonitis, there was a significant increase in the total BAL cells recovered, primarily because of an influx of lymphocytes bearing the Thy 1.2 marker. Although the number of cells with Lyt 1 and Lyt 2 markers increased, the most significant increase was in the proportion of lymphocytes with surface asialo-GM1. Delineating the roles of these various cell populations may provide insight into the pathogenetic mechanisms leading to CMV interstitial pneumonitis.

We evaluated the influence of host genetic factors on the course of murine cytomegalovirus (MCMV) lung infection after intranasal inoculation and on the development of interstitial pneumonitis after virus and cyclophosphamide (CP) administration. Susceptibility to virus replication in the lungs of various inbred murine strains was inherited as an autosomal dominant trait, which was associated with the H-2 locus. Similarly, the development of MCMV interstitial pneumonitis was inherited as an autosomal dominant, polygenic trait. Susceptibility to lung infection was necessary, but not sufficient for MCMV interstitial pneumonitis. Non-H-2-associated factors were also needed and probably related to CP metabolism or the character of immune recovery after CP administration. Therefore, inheritable host factors influence both susceptibility to MCMV lung infection and the genesis of MCMV interstitial pneumonitis.

We compared the effects of acyclovir (ACV) and 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG) on murine cytomegalovirus (MCMV) replication in lung and salivary gland tissues, the evolution of interstitial pneumonitis in vivo, and MCMV replication in mouse embryo cells in vitro. As measured by plaque reduction, ACV was more active than DHPG in vitro. In vivo, whether administered orally by gastric intubation or in the drinking water, or subcutaneously, DHPG was more effective than ACV in reducing MCMV titers in lung or salivary gland tissues. This was true in both normal and cyclophosphamide-treated mice. Neither drug was able to prevent MCMV interstitial pneumonitis, despite substantial reductions in virus titer, but both drugs reduced the severity of the pneumonitis.

Using a murine model of murine cytomegalovirus (MCMV) interstitial pneumonitis, we examined the relation between the virus content of the lung and lung disease. While MCMV alone does not cause lung disease, interstitial pneumonitis was present in all mice receiving both MCMV and a single dose of cyclophosphamide. In this case the severity of disease, judged by increases in wet weight of the lung, was proportional to the virus content of the lung. Although both acyclovir (50 mg/kg per day) and passive antibody administration reduced the MCMV titers in lung tissues by greater than 90%, histological evidence of interstitial pneumonitis was present in all animals. However, both virus inhibitors reduced the severity of interstitial pneumonitis in treated mice. While transient alterations in host immunity are necessary to induce interstitial pneumonitis after MCMV infection, the severity of interstitial pneumonitis seems to reflect the burden of virus replication. Reduction of virus growth does not prevent, but may moderate, MCMV interstitial pneumonitis.