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Erschienen in: Journal of NeuroVirology 5/2012

01.10.2012

Methamphetamine activates nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and induces human immunodeficiency virus (HIV) transcription in human microglial cells

verfasst von: Emily S. Wires, David Alvarez, Curtis Dobrowolski, Yun Wang, Marisela Morales, Jonathan Karn, Brandon K. Harvey

Erschienen in: Journal of NeuroVirology | Ausgabe 5/2012

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Abstract

Human immunodeficiency virus (HIV) primarily infects glial cells in the central nervous system (CNS). Recent evidence suggests that HIV-infected individuals who abuse drugs such as methamphetamine (METH) have higher viral loads and experience more severe neurological complications than HIV-infected individuals who do not abuse drugs. The aim of this study was to determine the effect of METH on HIV expression from the HIV long terminal repeat (LTR) promoter and on an HIV integrated provirus in microglial cells, the primary host cells for HIV in the CNS. Primary human microglial cells immortalized with SV40 T antigen (CHME-5 cells) were cotransfected with an HIV LTR reporter and the HIV Tat gene, a key regulator of viral replication and gene expression, and exposed to METH. Our results demonstrate that METH treatment induced LTR activation, an effect potentiated in the presence of Tat. We also found that METH increased the nuclear translocation of the nuclear factor kappa B (NF-κB), a key cellular transcriptional regulator of the LTR promoter, and the activity of an NF-κB-specific reporter plasmid in CHME-5 cells. The presence of a dominant-negative regulator of NF-κB blocked METH-related activation of the HIV LTR. Furthermore, treatment of HIV-latently infected CHME-5 (CHME-5/HIV) cells with METH induced HIV expression and nuclear translocation of the p65 subunit of NF-κB. These results suggest that METH can stimulate HIV gene expression in microglia cells through activation of the NF-κB signaling pathway. This mechanism may outline the initial biochemical events leading to the observed increased neurodegeneration in HIV-positive individuals who use METH.
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Literatur
Zurück zum Zitat Asanuma M, Cadet J (1998) Methamphetamine-induced increase in striatal NF-kappaB DNA-binding activity is attenuated in superoxide dismutase transgenic mice. Brain Res Mol Brain Res 60:305–9PubMedCrossRef Asanuma M, Cadet J (1998) Methamphetamine-induced increase in striatal NF-kappaB DNA-binding activity is attenuated in superoxide dismutase transgenic mice. Brain Res Mol Brain Res 60:305–9PubMedCrossRef
Zurück zum Zitat Buchacz K, McFarland W, Kellogg TA, Loeb L, Holmberg SD, Dilley J, Klausner JD (2005) Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco. AIDS 19:1423–4PubMedCrossRef Buchacz K, McFarland W, Kellogg TA, Loeb L, Holmberg SD, Dilley J, Klausner JD (2005) Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco. AIDS 19:1423–4PubMedCrossRef
Zurück zum Zitat Cadet JL, Krasnova IN (2007) Interactions of HIV and methamphetamine: cellular and molecular mechanisms of toxicity potentiation. Neurotox Res 12:181–204PubMedCrossRef Cadet JL, Krasnova IN (2007) Interactions of HIV and methamphetamine: cellular and molecular mechanisms of toxicity potentiation. Neurotox Res 12:181–204PubMedCrossRef
Zurück zum Zitat Cass W, Harned M, Peters L, Nath A, Maragos W (2003) HIV-1 protein Tat potentiation of methamphetamine-induced decreases in evoked overflow of dopamine in the striatum of the rat. Brain Res 984:133–42PubMedCrossRef Cass W, Harned M, Peters L, Nath A, Maragos W (2003) HIV-1 protein Tat potentiation of methamphetamine-induced decreases in evoked overflow of dopamine in the striatum of the rat. Brain Res 984:133–42PubMedCrossRef
Zurück zum Zitat Chang L, Ernst T, Speck O, Grob CS (2005) Additive effects of HIV and chronic methamphetamine use on brain metabolite abnormalities. Am J Psychiatry 162:361–9PubMedCrossRef Chang L, Ernst T, Speck O, Grob CS (2005) Additive effects of HIV and chronic methamphetamine use on brain metabolite abnormalities. Am J Psychiatry 162:361–9PubMedCrossRef
Zurück zum Zitat Copeland K (2005) Modulation of HIV-1 transcription by cytokines and chemokines. Mini Rev Med Chem 5:1093–101PubMedCrossRef Copeland K (2005) Modulation of HIV-1 transcription by cytokines and chemokines. Mini Rev Med Chem 5:1093–101PubMedCrossRef
Zurück zum Zitat Cox C, Cao S, Lu Y (2009) Enhanced detection and study of murine norovirus-1 using a more efficient microglial cell line. Virol J 6:196PubMedCrossRef Cox C, Cao S, Lu Y (2009) Enhanced detection and study of murine norovirus-1 using a more efficient microglial cell line. Virol J 6:196PubMedCrossRef
Zurück zum Zitat Dull T, Zufferey R, Kelly M, Mandel RJ, Nguyen M, Trono D, Naldini L (1998) A third‐generation lentivirus vector with a conditional packaging system. J Virol 72:8463–71 Dull T, Zufferey R, Kelly M, Mandel RJ, Nguyen M, Trono D, Naldini L (1998) A third‐generation lentivirus vector with a conditional packaging system. J Virol 72:8463–71
Zurück zum Zitat Ellis R, Childers M, Cherner M, Lazzaretto D, Letendre S, Grant I, Group HNRC (2003) Increased human immunodeficiency virus loads in active methamphetamine users are explained by reduced effectiveness of antiretroviral therapy. J Infect Dis 188:1820–6PubMedCrossRef Ellis R, Childers M, Cherner M, Lazzaretto D, Letendre S, Grant I, Group HNRC (2003) Increased human immunodeficiency virus loads in active methamphetamine users are explained by reduced effectiveness of antiretroviral therapy. J Infect Dis 188:1820–6PubMedCrossRef
Zurück zum Zitat Freeman P, Walker BC, Harris DR, Garofalo R, Willard N, Ellen JM, Team ftATNfHAIb (2011) Methamphetamine use and risk for HIV among young men who have sex with men in 8 US cities. Arch Pediatr Adolesc Med 165:736–740PubMedCrossRef Freeman P, Walker BC, Harris DR, Garofalo R, Willard N, Ellen JM, Team ftATNfHAIb (2011) Methamphetamine use and risk for HIV among young men who have sex with men in 8 US cities. Arch Pediatr Adolesc Med 165:736–740PubMedCrossRef
Zurück zum Zitat Gavrilin M, Mathes L, Podell M (2002) Methamphetamine enhances cell-associated feline immunodeficiency virus replication in astrocytes. J Neurovirol 8:240–9PubMedCrossRef Gavrilin M, Mathes L, Podell M (2002) Methamphetamine enhances cell-associated feline immunodeficiency virus replication in astrocytes. J Neurovirol 8:240–9PubMedCrossRef
Zurück zum Zitat Guilarte TR, Nihei MK, McGlothan JL, Howard AS (2003) Methamphetamine-induced deficits of brain monoaminergic neuronal markers: distal axotomy or neuronal plasticity. Neuroscience 122:499–513PubMedCrossRef Guilarte TR, Nihei MK, McGlothan JL, Howard AS (2003) Methamphetamine-induced deficits of brain monoaminergic neuronal markers: distal axotomy or neuronal plasticity. Neuroscience 122:499–513PubMedCrossRef
Zurück zum Zitat Janabi N, Peudenier S, Héron B, Ng KH, Tardieu M (1995) Establishment of human microglial cell lines after transfection of primary cultures of embryonic microglial cells with the SV40 large T antigen. Neurosci Lett 195:105–8PubMedCrossRef Janabi N, Peudenier S, Héron B, Ng KH, Tardieu M (1995) Establishment of human microglial cell lines after transfection of primary cultures of embryonic microglial cells with the SV40 large T antigen. Neurosci Lett 195:105–8PubMedCrossRef
Zurück zum Zitat Jayanthi S, Deng X, Ladenheim B, McCoy M, Cluster A, Cai N, Cadet J (2005) Calcineurin/NFAT-induced up-regulation of the Fas ligand/Fas death pathway is involved in methamphetamine-induced neuronal apoptosis. Proc Natl Acad Sci U S A 102:868–73PubMedCrossRef Jayanthi S, Deng X, Ladenheim B, McCoy M, Cluster A, Cai N, Cadet J (2005) Calcineurin/NFAT-induced up-regulation of the Fas ligand/Fas death pathway is involved in methamphetamine-induced neuronal apoptosis. Proc Natl Acad Sci U S A 102:868–73PubMedCrossRef
Zurück zum Zitat Kaul M, Lipton SA (2006) Mechanisms of neuronal injury and death in HIV-1 associated dementia. Curr HIV Res 4:307–18PubMedCrossRef Kaul M, Lipton SA (2006) Mechanisms of neuronal injury and death in HIV-1 associated dementia. Curr HIV Res 4:307–18PubMedCrossRef
Zurück zum Zitat Kaul M, Garden GA, Lipton SA (2001) Pathways to neuronal injury and apoptosis in HIV-associated dementia. Nature 410:988–94PubMedCrossRef Kaul M, Garden GA, Lipton SA (2001) Pathways to neuronal injury and apoptosis in HIV-associated dementia. Nature 410:988–94PubMedCrossRef
Zurück zum Zitat Kim YK, Bourgeois CF, Pearson R, Tyagi M, West MJ, Wong J, Wu SY, Chiang CM, Karn J (2006) Recruitment of TFIIH to the HIV LTR is a rate-limiting step in the emergence of HIV from latency. EMBO J 25:3596–604PubMedCrossRef Kim YK, Bourgeois CF, Pearson R, Tyagi M, West MJ, Wong J, Wu SY, Chiang CM, Karn J (2006) Recruitment of TFIIH to the HIV LTR is a rate-limiting step in the emergence of HIV from latency. EMBO J 25:3596–604PubMedCrossRef
Zurück zum Zitat King JE, Eugenin EA, Buckner CM, Berman JW (2006) HIV tat and neurotoxicity. Microbes Infect 8:1347–57PubMedCrossRef King JE, Eugenin EA, Buckner CM, Berman JW (2006) HIV tat and neurotoxicity. Microbes Infect 8:1347–57PubMedCrossRef
Zurück zum Zitat Langford D, Adame A, Grigorian A, Grant I, McCutchan JA, Ellis RJ, Marcotte TD, Masliah E, Group HNRC (2003) Patterns of selective neuronal damage in methamphetamine-user AIDS patients. J Acquir Immune Defic Syndr 34:467–74PubMedCrossRef Langford D, Adame A, Grigorian A, Grant I, McCutchan JA, Ellis RJ, Marcotte TD, Masliah E, Group HNRC (2003) Patterns of selective neuronal damage in methamphetamine-user AIDS patients. J Acquir Immune Defic Syndr 34:467–74PubMedCrossRef
Zurück zum Zitat LaVoie M, Card J, Hastings T (2004) Microglial activation precedes dopamine terminal pathology in methamphetamine-induced neurotoxicity. Exp Neurol 187:47–57PubMedCrossRef LaVoie M, Card J, Hastings T (2004) Microglial activation precedes dopamine terminal pathology in methamphetamine-induced neurotoxicity. Exp Neurol 187:47–57PubMedCrossRef
Zurück zum Zitat Lee SC, Hatch WC, Liu W, Brosnan CF, Dickson DW (1993a) Productive infection of human fetal microglia in vitro by HIV-1. Ann N Y Acad Sci 693:314–6PubMedCrossRef Lee SC, Hatch WC, Liu W, Brosnan CF, Dickson DW (1993a) Productive infection of human fetal microglia in vitro by HIV-1. Ann N Y Acad Sci 693:314–6PubMedCrossRef
Zurück zum Zitat Lee SC, Hatch WC, Liu W, Kress Y, Lyman WD, Dickson DW (1993b) Productive infection of human fetal microglia by HIV-1. Am J Pathol 143:1032–9PubMed Lee SC, Hatch WC, Liu W, Kress Y, Lyman WD, Dickson DW (1993b) Productive infection of human fetal microglia by HIV-1. Am J Pathol 143:1032–9PubMed
Zurück zum Zitat Mallardo M, Dragonetti E, Baldassarre F, Ambrosino C, Scala G, Quinto I (1996) An NF-kappaB site in the 5′-untranslated leader region of the human immunodeficiency virus type 1 enhances the viral expression in response to NF-kappaB-activating stimuli. J Biol Chem 271:20820–7PubMedCrossRef Mallardo M, Dragonetti E, Baldassarre F, Ambrosino C, Scala G, Quinto I (1996) An NF-kappaB site in the 5′-untranslated leader region of the human immunodeficiency virus type 1 enhances the viral expression in response to NF-kappaB-activating stimuli. J Biol Chem 271:20820–7PubMedCrossRef
Zurück zum Zitat Maragos WF, Young KL, Turchan JT, Guseva M, Pauly JR, Nath A, Cass WA (2002) Human immunodeficiency virus-1 Tat protein and methamphetamine interact synergistically to impair striatal dopaminergic function. J Neurochem 83:955–63PubMedCrossRef Maragos WF, Young KL, Turchan JT, Guseva M, Pauly JR, Nath A, Cass WA (2002) Human immunodeficiency virus-1 Tat protein and methamphetamine interact synergistically to impair striatal dopaminergic function. J Neurochem 83:955–63PubMedCrossRef
Zurück zum Zitat Mattson MP (2005) NF-kappaB in the survival and plasticity of neurons. Neurochem Res 30:883–93PubMedCrossRef Mattson MP (2005) NF-kappaB in the survival and plasticity of neurons. Neurochem Res 30:883–93PubMedCrossRef
Zurück zum Zitat Mocchetti I, Nosheny RL, Tanda G, Ren K, Meyer EM (2007) Brain-derived neurotrophic factor prevents human immunodeficiency virus type 1 protein gp120 neurotoxicity in the rat nigrostriatal system. Ann N Y Acad Sci 1122:144–54PubMedCrossRef Mocchetti I, Nosheny RL, Tanda G, Ren K, Meyer EM (2007) Brain-derived neurotrophic factor prevents human immunodeficiency virus type 1 protein gp120 neurotoxicity in the rat nigrostriatal system. Ann N Y Acad Sci 1122:144–54PubMedCrossRef
Zurück zum Zitat Nath A, Maragos W, Avison M, Schmitt F, Berger J (2001) Acceleration of HIV dementia with methamphetamine and cocaine. J Neurovirol 7:66–71PubMedCrossRef Nath A, Maragos W, Avison M, Schmitt F, Berger J (2001) Acceleration of HIV dementia with methamphetamine and cocaine. J Neurovirol 7:66–71PubMedCrossRef
Zurück zum Zitat Pearson R, Kim YK, Hokello J, Lassen K, Friedman J, Tyagi M, Karn J (2008) Epigenetic silencing of human immunodeficiency virus (HIV) transcription by formation of restrictive chromatin structures at the viral long terminal repeat drives the progressive entry of HIV into latency. J Virol 82:12291–303 Pearson R, Kim YK, Hokello J, Lassen K, Friedman J, Tyagi M, Karn J (2008) Epigenetic silencing of human immunodeficiency virus (HIV) transcription by formation of restrictive chromatin structures at the viral long terminal repeat drives the progressive entry of HIV into latency. J Virol 82:12291–303
Zurück zum Zitat Pereira L, Bentley K, Peeters A, Churchill M, Deacon N (2000) A compilation of cellular transcription factor interactions with the HIV-1 LTR promoter. Nucleic Acids Res 28:663–8PubMedCrossRef Pereira L, Bentley K, Peeters A, Churchill M, Deacon N (2000) A compilation of cellular transcription factor interactions with the HIV-1 LTR promoter. Nucleic Acids Res 28:663–8PubMedCrossRef
Zurück zum Zitat Ravi D, Mitra D (2007) HIV-1 long terminal repeat promoter regulated dual reporter: potential use in screening of transcription modulators. Anal Biochem 360:315–7PubMedCrossRef Ravi D, Mitra D (2007) HIV-1 long terminal repeat promoter regulated dual reporter: potential use in screening of transcription modulators. Anal Biochem 360:315–7PubMedCrossRef
Zurück zum Zitat Rippeth JD, Heaton RK, Carey CL, Marcotte TD, Moore DJ, Gonzalez R, Wolfson T, Grant I, Group H (2004) Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. J Int Neuropsychol Soc 10:1–14PubMedCrossRef Rippeth JD, Heaton RK, Carey CL, Marcotte TD, Moore DJ, Gonzalez R, Wolfson T, Grant I, Group H (2004) Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. J Int Neuropsychol Soc 10:1–14PubMedCrossRef
Zurück zum Zitat Sanchez JF, Sniderhan LF, Williamson AL, Fan S, Chakraborty-Sett S, Maggirwar SB (2003) Glycogen synthase kinase 3beta-mediated apoptosis of primary cortical astrocytes involves inhibition of nuclear factor kappaB signaling. Mol Cell Biol 23:4649–62PubMedCrossRef Sanchez JF, Sniderhan LF, Williamson AL, Fan S, Chakraborty-Sett S, Maggirwar SB (2003) Glycogen synthase kinase 3beta-mediated apoptosis of primary cortical astrocytes involves inhibition of nuclear factor kappaB signaling. Mol Cell Biol 23:4649–62PubMedCrossRef
Zurück zum Zitat Sekine Y, Ouchi Y, Sugihara G, Takei N, Yoshikawa E, Nakamura K, Iwata Y, Tsuchiya K, Suda S, Suzuki K, Kawai M, Takebayashi K, Yamamoto S, Matsuzaki H, Ueki T, Mori N, Gold M, Cadet J (2008) Methamphetamine causes microglial activation in the brains of human abusers. J Neurosci 28:5756–61PubMedCrossRef Sekine Y, Ouchi Y, Sugihara G, Takei N, Yoshikawa E, Nakamura K, Iwata Y, Tsuchiya K, Suda S, Suzuki K, Kawai M, Takebayashi K, Yamamoto S, Matsuzaki H, Ueki T, Mori N, Gold M, Cadet J (2008) Methamphetamine causes microglial activation in the brains of human abusers. J Neurosci 28:5756–61PubMedCrossRef
Zurück zum Zitat Sheng P, Ladenheim B, Moran T, Wang X, Cadet J (1996) Methamphetamine-induced neurotoxicity is associated with increased striatal AP-1 DNA-binding activity in mice. Brain Res Mol Brain Res 42:171–4PubMedCrossRef Sheng P, Ladenheim B, Moran T, Wang X, Cadet J (1996) Methamphetamine-induced neurotoxicity is associated with increased striatal AP-1 DNA-binding activity in mice. Brain Res Mol Brain Res 42:171–4PubMedCrossRef
Zurück zum Zitat Tallóczy Z, Martinez J, Joset D, Ray Y, Gácser A, Toussi S, Mizushima N, Nosanchuk J, Nosanchuk J, Goldstein H, Loike J, Sulzer D, Santambrogio L (2008) Methamphetamine inhibits antigen processing, presentation, and phagocytosis. PLoS Pathog 4:e28PubMedCrossRef Tallóczy Z, Martinez J, Joset D, Ray Y, Gácser A, Toussi S, Mizushima N, Nosanchuk J, Nosanchuk J, Goldstein H, Loike J, Sulzer D, Santambrogio L (2008) Methamphetamine inhibits antigen processing, presentation, and phagocytosis. PLoS Pathog 4:e28PubMedCrossRef
Zurück zum Zitat Tambuyzer BR, Ponsaerts P, Nouwen EJ (2009) Microglia: gatekeepers of central nervous system immunology. J Leukoc Biol 85:352–70PubMedCrossRef Tambuyzer BR, Ponsaerts P, Nouwen EJ (2009) Microglia: gatekeepers of central nervous system immunology. J Leukoc Biol 85:352–70PubMedCrossRef
Zurück zum Zitat Tang H, Kuhen K, Wong-Staal F (1999) Lentivirus replication and regulation. Annu Rev Genet 33:133–70PubMedCrossRef Tang H, Kuhen K, Wong-Staal F (1999) Lentivirus replication and regulation. Annu Rev Genet 33:133–70PubMedCrossRef
Zurück zum Zitat Theodore S, Cass W, Maragos W (2006a) Methamphetamine and human immunodeficiency virus protein Tat synergize to destroy dopaminergic terminals in the rat striatum. Neuroscience 137:925–35PubMedCrossRef Theodore S, Cass W, Maragos W (2006a) Methamphetamine and human immunodeficiency virus protein Tat synergize to destroy dopaminergic terminals in the rat striatum. Neuroscience 137:925–35PubMedCrossRef
Zurück zum Zitat Theodore S, Cass WA, Nath A, Steiner J, Young K, Maragos WF (2006b) Inhibition of tumor necrosis factor-alpha signaling prevents human immunodeficiency virus-1 protein Tat and methamphetamine interaction. Neurobiol Dis 23:663–8PubMedCrossRef Theodore S, Cass WA, Nath A, Steiner J, Young K, Maragos WF (2006b) Inhibition of tumor necrosis factor-alpha signaling prevents human immunodeficiency virus-1 protein Tat and methamphetamine interaction. Neurobiol Dis 23:663–8PubMedCrossRef
Zurück zum Zitat Thomas D, Kuhn D (2005) MK-801 and dextromethorphan block microglial activation and protect against methamphetamine-induced neurotoxicity. Brain Res 1050:190–8PubMedCrossRef Thomas D, Kuhn D (2005) MK-801 and dextromethorphan block microglial activation and protect against methamphetamine-induced neurotoxicity. Brain Res 1050:190–8PubMedCrossRef
Zurück zum Zitat Thomas D, Walker P, Benjamins J, Geddes T, Kuhn D (2004) Methamphetamine neurotoxicity in dopamine nerve endings of the striatum is associated with microglial activation. J Pharmacol Exp Ther 311:1–7PubMedCrossRef Thomas D, Walker P, Benjamins J, Geddes T, Kuhn D (2004) Methamphetamine neurotoxicity in dopamine nerve endings of the striatum is associated with microglial activation. J Pharmacol Exp Ther 311:1–7PubMedCrossRef
Zurück zum Zitat Toussi S, Joseph A, Zheng J, Dutta M, Santambrogio L, Goldstein H (2009) Short communication: methamphetamine treatment increases in vitro and in vivo HIV replication. AIDS Res Hum Retrovir 25:1117–21PubMedCrossRef Toussi S, Joseph A, Zheng J, Dutta M, Santambrogio L, Goldstein H (2009) Short communication: methamphetamine treatment increases in vitro and in vivo HIV replication. AIDS Res Hum Retrovir 25:1117–21PubMedCrossRef
Zurück zum Zitat Volkow ND, Fowler JS, Wang GJ, Shumay E, Telang F, Thanos PK, Alexoff D (2010) Distribution and pharmacokinetics of methamphetamine in the human body: clinical implications. PLoS One 5:e15269PubMedCrossRef Volkow ND, Fowler JS, Wang GJ, Shumay E, Telang F, Thanos PK, Alexoff D (2010) Distribution and pharmacokinetics of methamphetamine in the human body: clinical implications. PLoS One 5:e15269PubMedCrossRef
Zurück zum Zitat Wang X, Watanabe Y, Osugi T, Ikemoto M, Hirata M, Miki N (1992) In situ DNA-protein binding: a novel method for detecting DNA-binding activity of transcription factor in brain. Neurosci Lett 146:25–8PubMedCrossRef Wang X, Watanabe Y, Osugi T, Ikemoto M, Hirata M, Miki N (1992) In situ DNA-protein binding: a novel method for detecting DNA-binding activity of transcription factor in brain. Neurosci Lett 146:25–8PubMedCrossRef
Metadaten
Titel
Methamphetamine activates nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and induces human immunodeficiency virus (HIV) transcription in human microglial cells
verfasst von
Emily S. Wires
David Alvarez
Curtis Dobrowolski
Yun Wang
Marisela Morales
Jonathan Karn
Brandon K. Harvey
Publikationsdatum
01.10.2012
Verlag
Springer US
Erschienen in
Journal of NeuroVirology / Ausgabe 5/2012
Print ISSN: 1355-0284
Elektronische ISSN: 1538-2443
DOI
https://doi.org/10.1007/s13365-012-0103-4

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