INTRODUCTION
Hepatitis C virus (HCV) is among the most important human pathogens and is capable of causing chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC) (
1). Worldwide, HCV prevalence is estimated at 2.5% of the general population, given that the virus is believed to infect 177 million people around the globe (
2). HCV is a plus-stranded RNA virus that is classified into 7 recognized genotypes (
3). The virus belongs to the genus
Hepacivirus of the
Flaviviridae family, a family that includes flaviviruses (such as Zika virus, dengue virus [DENV], yellow fever virus, and tick-borne encephalitis virus), and animal pestivirus genera (such as bovine viral diarrhea virus) (
4).
Plus-stranded RNA viruses depend on cellular membranes in all steps of the viral life cycle (
5). These viruses, including HCV, share the characteristic of remodeling intracellular membranes in order to create membrane replication factories or replication organelles, which are vesicles where viral RNA replication occurs (
6–8). These vesicles not only represent the site of viral replication but also act as one of the strategies of viral immune evasion mechanisms, shielding the viral RNA from cellular innate immune sensors (
9–11). Electron microscopic investigations have defined the membrane replication factory or vesicle as a complex structure of remodeled membranes with negative and positive curvatures; these vesicles exhibit little similarity to the parental organelles from which the factories are remodeled (
5,
12–14). Almost all of the intracellular membranes in eukaryotic cells, including the endoplasmic reticulum (ER), the Golgi, the outer membrane of the mitochondria, and the peroxisomal membranes, represent substrates for the biosynthesis of membrane replication factories induced by plus-stranded RNA viruses (
5). These vesicles exist in two different morphological types, the invaginated vesicle/spherule type and the double-membrane vesicle (DMV) type. Infection by HCV, picornaviruses, and coronaviruses leads to the formation of DMVs, whereas infection by DENV and West Nile virus (WNV) induces the formation of invaginated vesicles (
15). The differences from their parental organelles reflect changes in both structure and in protein and lipid composition (
5).
Lipids represent the major macromolecule responsible for the unique physical properties of different membranes, which include permeability, fluidity, and bending characteristics (
16). Sphingomyelin (SM) is among the most common sphingolipids in many mammalian cells and tissues; SM plays significant structural and functional roles in mammalian cells through the generation of lipid rafts, participation in cell signaling pathways, and membrane homeostasis and curvature (
17–19). SM is also involved in many viral infections, such as those by Ebola virus (
20), human immune deficiency virus (HIV) (
21), Japanese encephalitis virus (
22), rabies virus (
23), and bovine viral diarrhea virus (
24). SM plays several roles in the HCV infection cycle, including in the replication, morphogenesis, and egress steps (
25,
26). As indicated in
Fig. 1A, SM is biosynthesized in the ER by two different pathways, the
de novo and salvage pathways. Both pathways yield ceramide. The ceramide transfer protein (CERT) is responsible for extracting ceramide from the ER and carrying this compound to the Golgi apparatus in a nonvesicular manner; the efficient CERT-mediated trafficking of ceramide occurs at membrane contact sites between the ER and the Golgi apparatus (
27). In the Golgi, ceramide is converted to SM by the sphingomyelin synthase (SGMS) enzyme. Within the CERT protein, three sites are known to be important for CERT’s ability to transfer ceramide from the ER to the Golgi. The START domain is responsible for extracting ceramide from the ER membrane and transferring the compound to membranes of the Golgi. Two other CERT domains contribute to START function. The first, the FFAT motif, directs CERT to the ER by binding to the ER-resident vesicle-associated membrane protein-associated protein (VAP); the second, the PH domain, targets ceramide to the Golgi membrane by binding to phosphatidylinositol 4-phosphate (PI4P) on the surface of the Golgi apparatus (
27,
28). While the function of CERT in SM synthesis, including the involvement of SM in binding and activation of RNA-dependent RNA polymerase of some HCV genotypes (
29), has been detailed in multiple reports, the role of CERT and/or SM in HCV replication remains unclear.
Despite extensive progress in the molecular characterization of HCV replication and the accumulation of an increasing list of host factors necessary for HCV replication, the structure of the membrane replication factories or vesicles and the cooperative action between HCV proteins and host factors to remodel the ER membranes, the parental organelle of DMVs, remain poorly characterized (
6,
8,
12,
15,
30). Although the important requirement of SM in HCV replication has been reported previously, it remains unclear whether SM is an essential component of the functional membrane replication factories. In the present study, we sought to analyze the importance of SM in the biogenesis of the functional membrane replication factories. Specifically, we provide several lines of evidence demonstrating the essential role of SM in the biosynthesis of DMVs induced by HCV infection. We also show that SM is required for the replication of poliovirus, which is known to generate DMVs. This investigation will serve as a cornerstone for the future analysis of a lipid host factor in the biogenesis of membrane replication factories induced by various plus-stranded RNA viruses. Based on our findings, we suggest that the DMV, a structure unique to cells infected by positive-stranded RNA viruses, may serve as a target for viral diagnosis, prognosis, and therapeutics.
DISCUSSION
Previous reports assumed that SM is essential for HCV replication, but the mechanism of SM’s involvement in the process was not clear. In this study, we showed for the first time that SM is essential for the biosynthesis of the membrane replication factories, the site of viral replication.
To assess the importance of SM to HCV replication, we used two methods to inhibit SM biosynthesis; one by using small molecule inhibitors of SM biosynthesis pathways and another by KO of CERT, a key player in SM biosynthesis pathways. We showed that suppression of HCV replication by three inhibitors of SM biosynthesis, namely myriocin, fumonisin B1, and D609, was concentration dependent and genotype independent. Notably, all three compounds inhibited SGR replication of HCV of both genotypes 1b and 2a; the sole exception was that the effect of myriocin could not be analyzed on JFH1/SGR because of cell cytotoxicity (data not shown). However, all three SM biosynthesis inhibitors, including myriocin, suppressed genotype 2a replication in an HCV infection system (
Fig. 1). These data were consistent with those of previous studies showing that inhibition of SM biosynthesis using small-molecule inhibitors suppressed HCV replication in a genotype-independent manner (
43). This result suggested the existence of an additional role of SM in HCV replication, separate from the previous report that SM activates RdRp in a genotype-specific manner (
29).
Suppression of HCV replication in different CERT-KO cell clones that showed significant reductions of SM levels at different time points gives another line of evidence of the importance of SM to HCV replication (
Fig. 2C). Expression of CERT-wt in CERT-KO cells, which rescued SM biosynthesis, efficiently restored viral replication, indicating the importance of ceramide trafficking, from the ER to the Golgi, and that of SM to HCV replication (
Fig. 3A). In contrast, the expression of the two mutant CERT forms that impaired ER-Golgi transport of ceramide, namely ΔFFAT (d321-327), which abolishes the binding of CERT to the ER-resident protein VAP, and the G67E mutation, which abolishes the PI4P-binding capacity of the PH domain, failed to rescue viral replication. These data confirm the requirement of ER to Golgi ceramide trafficking and SM to HCV replication. The suppression of HCV replication in CERT-KO cells was counteracted by supplementation with various kinds of SM as well (
Fig. 3B). C6-SM and C5-SM-BODIPY (i.e., derivatives with the shortest-chain fatty acids) exhibited the most efficient rescue of HCV replication in CERT-KO cells (
Fig. 3B and
C). These data are consistent with previous reports showing that short-chain fatty acid SMs are imported through the cell membrane and accumulate inside the cells (
45). Supplementation with SM rescued the signals for both NS5A and dsRNA, while SM localized with both NS5A and dsRNA (
Fig. 3D and
E). These results indicated a specific requirement for SM in HCV replication, along with the accumulation of SM at the site of viral replication. Some previous reports have suggested that ceramide accumulation suppresses the replication of certain RNA viruses (
46,
47), while others have indicated that both SM and ceramide accumulate in HCV-infected cells (
35). Consequently, it is possible that the inhibition of HCV replication in both CERT-KO cells and cells treated with D609, a direct inhibitor of SGMS, and that in myriocin- and fumonisin B1-treated cells might be attributed to accumulation or depletion of ceramide, respectively (
Fig. 1A) (
35). In the present work, inhibition of HCV replication was observed using any of three inhibitors of the SM biosynthesis pathways, which included the two inhibitors (myriocin and fumonisin B1) that inhibit steps upstream of ceramide synthesis and another inhibitor (D609, a direct inhibitor of SGMS) that inhibits a step downstream of ceramide synthesis; an effect on the suppression in HCV replication also was seen in cells harboring a KO for the genes encoding CERT, a protein that transfers CERT from the ER to the Golgi, as well (
Fig. 1A). Together, these results demonstrated that the observed suppression of HCV replication was not due to ceramide accumulation or depletion. Additionally, the rescue of HCV replication in CERT-KO cells by exogenous supplementation with SM confirmed that inhibition of HCV replication results from decreased SM content rather than from ceramide accumulation (
Fig. 3B to
E). These data were consistent with the results of Hirata et al. (
35), a report that indicated that SM levels were upregulated in humanized chimeric mouse livers and human hepatocytes upon infection with HCV and that also showed that SM was concentrated in the DRM fractions in which HCV replicates. This report also showed that our data represent strong evidence that SM is required for HCV replication. It was previously reported that the exogenously supplied short-chain SM (either C6-SM or C5-SM-BODIPY) are directed more effectively to the plasma membrane and the Golgi, while the long-chain SMs (either egg-SM or milk-SM) are transported along the late endocytic pathway and recycled back (
45). This may explain why C6-SM and C5-SM could restore the replication of HCV in CERT-KO cells, whereas egg-SM or milk-SM could not rescue the HCV replication in these cells.
Previous reports indicated that membrane replication vesicles are enriched in the DRM fraction of HCV-infected cells (
31–35). Therefore, membrane vesicles containing replication complexes in this DRM fraction were roughly purified and analyzed. Our data showed that the degradation of the SM in these vesicles resulted in deterioration of the vesicles and shrinkage of their size (
Fig. 5B and
C). Previous work reported that depletion of cholesterol from purified DMVs resulted in decreased DMV diameters (
40). These data suggested that both SM and cholesterol, the major components of lipid rafts, are essential structural components of HCV DMVs, consistent with previous reports showing that the membrane replication factories are composed of lipid raft-associated membranes enriched in cholesterol and SM (
31–34). Inhibition of RNA replication activity by degradation of SM in isolated vesicles or by treatment of the isolated vesicles with β-CD (a compound that extracts cholesterol from the membrane) supported the same conclusion (
Fig. 6C). It is believed that the membrane replication factories protect the contained viral replication complex from cellular innate immune responses by limiting the replication complex’s interaction with the pattern recognition receptors and also by protecting the replication complex from intracellular RNase and protease activities (
5,
15,
48). Our data showed that the degradation of SM in purified vesicles increased the sensitivity of HCV RNA and proteins to RNase and protease treatments, respectively (
Fig. 6A and
B). The SM content of the isolated membranes correlated with protection of the replication complex in DMVs. Approximately 30% of HCV RNA was degraded by RNase treatment alone, and more than 60% of HCV RNA was degraded by treatment with both RNase and SMase (
Fig. 6B), supporting the previously proposed localization of the HCV replication process to the outer and inner parts of the membrane replication vesicles (
40). This result suggested that one of the proposed functions of the membrane replication factory is to increase the local concentration of the factors required for the replication process (
5,
15). Collectively, the degradation of SM of the isolated vesicles by SMase treatment affected the morphology, size, and function of the DMVs. SM degradation of the isolated vesicles not only resulted in a change of the morphology from DMVs to deformed vesicles and the reduction of the size (
Fig. 5B and
C), but the protective function of these vesicles was affected as well (
Fig. 6).
CERT has previously been reported to be involved in the HCV life cycle (
49), but the detailed mechanism of CERT’s role in virus replication is unknown. We constructed genes encoding CERT-wt (that is, the wild-type protein) or either of two mutant versions of the CERT protein, ΔFFAT (d321-327), harboring a mutation that abolishes binding to the ER-resident VAP protein, and the G67E mutant, in which the PI4P-binding activity of PH domain is abolished, yielding impairment of Golgi trafficking of ceramide (
27). Compared to control CERT-KO cells that were infected with empty lentivirus, CERT-KO cells engineered to overproduce CERT-wt showed a significant rescue of HCV replication, an effect that was not seen in CERT-KO cells overproducing ΔFFAT (d321-327) or the G67E mutant CERT (
Fig. 3A). However, it has been demonstrated in an experiment with semi-intact CHO cells that overexpression of the G67E or ΔFFAT mutations can restore SM synthesis (
22). In
Fig. 3A, the rescue of HCV replication in CERT-KO cells infected with a control lentiviral vector may reflect the induction of autophagosomal membranes by lentiviral infection. Several reports have shown (using large-scale small RNA interference [RNAi] screens, stable knockdown of some autophagic cofactors, or inhibition of autophagy) that lentivirus infection induces autophagy and biogenesis of autophagosomal DMVs (
50–54), which presumably facilitates HCV replication (
33,
55,
56). Although PI4P and SM, which are essential for HCV replication, are enriched in the Golgi, several studies have reported that DMVs are derived from the ER (
7,
57,
58). Therefore, the identity of the parental membrane from which DMVs are derived remains unclear. We propose two models. In the first model, CERT combines ER and Golgi membranes at a membrane contact site to form DMVs, because CERT has binding sites for both VAP (an ER protein) and PI4P (a Golgi component). In the second model, an entirely new membrane containing both ER and Golgi components is formed. The latter model is consistent with the replication of HCV occurring on both the outside and the inside of the membrane vesicles (
Fig. 6B). Several recent publications have reported that HCV induces autophagy to enhance the replication process (
56,
59–61) and that replication occurs in autophagosomal DMVs (
33,
55,
56). Proteomic analysis of proteins associated with HCV-induced autophagosomes has identified several proteins associated with lipid rafts and confirmed the involvement of cholesterol in such vesicles (
33). Further analysis is required to connect the role of SM and autophagosomes in the construction of DMVs.
The requirement for SM is not unique to HCV viral replication. It is specific for DMV-inducing viruses, such as HCV and poliovirus (
Fig. 7A), since infection with viruses that induce invaginated vesicles, such as DENV, did not require SM in their replication (
Fig. 7B). The inhibitory effect of SM on DENV replication shown in
Fig. 7B has been reported in several previous studies. Either myriocin or fumonisin B1 treatment enhanced DENV replication (
47), while genome-wide analysis showed that SGMS is a significant host factor required for HCV infection but not for DENV infection (
62). The inhibitory mechanism of SM to DENV replication has not been examined yet (
47). Others reported that sphingolipids, especially ceramide, may play a protective or antiviral role by the host cell against some other viral infection, such as those caused by influenza A virus and HIV (
46,
63). The mechanism underlying this protective role is unidentified, but it may represent a target for discovering new therapies for some viral infections. It is noteworthy that DMV induction by HCV or poliovirus shares the requirement for PI4P and oxysterol binding protein (OSBP), suggesting an evolutionarily conserved mechanism (
64). Some reports have shown that DENV replication does not require cholesterol, OSBP, or PI4P (
65), a pattern that is distinct from those of both HCV and poliovirus. Further analysis will be needed to understand the differences of the morphological forms of membrane replication vesicles and cell types.
In summary, we have demonstrated that SM is an essential constituent of HCV DMVs and in their function; SM appears to participate in the biosynthesis of membrane replication factories by contributing to the integrity and function of these structures. DMVs are considered abnormal organelles, given that these structures do not exist under normal conditions. Thus, DMVs represent diagnostic and prognostic markers for infection by many positive-stranded viruses, and additionally may serve as excellent therapeutic targets.