Attachment of influenza A virus to sialic acid (SA) on the cell surface is a critical first step in the initiation of infection (
56). More specifically, the receptor-binding site (RBS) of the viral hemagglutinin (HA) glycoprotein binds to SA expressed by cell surface glycoproteins and/or glycolipids to mediate virus attachment. On mammalian cells, SA generally forms glycosidic linkages with the underlying galactose (Gal) residues in SA-(α-2,3)-Gal or SA-(α-2,6)-Gal configurations (
56), and this is a critical factor in determining the tropism of influenza virus for particular host cells (
53,
54). SA-(α-2,3)-Gal is expressed throughout the avian gastrointestinal tract and is preferentially bound by avian influenza A viruses (
67), whereas SA-(α-2,6)-Gal is abundant in the human respiratory tract and is the preferred linkage recognized by human virus strains (
70).
Despite the important role of HA-mediated recognition of SA, SA-independent entry of influenza virus into host cells has been reported (
64). Moreover, the availability of SA on the cell surface does not always result in productive infection (
33). Of interest, Chu and Whittaker reported that Lec1 cells, a mutant Chinese hamster ovary (CHO) cell line deficient in expression of N-linked glycans (
44,
61), were resistant to influenza virus infection, despite retaining full capacity for virus binding and fusion and having no defect in their inherent ability to support viral replication (
12). Hence, despite an abundance of cell surface SA, Lec1 cells appeared to lack the specific receptor(s) required for endocytosis and internalization of virions. Thus, binding to SA facilitates attachment of influenza virus to the cell surface; however, the specific receptors that mediate virus entry have not been identified.
For many viruses, identification of cell surface receptors has been demonstrated following the transfection of gene(s) encoding putative receptor(s) into a cell line that is resistant to infection, such that the cells are rendered susceptible to virus entry. Such approaches have been utilized to identify functional receptors for herpes simplex virus (
41) and reovirus (
3) and to identify a coreceptor for HIV-1 (
22). In the case of influenza virus, such approaches are confounded by the abundance of SA on the surface of mammalian cells such that it has been difficult to identify cell lines that are not susceptible to at least the early stages of virus infection. In the present study, we demonstrate that Lec2 CHO cells, a mutant cell line deficient in terminal SA residues due to a defect in transport of SA across Golgi vesicles by the CMP-SA transporter (
44,
63), are resistant to influenza virus infection. Furthermore, we have used Lec2 CHO cells to develop a transfection-based approach to investigate SA-independent interactions between influenza virus and two human Ca
2+-dependent (C-type) lectins.
DC-SIGN (CD209) and L-SIGN (DC-SIGNR and CD209L) are closely related C-type lectins that recognize a variety of microbes, including viruses (
32,
59). Both are tetrameric type II transmembrane proteins that contain C-type carbohydrate recognition domains that interact with mannose-rich oligosaccharides (
21,
40). DC-SIGN is expressed at high levels by monocyte- and CD34
+-derived subsets of immature and mature dendritic cells (DCs) (
24,
25), as well as alveolar Mφ (
60). The expression pattern of L-SIGN is very different from that of DC-SIGN, being restricted predominantly to endothelial cells, including those in the lung and lymph nodes, as well as lung alveolar epithelial cells (
20,
30). Previous studies have demonstrated that DC-SIGN and/or L-SIGN act as capture and/or entry receptors for a number of enveloped viruses, including HIV-1 (
21,
24,
58,
72), SARS-CoV (
29,
39), West Nile virus (WNV [
16]), hepatitis C virus (
38), Ebola virus (
37), and dengue virus (
69). Recently, DC-SIGN has shown to act as an attachment receptor for H5N1 influenza virus, enhancing virus infection in
trans, as well as promoting virus entry in
cis via secondary interactions with sialylated cell surface molecules on the same cell (
76).
We generated stable Lec2-transfected cell lines expressing either human DC-SIGN or L-SIGN at the cell surface and show that both receptors can mediate attachment and entry of influenza virus strain BJx109 (H3N2). Treatment of transfected CHO Lec2 cells with mannan, but not bacterial neuraminidase (sialidase), blocked infection, a finding consistent with SA-independent infection via C-type lectins. Finally, we demonstrate that virus bearing low levels of mannose-rich glycans (PR8 [H1N1]) was inefficient at infecting Lec2 cells expressing either DC-SIGN or L-SIGN. Together, these data demonstrate that DC-SIGN and L-SIGN can recognize mannose-rich glycans on influenza virus to mediate SA-independent attachment and infection of cells.
MATERIALS AND METHODS
Cell lines.
CHO Pro-5 cells (
62) were obtained from the American Type Culture Collection (ATCC), Manassas, VA. The glycosylation mutant cell line, Lec2, derived from CHO Pro-5 cells (
19,
44,
63) was also obtained from the ATCC. Both cell lines were cultured in alpha-minimal essential medium (αMEM; Gibco-BRL, New York) supplemented with 10% (vol/vol) fetal calf serum (JRH Biosciences, Kansas), 4 mM
l-glutamine, 100 IU of penicillin, 10 μg of streptomycin/ml, nonessential amino acids (Gibco-BRL), and 50 μM β-mercaptoethanol. LA-4 cells were also obtained from the ATCC and cultured in Kaighn's modification of Ham F-12 medium (Gibco), supplemented as described above.
Generation of Lec2 cells transfected with DC-SIGN and L-SIGN.
Transfected Lec2 cells were generated by using neomycin-resistant plasmids encoding human DC-SIGN (
46) or human L-SIGN (
47). The pcDNA3-DC-SIGN plasmid was obtained through the AIDS Research and Reference Reagent Program, National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH). pcDNA3-DC-SIGN was obtained from S. Pohlmann, F. Baribaud, F. Kirchhoff, and R. W. Doms, and the pcDNA3-L-SIGN plasmid was obtained through the AIDS Research and Reference Program, Division of AIDS, NIAID, NIH. pcDNA3-DC-SIGNR was obtained from S. Pohlman, E. Soilleux, F. Baribaud, and R. W. Doms. Subconfluent Lec2 cells in six-well tissue culture plates (Nunc, New York) were transfected by using FuGene 6 transfection reagent (Roche Diagnostics, Switzerland) according to the manufacturer's instructions. Control-transfected Lec2 cells (designated Lec2-control cells) were generated by using a neomycin-resistant plasmid expressing cytoplasmic hen egg ovalbumin (OVA) (
6) generously donated by A. M. Lew and J. L. Brady, The Walter and Eliza Hall Institute, Parkville, Australia. This construct lacks the sequence for cell surface trafficking ensuring intracellular expression of the OVA protein. For the selection of stable transfectants expressing DC-SIGN and L-SIGN or cytoplasmic OVA, transfected cells were cultured in the presence of 1 mg of the selective antibiotic G418 (Gibco)/ml. Clones with high surface expression of DC-SIGN and L-SIGN were obtained via limiting dilution and selected by flow cytometric analysis after staining with monoclonal antibodies (MAbs) directed to human DC-SIGN (clone 120507, conjugated to allophycocyanin [APC]; R&D Systems, Inc.) or human L-SIGN-PE (clone 120604, conjugated to phycoerythrin [PE]; R&D Systems, Inc.). Lec2-DC-SIGN, Lec2-L-SIGN, and Lec2-OVA cells were cultured in supplemented αMEM as described above, in the presence of 1 mg of G418/ml to maintain transgene expression.
Viruses.
The influenza A virus strains used in the present study were A/PR/8/34 (PR8, H1N1) and BJx109 (H3N2), a high-yielding reassortant of PR8 with A/Beijing/353/89 (Beij/89; H3N2) bearing the H3N2 surface glycoproteins. The seasonal H1N1 virus strains A/New Caledonia/20/1999 (New Cal/99) and A/Solomon Islands/3/2006 (Sol Is/06) were obtained from the World Heath Organization Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia. Based on sequence analysis, New Cal/99 and Sol Is/06 both bear four potential sites of N-linked glycosylation on the head of HA (GenBank accession numbers AY289929 and CY031340, respectively). All viruses were grown in 10-day-old embryonated eggs by standard procedures and titrated on Madin-Darby canine kidney (MDCK) cells, and viruses were purified from allantoic fluid by rate zonal sedimentation on 25 to 75% (wt/vol) sucrose gradients, as described previously (
2).
Additional reassortant influenza viruses used in the present study were generated by eight-plasmid reverse genetics as previously described (
42). The viruses included (i) 7:1 reassortants consisting of the PR8 backbone with either the HA or NA gene from Beij/89 (RG-PR8-Beij/89 HA and RG-PR8-Beij/89 NA, respectively), (ii) eight genes from PR8 (RG-PR8), and (iii) a 6:2 reassortant consisting of six genes from PR8 and the HA and NA from Beij/89 (RG-PR8-Beij/89 HA/NA). The rescued viruses were recovered after 3 days and amplified in the allantoic cavity of 10-day-old embryonated hens' eggs.
Binding of lectin, influenza virus, and mannan to the cell surface.
Levels of cell surface SA-(α-2,3)-Gal were determined by using the biotinylated plant lectin Maackia amurensis agglutinin II (MAA; EY Laboratories, California), which binds specifically to SA-(α-2,3)-Gal. Cells were detached from plastic flasks using 0.75 mM EDTA in Tris-buffered saline (TBS; 0.05 M Tris-HCl in 0.15 M NaCl [pH 7.4]) and incubated with 5 μg of biotinylated-MAA (b-MAA)/ml in lectin buffer (TBS containing 10 mM CaCl2 and 1 mg of bovine serum albumin [BSA]/ml; Sigma-Aldrich, Missouri) at 4°C for 30 min. The cells were washed, and bound MAA was detected by using streptavidin conjugated to APC and flow cytometry. To ensure binding specificity, cells were pretreated for 30 min at 37°C with 200 mU of broad-spectrum bacterial sialidase derived from Vibrio cholerae (type III; Sigma Aldrich)/ml to remove SA prior to b-MAA binding.
The ability of influenza virus to bind to cells was determined by using a virus-binding assay. Briefly, detached cells were incubated with 5 μg of purified BJx109 virus/ml in lectin buffer at 4°C for 30 min. Bound virus was detected by using biotinylated MAb recognizing the HA of Beij/89 (MAb C1/1; L. E. Brown, produced in the Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia) in conjunction with streptavidin conjugated to APC and flow cytometry. All antibody-binding steps were performed at 4°C in lectin-binding buffer. In experiments assessing the Ca2+ dependence of virus binding, CaCl2 was omitted from the lectin-binding buffer and replaced with 10 mM EDTA.
Binding of mannan to the cell surface was assessed by using an adaptation of the virus-binding assay. Briefly, detached cells were incubated with biotin-labeled mannan (b-mannan; 10 μg/ml) in lectin-binding buffer for 1 h at 4°C. Biotinylated mannan used in the study was prepared as previously described (
31). Bound mannan was detected using streptavidin conjugated to APC in conjunction with flow cytometry. In experiments assessing the Ca
2+ dependence of mannan binding, CaCl
2 was omitted from the lectin-binding buffer and replaced with 10 mM EDTA.
Virus infection assays.
Cells were cultured overnight in eight-well chamber slides (Lab-Tek), and confluent cell monolayers were washed with serum-free αMEM and infected with influenza virus as described previously (
49). At 6 to 8 h postinfection, slides were washed in phosphate-buffered saline (PBS), fixed in 80% (vol/vol) acetone, and stained with MAb MP3.10g2.IC7 (WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia), specific for the nucleoprotein (NP) of type A influenza viruses, followed by fluorescein isothiocyanate (FITC)-conjugated rabbit anti-mouse immunoglobulin (Dako, Glostrup, Denmark). The percentage of infected cells was determined by costaining with propidium iodide and counting the total number of cells versus FITC-positive cells under ×100 magnification. A minimum of four random fields were selected for counting, assessing at least 200 cells for each sample. Infected cells were photographed by using a Leica DMLB microscope (Leica Microsystems, Germany) and a Leica DFC 490 camera in conjunction with Leica IM50 Image Manager software. In some experiments, cell monolayers were pretreated before infection with 200 mU of bacterial sialidase from
Vibrio cholerae type III (Sigma-Aldrich)/ml,
Clostridium perfringens (Sigma-Aldrich) or
Arthrobacter ureafaciens (Roche), or with 10 mg of mannan (Sigma-Aldrich)/ml in serum-free medium for 1 h at 37°C to remove cell surface SA or block C-type lectins, respectively.
To determine release of infectious virus from cells, confluent cell monolayers were infected in chamber slides as described above. Cell supernatants were collected at 2 and 24 h postinfection, incubated with TPCK (tolylsulfonyl phenylalanyl chloromethyl ketone)-treated trypsin (10 μg/ml; Sigma-Aldrich) for 45 min at 37°C to facilitate cleavage of the viral HA
0 (
56), and titers of infectious virus were determined by plaque assay on MDCK cells.
qRT-PCR for influenza mRNA and vRNA.
Viral RNA (vRNA) and mRNA in virus-infected cells were determined by using quantitative real-time reverse transcription-PCR (qRT-PCR). Briefly, 10
6 cells in 24-well tissue culture plates were infected with 2 × 10
7 PFU of BJx109 for 1 h at 37°C, washed twice, and incubated in serum-free medium. At 2 and 8 h postinfection, RNA was extracted from cells by using an RNeasy minikit (Qiagen) and stored at −70°C. Levels of matrix (M) gene vRNA and mRNA were determined via qRT-PCR using TaqMan chemistry. The primers and probes for the influenza A virus M gene were as follows: forward primer, 5′-GAC CRA TCC TGT CAC CTC TGA C-3′; reverse primer, 5′-GGG CAT TYT GGA CAA AKC GTC TAC G-3′; and probe, 5′-FAM-TGC AGT CCT CGC TCA CTG GGC ACG-BHQ1 (
17). The forward primer was used for vRNA detection, and the reverse primer was used for mRNA detection with the ThermoScript RT-PCR system (Invitrogen, Carlsbad, CA) to produce cDNA. cDNA was then used for real-time PCR with TaqMan Fast Universal PCR Master Mix (Applied Biosystems, Foster City, CA) on an ABI 7500 fast real-time PCR instrument (Applied Biosystems) using a standard program. vRNA and mRNA copy numbers were calculated according to a standard curve generated using 10
1, 10
2, 10
3, 10
4, and 10
6 copies of M gene RNA.
ELISA for binding of concanavalin A to influenza virus.
Enzyme-linked immunosorbent assay (ELISA) plates were coated overnight with 50 μl of purified influenza virus in PBS and then blocked for 1 h with BSA (10 mg/ml). The wells were washed with PBS containing 0.05% Tween 20 (PBST) and incubated for 2 h with 2 mg of biotin-labeled concanavalin A (ConA; Sigma-Aldrich)/ml in PBS containing 5 mg of BSA per ml. The wells were washed again, and bound lectin was detected after incubation with streptavidin conjugated to horseradish peroxidase (HRP; Silenus, Victoria, Australia). To confirm that different viruses bound to ELISA wells with similar efficiency, additional virus-coated and blocked wells were incubated for 2 h with MAb 165, which recognizes the cross-reactive host antigen common to all egg-grown influenza viruses (
50), followed by sheep anti-mouse immunoglobulins conjugated to HRP (Silenus).
Western blotting and virus overlay protein blot assays (VOPBAs).
Whole-cell lysates were prepared using a buffer comprising 50 mM Tris-HCl (pH 7.5), 150 mM NaCl, 0.5% (vol/vol) Triton X-100, 1 mM CaCl2, 1 mM MgCl2, and broad-spectrum protease inhibitor cocktail (Roche, Manheim, Germany), followed by incubation with cells for 1 h on ice. Lysates were clarified by centrifugation at 10,000 × g for 3 min. Protein concentrations were determined by Bradford assay (Bio-Rad Protein Dye; Bio-Rad, California). Samples (∼10 μg of protein) were boiled for 5 min before separation by SDS-PAGE under nonreducing conditions using 10 to 12.5% gels, followed by transfer to polyvinylidene difluoride (PVDF) membrane (Millipore) in Tris-glycine transfer buffer (25 mM Tris containing 192 mM glycine and 10% [vol/vol] methanol; pH 8.3).
To detect DC-SIGN and L-SIGN in whole-cell lysates by Western blot, membranes were blocked in phosphate-buffered saline (PBS) containing 0.5% (wt/vol) BSA and 0.1% (vol/vol) Tween 20 overnight at 4°C after protein transfer. All subsequent wash and antibody binding steps were performed in PBS containing 0.05% (vol/vol) Tween 20. Membranes were then incubated for 1 h at room temperature with an MAb recognizing both DC- and L-SIGN (clone DC28; R&D Systems, Inc.) that had been labeled with biotin (EZ-link Sulfo-NHS-LC-LC-Biotin; Pierce, Illinois) according to the manufacturer's instructions. Bound MAb was detected using SA-HRP in conjunction with enhanced chemiluminescence (ECL; Western Lightning Plus ECL; Perkin-Elmer, Connecticut). Blots were developed by using the Kodak Image Station 4000Mm, and images were managed by using Adobe Photoshop software.
To detect virus binding, VOPBAs were performed where membranes were blocked with VOPBA buffer (TBS containing 1% [wt/vol] BSA, 0.05% [vol/vol] Tween 20, and 5 mM CaCl2) for 3 to 4 h at 4°C. Purified BJx109 (2 μg/ml) was incubated overnight, the membrane was washed, and 2 μg of biotinylated MAb C1/1 was added/ml. Bound virus was detected by using streptavidin-conjugated HRP and ECL imaging, as described above. Note that all steps were performed in VOPBA buffer and that antibody binding was performed at 4°C. To assess the Ca2+ dependence of virus binding, CaCl2 was omitted from the VOPBA buffer and replaced with 10 mM EDTA.
Statistical analysis.
Graphing and statistical analysis of data was performed by using GraphPad Prism (GraphPad Software, San Diego, CA). For comparison of multiple data sets, a one-way analysis of variance (ANOVA) with Tukey's multiple comparative analysis was used. A P value of ≤0.05 was considered significant.
DISCUSSION
Virus attachment and entry into host cells can be a multistep process involving sequential recognition of multiple receptors and cofactors. The present study has defined a system in which SA-independent interactions between influenza virus and putative cell surface receptors can be investigated. SA-deficient Lec2 cells did not bind efficiently to influenza A virus (Fig.
1B) and were resistant to infection (Fig.
1C). To our knowledge, this is the first description of a mammalian epithelial cell line that influenza virus does not bind to and/or infect efficiently. A related mutant CHO cell line (Lec1), deficient in N-linked glycans due to lack of GnT1 glycosyltransferase (
61,
62), was largely resistant to infection by A/WSN/33 (H1N1) and A/Udorn/307/72 (H3N2) (
12), although virus binding was unaffected presumably due to expression of SA on O-linked glycoproteins and glycosphingolipids.
Previous studies implicating C-type lectins (e.g., MMR and MGL) in infectious entry of influenza virus into murine Mφ have been informative but not definitive (
49,
73). We hypothesized that expression of C-type lectins by Lec2 cells would allow virus attachment/entry to be assessed without the added complexity associated with HA-mediated recognition of cell surface SA. In previous studies, transfection of Lec2 CHO cells led to abundant biosynthesis of MMR, but recognition of mannose-specific ligands was compromised, indicating a critical role for terminal sialylation in ligand binding (
65). In contrast, human DC-SIGN and L-SIGN expressed by Lec2 CHO cells mediated Ca
2+-dependent binding to mannan (Fig.
3) and to virus (Fig.
4). DC-SIGN and L-SIGN express a single N-linked glycosylation site near the neck region of each molecule (GenBank accession numbers M98457 and AF245219), and removal of this site increased the multimerization and lectin function of DC-SIGN (
55). Consistent with our data, recombinant DC-SIGN and L-SIGN expressed in
Escherichia coli retained the ability to bind mannose-rich glycans (
40).
Expression of DC-SIGN and L-SIGN restored the capacity of Lec2 cells to support influenza virus infection (Fig.
5A). To our knowledge, this is the first demonstration that L-SIGN can play a role in influenza virus attachment and entry. Wang et al. implicated DC-SIGN in promoting H5N1 virus infection as a capture/attachment molecule rather than a virus entry receptor (
76). H5N1-pseudotyped particles were captured by DC-SIGN expressed by B-THP-1 (human Raji B cells) and THP-1 (human monocytic cells) to enhance infection in
cis and to transfer virus to permissive cells in
trans. However, desialylation was associated with reduced virus infection, an observation consistent with the ability of DC-SIGN to facilitate infection in
cis via SA-expressing receptors (
76). Sialylated species have been reported as absent (
44) or present in small amounts (
36) on Lec2 cells, and we observed low levels of sialidase-sensitive binding of MAA to Lec2 cells (Fig.
1). Treatment of DC-SIGN-Lec2 and L-SIGN-Lec2 cells with bacterial sialidase confirmed that attachment and entry of virus can occur independently of cell surface SA.
Influenza virus HA/NA express a mixture of high-mannose and complex oligosaccharides, including glycans bearing terminal galactose, mannose, and fucose residues (
4,
13,
51,
77). ConA binding confirmed BJx109 expressed high levels of mannose-rich glycans compared to PR8 (Fig.
7A), and BJx109 infected Lec2-DC-SIGN and Lec2-L-SIGN efficiently, whereas PR8 did not (Fig.
7B). Moreover, the ability of BJx109 to infect Lec2-DC-SIGN and Lec2-L-SIGN was blocked by mannan (Fig.
6). Together, these data indicate that differences in glycosylation are likely to modulate recognition and/or internalization of influenza virus by DC-SIGN/L-SIGN. Site-directed mutagenesis has defined particular oligosaccharides expressed by WNV (
16) and SARS-CoV (
29) that promote interaction with DC-SIGN/L-SIGN. Addition of specific sites of N glycosylation to PR8 HA and characterization of the oligosaccharide composition of HA of different virus strains will provide important information regarding specific ligands for DC-SIGN/L-SIGN expressed by influenza viruses.
The principal targets for influenza virus infection in humans are cells of the upper and lower airways. L-SIGN is expressed by bronchiolar epithelial cells, type II alveolar cells, endothelial cells of the lung, and subsets of lung stem/progenitor cells (
10,
30). Influenza virus infection of epithelial cells and endothelial cells generally results in productive replication and virus amplification (
8,
66). Therefore, we postulate that recognition of influenza virus by L-SIGN on cells in the lung may contribute to sustained replication and spread of virus
in vivo. In contrast, DC-SIGN is expressed on human alveolar Mφ (
60) and subpopulations of lung DCs, including interstitial-type DCs (
68,
74), and expression is modulated during infection and inflammation. It has been reported that human Mφ do (
11,
45) and do not (
52) support productive virus replication. The outcomes of virus infection described herein (i.e., nonproductive replication) in CHO/CHO Lec2 cells are likely to be very different to those in primary cells, and further studies are required to elucidate responses of human airway Mφ/DC subsets to influenza virus. DC-SIGN and L-SIGN recognize mannose-rich glycans but only DC-SIGN displays affinity for fucosylated oligosaccharides (
27). Moreover, binding of DC-SIGN by distinct pathogens can lead to inhibition or promotion of particular T-cell responses (
5,
57), which may relate to the distinct signaling pathways induced by mannose and fucose-expressing pathogens (
26). In light of such findings, it will be of particular interest to determine the composition of glycans expressed by different influenza viruses and how these impact on intracellular signaling and cytokine production by human Mφ/DCs.
DC-SIGN has been implicated as a direct route for infection of cells by dengue virus (
69), cytomegalovirus (CMV) (
28), Ebola virus (
1), and WNV (
16) and can promote infection of permissive cells in
trans by Ebola virus (
1), hepatitis C virus (
15), and CMV (
28). L-SIGN has been reported to capture and transfer hepatitis C pseudovirus to human hepatocytes (
15), as well as promoting infection in
cis by WNV (
16), dengue virus (
69), CMV (
28), and Ebola virus (
1). Of interest, DC-SIGN was shown to mediate endocytosis, receptor recycling, and the release of ligand at endosomal pH, whereas L-SIGN did not (
27). However, L-SIGN-mediated uptake and trafficking of ligand into endosomal compartments (
75), as well as the uptake and degradation of SARS-CoV, have been reported (
9). Our data suggest that L-SIGN-mediated delivery of influenza virus into the endosomal pathway facilitates fusion of viral and endosomal membranes in the late endosome, resulting in commencement of viral replication. Moreover, efficient infection of SA-deficient DC-SIGN-Lec2 and L-SIGN-Lec2 cells suggest that HA-SA interactions are not always required for efficient pH-induced fusion (
18).
Expression of putative receptors in Lec2 cells removed the confounding factor of multiple low-affinity interactions between influenza virus HA and cell surface SA. While SA was long considered to be the sole receptor for influenza virus, studies have shown that desialylated mammalian cells can support virus infection (
64,
70). In addition to DC-SIGN and L-SIGN, other cell surface lectins might also mediate SA-independent binding and/or entry. Rapoport et al. demonstrated that oligosaccharide probes showed different patterns of binding to MDCK and Vero cells (
48), which is consistent with the notion that cell surface galectins and/or mannose-binding lectins could potentially bind virus. Multiple pathways are likely to exist for influenza virus entry into cells (reviewed by Nicholls et al. [
43]), and understanding the mechanisms of SA-independent virus entry may have relevance to development of potential treatments for influenza, including inhaled sialidases (
71). As demonstrated here, virus attachment and entry can occur independently of SA; however, efficiency might be markedly enhanced if virus were concentrated at the cell surface by low-affinity interactions with SA. Such a multistep model would allow virus to “browse” the cell surface (
7) before recognition by secondary receptors such as DC-SIGN or L-SIGN for subsequent entry.