Abstract
Human T-lymphotropic virus type 1 (HTLV-1) and other members of the Deltaretrovirus genus code for a regulatory protein named Rex that binds to the Rex-responsive element present on viral mRNAs. Rex rescues viral mRNAs from complete splicing or degradation and guides them to the cytoplasm for translation. The activity of Rex is essential for expression of viral transcripts coding for the virion components and thus represents a potential target for virus eradication. We present an overview of the functional properties of the HTLV-1 and HTLV-2 Rex proteins (Rex-1 and Rex-2), outline mechanisms controlling Rex function, and discuss similarities and differences in the sequences of Rex coded by HTLV-1, -2, -3, and -4 that may influence their molecular anatomy and functional properties.
Introduction
Human T-lymphotropic virus type 1 (HTLV-1) infects approximately 10 million persons worldwide (). HTLV-1 is the causative agent of adult T-cell leukemia/lymphoma (ATLL), tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM) and several inflammatory diseases (). HTLV-1 is classified in seven molecular subtypes, named a, b, c, d, e, f, and g, with characteristic geographic distributions in several endemic regions (). The closely related virus HTLV-2 circulates as two major subtypes, named a and b, mainly in indigenous populations of South America and western and central Africa, and in injection drug users (). Although the pathogenic spectrum of HTLV-2 is not clearly defined (), infection with this virus may be associated with neurological disease () and appears to significantly increase all-cause and cancer-related mortality (). Two other HTLVs, named HTLV-3 (; ) and HTLV-4 (), were identified in individuals living in the rainforests of Cameroon and are of unknown pathogenicity (). The HTLVs are classified in the Deltaretrovirus genus, which also includes the closely related simian T-lymphotropic viruses and bovine leukemia virus. Deltaretroviruses are considered to be “complex” retroviruses, as they produce regulatory and accessory proteins and exhibit 2-phase expression of alternatively spliced mRNAs (; ).
The replication cycle of the HTLVs (and all Deltaretroviruses) is controlled by the viral regulatory proteins Tax and Rex, which are coded in open reading frames (ORFs) named x-IV and x-III, respectively, located on the plus-strand of the proviral genome. Tax increases transcription from the 5′LTR promoter as well as the promoters of many cellular genes, and plays a key role in viral replication and cell transformation (). As illustrated in Figure 1, Rex regulates viral mRNA expression at the post-transcriptional level by interacting with a complex stem-loop RNA structure termed the Rex-responsive element (RXRE), present at the 3′ portion of all plus-strand viral transcripts. This interaction relieves the inhibitory effects of the RXRE and of cis-acting repressive sequences (CRS) present in incompletely spliced mRNAs, rescues these mRNAs from splicing or degradation, and allows their exit from the nucleus through a pathway mediated by the cellular export factor CRM1 (also referred to as exportin 1/XPO1) ().
FIGURE 1
The RXRE is located in the 3′LTR, with RXRE-1 mapping to a short portion of U3 and most of R () and RXRE-2 including the entire R segment and a small portion of U5 (). Its stem-loop structure brings the polyadenylation signal close to the polyadenylation site (), ensuring efficient polyadenylation of viral mRNAs. This position suggests that all transcripts, including multiply spliced species, may have some degree of Rex-responsiveness; this was confirmed for constructs expressing HTLV-1 spliced mRNAs as intronless cDNAs (; ). An incomplete RXRE (R for RXRE-1 and R-U5 for RXRE-2) is also present at the 5′ end of the unspliced transcript.
In addition to CRS, introns and the RXRE, HTLV transcripts contain multiple stop codons, two ribosomal frameshifting signals and multiple splice acceptors that could be recognized by the non-sense-mediated decay (NMD) machinery. A study of HTLV-1-infected cells provided evidence that Rex contributes to suppress NMD of viral and cellular transcripts through a mechanism that does not involve interaction with the RXRE (). Results of in vitro experiments suggest that Rex-1 may also interfere with the activity of Dicer (), a key component of the siRNA- and microRNA processing machinery. Its interactions with NMD and Dicer-dependent pathways suggest that Rex may have broad effects on cellular RNA processing and expression.
Studies of Rex and its HIV homolog Rev have contributed substantially to our knowledge of RNA processing as well as nucleo-cytoplasmic shuttling of proteins and RNA (; ; ). The following sections provide a brief description of Rex coded by HTLV-1 and HTLV-2, referred to as Rex-1 and Rex-2, respectively, and point out mechanisms that control Rex’s activity. We also comment on similarities and differences in the sequences of Rex-1, Rex-2, and Rex proteins coded by HTLV-3 and HTLV-4, whose activities have not been studied to date, and highlight aspects of Rex function that remain to be understood.
Functional Domains in Rex-1 and Rex-2
Almost all of the information on Rex was gathered from studies of Rex-1 coded by subtype-a isolate ATK-1 and Rex-2 coded by subtype-a isolate Mo. Rex-1 (ATK-1) and Rex-2 (Mo) contain 189- and 170 amino acids, respectively, and four main functional domains (Figure 2A; ; ). An amino-terminal, arginine-rich nuclear/nucleolar localization signal (NLS) targets Rex to the nucleus through binding to importin β. This sequence also functions as an RNA binding domain (RBD) that mediates binding to the RXRE. A centrally positioned nuclear export sequence (NES) mediates binding of Rex to CRM1. The NES is flanked by two regions required for the formation of Rex multimers, a process that is facilitated by interaction with CRM1. A phosphorylation-regulated carboxy-terminal domain enhances Rex’s stability and function (, ; ).
FIGURE 2
Figure 2B shows a CLUSTAL alignment of Rex-1 (ATK-1), Rex-2 (Mo) and the Rex-3 and Rex-4 proteins coded by 2 full-length HTLV-3 and HTLV-4 isolates (GenBank nos. listed in Supplementary Table 1). Overall, the NLS/RBD and NES show higher sequence identity compared to the multimerization- and stability domains. However, 9 of the 21 residues comprising Rex-2’s stability domain show perfect identity among the Rex proteins, suggesting a conserved functional role for this region. Percent-identity calculations showed that Rex-1 (ATK-1) is more similar to Rex-2 (Mo) than to Rex-3 or Rex-4, while Rex-2 (Mo) is most similar to Rex-4 (see Supplementary Table 2).
Rex-1 proteins coded by isolates of subtypes a, b, and c also showed some variation, especially between subtype-a and subtype-c ORFs (86.77–88.36% identity, see Supplementary Table 3). One subtype-a isolate, from an ATL patient in Iran, codes for Rex with 20 additional carboxy-terminal amino acids, a feature that might influence its stability domain (see Supplementary Figure 1). Alignments of 11 Rex-2 ORFs (5 subtype-a and 6 subtype-b) revealed 93.53–95.88% identity between the two subtypes (Supplementary Table 4), with distinct “signatures” of amino acids at positions 104, 105, 123, 126, and 136 (see arrows in Supplementary Figure 1). Interestingly, Rex-2 (Mo) was not the most common subtype-a sequence.
Control of Rex Function by Phosphorylation
Early studies of Rex-1 showed that it migrates as a 27-kDa band in SDS-PAGE and is phosphorylated on multiple serines and threonines (
Five of the seven phosphoacceptor sites identified in Rex-1 (ATK-1) (i.e., Thr-22, Ser-36, Thr-37, Ser-97, and Thr-174; Figure 2C) are conserved across the 15 HTLV-1 isolates aligned in Supplementary Figure 1. It is noteworthy that Ser-36 and Ser-97 are also conserved in Rex-2, Rex-3, and Rex-4 (see Supplementary Figure 1).
The Rex-2 (Mo) ORF produces two isoforms of 24- and 26 kDa that differ in phosphorylation (
The protein kinases responsible for Rex phosphorylation have not been experimentally identified. Analysis of the Rex-1 (ATK-1) and Rex-2 (Mo) ORFs with the NetPhos and ScanSite prediction tools yielded one or more candidate kinases for most of the phosphoacceptor sites identified by mass spectrometry (
Most of the studies of Rex phosphorylation have been carried out in cell lines of non-lymphoid derivation (e.g., 293T, Cos, HeLa) transfected with Rex expression plasmids. As the expression of protein kinases can be highly cell-type specific, it will be important to study the protein in cells that are natural targets of HTLV infection in vivo – predominantly CD4 + T-cells for HTLV-1 (
Truncated Rex Isoforms
As depicted in Figure 3, Tax and Rex are expressed from a doubly spliced, bicistronic mRNA containing exons 1, 2, and 3. In addition to mRNA 1-2-3, HTLV-1, and HTLV-2 also produce transcripts that code for truncated forms of Rex. In HTLV-1, an mRNA that contains exon 1 linked to exon 3 (
FIGURE 3

Rex isoforms coded by HTLV-1 (A) and HTLV-2 (B). mRNAs coding for Tax/Rex and Rex isoforms are indicated on the left. The Tax and Rex ORFs are indicated by yellow and blue boxes, respectively, and the HTLV-2 p28 (x-II) ORF is indicated by a light purple box. The domain structures of Rex isoforms are indicated on the right. The red X indicates a stop codon upstream of the exon 3 splice acceptor that is in frame with the Tax ORF. p16Rex is a very low-abundance truncated Rex-2 isoform (
In HTLV-2, spliced mRNAs 1-3 and 1-B code for truncated Rex-2 proteins named p22/p20Rex and p17Rex (
While Met-33 is not present in any of the 15 Rex-1 proteins or in Rex-3 shown in Supplementary Figure 1, it is present in 10 out of 11 Rex-2 proteins and in Rex-4. It is noteworthy that the Rex-1 ORFs coded by 2 Australian isolates examined in Supplementary Figure 1 contain a methionine seven codons downstream the position aligning with Met-33. These isolates, as well as HTLV-4, thus have the potential to produce proteins similar to p22/p20Rex and p21Rex.
Functional Rex Isoforms
A search for novel monocistronic HTLV-1 transcripts coding for only Tax or Rex revealed the production of mRNAs that contain exons 1 and 2 linked to splice acceptors (SA) located upstream (C, Ca) or downstream (3a) of the canonical exon 3 SA; the use of these SA results in insertion or deletion of amino acids in the Rex ORF just after the NLS/RBD (Figure 3A;
The possibility that the other HTLVs produce analogous Rex isoforms remains to be investigated. SAs C, Ca and 3a are present in all 15 HTLV-1 isolates listed in Supplementary Table 1. However, six of the isolates, including the prototype ATK-1, contain a stop codon between SAs C and 3, and are thus predicted to produce Rexa but not Rexb or Rexc. Among the HTLV-2, HTLV-3, and HTLV-4 isolates in Supplementary Table 1, all but one are likewise predicted to produce a Rexa-like protein but not Rexb or Rexc due to the absence of the corresponding SAs and presence of one or more stop codons. HTLV-2b isolate Gu lacks all three alternative SAs and contains stop codons, and thus should not produce any of the extra Rex isoforms.
The Two-Phase Model of HTLV Expression and Viral Latency
The first investigation of HTLV-1 mRNA expression kinetics, performed by transfecting a full-length HTLV-1 provirus and northern blotting, revealed early (Rex-independent) expression of multiply spliced mRNA and late (Rex-dependent) accumulation of singly spliced and unspliced mRNA (
Mathematical modeling of HTLV-1 expression indicated the requirement for a delay in Rex function compared with Tax in order to support the 2-phase kinetics observed experimentally (
It is also possible that changes in the availability of cellular factors influence the relative activity of the 2 proteins during the expression cycle. An example is heterogenous nuclear ribonucleoprotein A1 (hnRNP A1), an important regulator of RNA processing that was shown to interfere with Rex function by competitively binding to the RXRE (
FIGURE 4

Factors controlling Rex function. Summarized are factors that promote (→) and interfere with (⊣) Rex function, as described in the text.
Recent studies indicated that individual HTLV-1-infected cells undergo alternating bursts of viral gene expression and latency (
Studies of HTLV-2 expression kinetics indicated a similar 2-phase pattern of mRNA production (
Conclusion and Perspectives
Comparisons of the biological properties of wild-type and Rex-defective HTLV-1 molecular clones indicated that while Rex is not essential for in vitro immortalization of cultured T-cells (a hallmark of HTLV-1 and HTLV-2), it is required for establishment of persistent infection in a rabbit model (
The discovery of Rex-1 as an essential factor for expression of Gag/Pro/Pol RNA (
Statements
Author contributions
All authors worked together to prepare the manuscript. DD performed the sequence alignments and prepared the Supplementary  Material.
Funding
This work was supported by grants from a Joint Project, University of Verona, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy (to VC and MR); from the Associazione Italiana per la Ricerca sul Cancro (AIRC, IG# 17794, to VC); and from the University of Padova (to VC and DD).
Acknowledgments
The authors would like to thank the many researchers who have made major contributions to the understanding of the Rex regulatory pathway, and apologize for the omission of individual publications.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Supplementary material
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmicb.2019.01958/full#supplementary-material
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Summary
Keywords
HTLV-1, HTLV-2, splicing, RNA export, Rex
Citation
D’Agostino DM, Cavallari I, Romanelli MG and Ciminale V (2019) Post-transcriptional Regulation of HTLV Gene Expression: Rex to the Rescue. Front. Microbiol. 10:1958. doi: 10.3389/fmicb.2019.01958
Received
31 May 2019
Accepted
08 August 2019
Published
22 August 2019
Volume
10 - 2019
Edited by
Louis M. Mansky, University of Minnesota, Twin Cities, United States
Reviewed by
Toshiki Watanabe, The University of Tokyo, Japan; Roberto S. Accolla, University of Insubria, Italy
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Copyright
© 2019 D’Agostino, Cavallari, Romanelli and Ciminale.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Donna M. D’Agostino, dm.dagostino@unipd.itVincenzo Ciminale, v.ciminale@unipd.it
This article was submitted to Virology, a section of the journal Frontiers in Microbiology
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