Rotavirus Induces Intercellular Calcium Waves through ADP Signaling

Rotavirus causes severe diarrheal disease in children by broadly dysregulating intestinal homeostasis. However, the underlying mechanism(s) of rotavirus-induced dysregulation remains incompletely characterized. Here we show that rotavirus-infected cells produce paracrine signals that manifest as intercellular calcium waves (ICWs); which are observed in both cell lines and human intestinal enteroids. Rotavirus ICWs are caused by the release of extracellular adenosine diphosphate (ADP) that activates P2Y1 purinergic receptors on neighboring cells and are blocked by P2Y1 antagonists or CRISPR/Cas9 knockout of P2Y1. Blocking the paracrine ADP signal reduces rotavirus replication, inhibits rotavirus-induced serotonin release and fluid secretion, and reduces diarrhea severity in neonatal mice. This is the first evidence that viruses exploit ICWs to amplify diarrheal signaling; a finding which has broad implications for gastrointestinal physiology. Summary Rotavirus triggers the extracellular release of ADP from infected cells to dysregulate nearby uninfected cells and activate pro-disease pathways.