High Levels of Extracellular Potassium Can Delay Myxoma Virus Replication by Preventing Release of Virions from the Endosomes

Potassium (K⁺) is one of the most abundant cations in the human body. Under normal conditions, the vast majority of K⁺ is found within cells, and the extracellular [K⁺] is tightly regulated to within 3.0 to 5.0 mM. However, it has recently been shown that high levels of localized necrosis can increase the extracellular concentration of K⁺ to above 50 mM. This raises the possibility that elevated extracellular K⁺ might influence a variety of biological processes that occur within regions of necrotic tissue. For example, K⁺ has been shown to play a central role in the replication cycles of numerous viral families, and in cases of lytic infection, localized regions containing large numbers of necrotic cells can be formed. Here, we show that the replication of the model poxvirus myxoma virus (MYXV) is delayed by elevated levels of extracellular K⁺. These increased K⁺ concentrations alter the cellular endocytic pathway, leading to increased phagocytosis but a loss of endosomal/lysosomal segregation. This slows the release of myxoma virus particles from the endosomes, resulting in delays in genome synthesis and infectious particle formation as well as reduced viral spread. Additionally, mathematical modeling predicts that the extracellular K⁺ concentrations required to impact myxoma virus replication can be reached in viral lesions under a variety of conditions. Taken together, these data suggest that the extracellular [K⁺] plays a role in determining the outcomes of myxoma infection and that this effect could be physiologically relevant during pathogenic infection. IMPORTANCE Intracellular K⁺ homeostasis has been shown to play a major role in the replication of numerous viral families. However, the potential impact of altered extracellular K⁺ concentrations is less well understood. Our work demonstrates that increased concentrations of extracellular K⁺ can delay the replication cycle of the model poxvirus MYXV by inhibiting virion release from the endosomes. Additionally, mathematical modeling predicts that the levels of extracellular K⁺ required to impact MYXV replication can likely be reached during pathogenic infection. These results suggest that localized viral infection can alter K⁺ homeostasis and that these alterations might directly affect viral pathogenesis.