Cell culture-adapted laboratory strains of Sindbis virus (SB) exhibit efficient initial attachment to cell surface heparan sulfate (HS) receptors. In contrast, non-cell-adapted strains, such as the SB consensus sequence virus TR339, interact weakly with HS and cell surfaces. Regardless of their HS binding phenotype, most SB strains do not cause fatal disease in adult mice, whether inoculated subcutaneously (s.c.) or intracranially (i.c.). However, laboratory strains of SB can be rendered neurovirulent for adult mice by introduction of a glutamine (Gln)-to-histidine (His) mutation at position 55 of the E2 envelope glycoprotein. In the current work, we have determined that E2 His 55-containing viruses require a second-site mutation (Glu to Lys) at E2 position 70 that confers efficient HS binding in order to exhibit virulence for adult mice and that virulence is correlated with very high infectivity for many cell types. Furthermore, introduction of E2 Lys 70 or certain other HS-binding mutations alone also increased morbidity and/or mortality over that of TR339 for older mice inoculated i.c. However, all viruses containing single HSbinding mutations were attenuated in s.c. inoculated suckling mice in comparison with TR339. These results suggest that HS binding may attenuate viral disease that is dependent on high-titer viremia; however, efficient cell attachment through HS binding can increase virulence, presumably through enhancing the replication of SB within specific host tissues such as the brain.Sindbis virus (SB) strain AR339 is considered the prototypic virus of the Alphavirus genus, family Togaviridae. This family of mosquito-borne RNA viruses includes several significant human pathogens and potential bioterrorism or biowarfare agents such as Venezuelan and Eastern equine encephalitis viruses (VEEV and EEEV, respectively) (3, 44). Consequently, there has been a resurgence of interest in characterizing the molecular determinants of alphavirus neurovirulence. Due to the relative difficulty and risk of handling the more pathogenic alphaviruses, SB has been used extensively as a model system for the study of the alphavirus replication cycle and the pathogenesis of disease (reviewed in reference 16).Many laboratory strains descended from SB AR339 initially attach to cells through interaction with heparan sulfate (HS), a negatively charged glycosaminoglycan (GAG) found on the surfaces of most cells (4,26). This also appears to be the case with cell culture-adapted laboratory strains of other alphaviruses (1, 18, 39). However, in contrast to laboratory strains, virus particles derived from a cDNA clone representing a consensus sequence of SB group viruses (strain TR339) (32) do not attach efficiently to HS or cell surfaces (26). Furthermore, the cell attachment phenotype of TR339 is indistinguishable from that of a virus generated from a cDNA clone of an ancestral SB AR339 preserved prior to adaptation for growth in cultured cells (W. B. Klimstra, D. E. Deming, R. E. Johnston, and K. D. Ryman, unpublished observat...