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      Zika virus infection in pregnant rhesus macaques causes placental dysfunction and immunopathology

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      1 , 2 , , 3 , 3 , 4 , 1 , 2 , 5 , 6 , 5 , 4 , 5 , 5 , 1 , 2 , 3 , 1 , 2 , 1 , 2 , 1 , 1 , 1 , 1 , 2 , 7 , 8 , 1 , 2 , 3 , 4 , 9 , 10 , 10 , 10 , 2 , 2 , 2 , 11 , 1 , 2 , 4 , 12 , 3 , 4 , , 1 , 2 ,
      Nature Communications
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          Abstract

          Zika virus (ZIKV) infection during pregnancy leads to an increased risk of fetal growth restriction and fetal central nervous system malformations, which are outcomes broadly referred to as the Congenital Zika Syndrome (CZS). Here we infect pregnant rhesus macaques and investigate the impact of persistent ZIKV infection on uteroplacental pathology, blood flow, and fetal growth and development. Despite seemingly normal fetal growth and persistent fetal-placenta-maternal infection, advanced non-invasive in vivo imaging studies reveal dramatic effects on placental oxygen reserve accompanied by significantly decreased oxygen permeability of the placental villi. The observation of abnormal oxygen transport within the placenta appears to be a consequence of uterine vasculitis and placental villous damage in ZIKV cases. In addition, we demonstrate a robust maternal-placental-fetal inflammatory response following ZIKV infection. This animal model reveals a potential relationship between ZIKV infection and uteroplacental pathology that appears to affect oxygen delivery to the fetus during development.

          Abstract

          Zika virus infection during pregnancy can result in birth defects, but underlying pathogenesis at the maternal-fetal interface is unclear. Here, the authors use non-invasive in vivo imaging of Zika-infected rhesus macaques and show that infection results in abnormal oxygen transport across the placenta.

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          Most cited references43

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          Purification, characterization, and in vitro differentiation of cytotrophoblasts from human term placentae.

          Highly purified functional cytotrophoblasts have been prepared from human term placentae by adding a Percoll gradient centrifugation step to a standard trypsin-DNase dispersion method. The isolated mononuclear trophoblasts averaged 10 microns in diameter, with occasional cells measuring up to 20-30 microns. Viability was greater than 90%. Transmission electron microscopy revealed that the cells had fine structural features typical of trophoblasts. In contrast to syncytial trophoblasts of intact term placentae, these cells did not stain for hCG, human placental lactogen, pregnancy-specific beta 1-glycoprotein or low mol wt cytokeratins by immunoperoxidase methods. Endothelial cells, fibroblasts, or macrophages did not contaminate the purified cytotrophoblasts, as evidenced by the lack of immunoperoxidase staining with antibodies against vimentin or alpha 1-antichymotrypsin. The cells produced progesterone (1 ng/10(6) cells . 4 h), and progesterone synthesis was stimulated up to 8-fold in the presence of 25-hydroxycholesterol (20 micrograms/ml). They also produced estrogens (1360 pg/10(6) cells . 4 h) when supplied with androstenedione (1 ng/ml) as a precursor. When placed in culture, the cytotrophoblasts consistently formed aggregates, which subsequently transformed into syncytia within 24-48 h after plating. Time lapse cinematography revealed that this process occurred by cell fusion. The presumptive syncytial groups were proven to be true syncytia by microinjection of fluorescently labeled alpha-actinin, which diffused completely throughout the syncytial cytoplasm within 30 min. Immunoperoxidase staining of cultured trophoblasts between 3.5 and 72 h after plating revealed a progressive increase in cytoplasmic pregnancy-specific beta 1-glycoprotein, hCG, and human placental lactogen concomitant with increasing numbers of aggregates and syncytia. At all time points examined, occasional single cells positive for these markers were identified. RIA of the spent culture media for hCG revealed a significant increase in secreted hCG, paralleling the increase in hCG-positive cells and syncytia identified by immunoperoxidase methods. We conclude that human cytotrophoblasts differentiate in culture and fuse to form functional syncytiotrophoblasts.
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            Congenital Zika Virus Infection: Beyond Neonatal Microcephaly.

            Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects.
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              Pathology of congenital Zika syndrome in Brazil: a case series.

              Zika virus is an arthropod-borne virus that is a member of the family Flaviviridae transmitted mainly by mosquitoes of the genus Aedes. Although usually asymptomatic, infection can result in a mild and self-limiting illness characterised by fever, rash, arthralgia, and conjunctivitis. An increase in the number of children born with microcephaly was noted in 2015 in regions of Brazil with high transmission of Zika virus. More recently, evidence has been accumulating supporting a link between Zika virus and microcephaly. Here, we describe findings from three fatal cases and two spontaneous abortions associated with Zika virus infection.
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                Author and article information

                Contributors
                hirschal@ohsu.edu
                friasa@ohsu.edu
                streblow@ohsu.edu
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                17 January 2018
                17 January 2018
                2018
                : 9
                : 263
                Affiliations
                [1 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, The Vaccine & Gene Institute, , Oregon Health and Science University (OHSU), ; 505 NW 185th Ave, Beaverton, 97006 USA
                [2 ]ISNI 0000 0004 0619 6542, GRID grid.410436.4, Division of Pathobiology & Immunology, , Oregon National Primate Research Center (ONPRC), ; 505 NW 185th Ave, Beaverton, 97006 USA
                [3 ]ISNI 0000 0004 0619 6542, GRID grid.410436.4, Division of Reproductive & Developmental Sciences, , ONPRC, ; 505 NW 185th Ave, Beaverton, 97006 USA
                [4 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, Department of Obstetrics & Gynecology, , OHSU, ; 3181 Sam Jackson Park Road, Portland, OR 97239 USA
                [5 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, Advanced Imaging Research Center, , OHSU, ; 3181 Sam Jackson Park Road, Portland, OR 97239 USA
                [6 ]ISNI 0000 0001 2193 0096, GRID grid.223827.e, Utah Center for Advanced Imaging Research, Department of Radiology, , University of Utah, ; 201 President’s Circle, Salt Lake City, UT 84112 USA
                [7 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, Department of Molecular Microbiology & Immunology, , OHSU, ; 3181 Sam Jackson Park Road, Portland, OR 97239 USA
                [8 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, Department of Medicine, Division of Infectious Diseases, , OHSU, ; 3181 Sam Jackson Park Road, Portland, OR 97239 USA
                [9 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, Neuropathology, , OHSU, ; 3181 Sam Jackson Park Road, Portland, OR 97239 USA
                [10 ]ISNI 0000 0004 0619 6542, GRID grid.410436.4, Pathology Services Unit, Division of Comparative Medicine, , ONPRC, ; 505 NW 185th Ave, Beaverton, 97006 USA
                [11 ]ISNI 0000 0004 0619 6542, GRID grid.410436.4, Clinical Services Unit, Division of Comparative Medicine, , ONPRC, ; 505 NW 185th Ave, Beaverton, 97006 USA
                [12 ]ISNI 0000 0000 9758 5690, GRID grid.5288.7, Department of Pathology, , OHSU, ; 3181 Sam Jackson Park Road, Portland, OR 97239 USA
                Author information
                http://orcid.org/0000-0002-1984-5906
                Article
                2499
                10.1038/s41467-017-02499-9
                5772047
                29343712
                0fd749ac-fb46-432c-bbe9-4679200ebe2e
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 19 July 2017
                : 4 December 2017
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