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Timing of gestational exposure to Zika virus is associated with postnatal growth restriction in a murine model - 31/07/18

Doi : 10.1016/j.ajog.2018.06.005 
Gregory C. Valentine, MD a, Maxim D. Seferovic, PhD b, Stephanie W. Fowler, PhD d, Angela M. Major e, Rodion Gorchakov, MS c, Rebecca Berry, BS c, Alton G. Swennes, DVM d, Kristy O. Murray, DVM, PhD c, Melissa A. Suter, PhD b, Kjersti M. Aagaard, MD, PhD b,
a Department of Pediatrics, Section of Neonatology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 
b Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 
c Department of Pediatrics, Section of Pediatric Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 
d Center for Comparative Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 
e Department of Pathology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 

Corresponding author: Kjersti M Aagaard, MD.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 31 July 2018

Abstract

Background

Vertical transmission of Zika virus leads to infection of neuroprogenitor cells and destruction of brain parenchyma. Recent evidence suggests that the timing of infection as well as host factors may affect vertical transmission. As a result, congenital Zika virus infection may only become clinically apparent in the postnatal period.

Objective

We sought to develop an outbred mouse model of Zika virus vertical transmission to determine if the timing of gestational Zika virus exposure yields phenotypic differences at birth and through adolescence. We hypothesized that later gestational inoculations would only become apparent in adolescence.

Study Design

To better recapitulate human exposures, timed pregnant Swiss-Webster dams (n = 15) were subcutaneously inoculated with 1 × 104 plaque-forming units of first passage contemporary Zika virus HN16 strain or a mock injection on embryonic day 4, 8, or 12 with bioactive antiinterferon alpha receptor antibody administered in days preceding and proceeding inoculation. The antibody was given to prevent the robust type I interferon signaling cascade that make mice inherently resistant to Zika virus infection. At birth and adolescence (6 weeks of age) offspring were assessed for growth, brain weight, and biparietal head diameters, and Zika virus viral levels by reverse transcription–polymerase chain reaction or in situ hybridization.

Results

Pups of Zika virus–infected dams infected at embryonic days 4 and 8 but not 12 were growth restricted (P < .003). Brain weights were significantly smaller at birth (P = .01) for embryonic day 8 Zika virus–exposed offspring. At 6 weeks of age, biparietal diameters were smaller for all Zika virus–exposed males and females (P < .05), with embryonic day 8–exposed males smallest by biparietal diameter and growth-restriction measurements (weight >2 SD, P = .0007). All pups and adolescent mice were assessed for Zika virus infection by reverse transcription–polymerase chain reaction. Analysis of all underweight pups reveled 1 to be positive for neuronal Zika virus infection by in situ hybridization, while a second moribund animal was diffusely positive at 8 days of age by Zika virus infectivity throughout the brain, kidneys, and intestine.

Conclusion

These findings demonstrate that postnatal effects of infection occurring at single time points continue to be detrimental to offspring in the postnatal period in a subset of littermates and subject to a window of gestational susceptibility coinciding with placentation. This model recapitulates frequently encountered clinical scenarios in nonendemic regions, including the majority of the United States, where travel-related exposure occurs in short and well-defined windows of gestation. Our low rate of infection and relatively rare evidence of congenital Zika syndrome parallels human population-based data.

Le texte complet de cet article est disponible en PDF.

Key words : congenital infection, growth restriction, ZIKV


Plan


 This study was supported in part by the Evangelina Whitlock grant provided to G.C.V. The funders had no role in developing the study design, data collection, and/or analysis, decision to publish, or preparation of the manuscript.
 The authors report no conflict of interest.
 Cite this article as: Valentine GC, Seferovic MD, Fowler SW, et al. Timing of gestational exposure to Zika virus is associated with postnatal growth restriction in a murine model. Am J Obstet Gynecol 2018;volume:x.ex-x.ex.


© 2018  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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