title: Human cytomegalovirus transmission from the uterus to the placenta correlates with the presence of pathogenic bacteria and maternal immunity.
abstract: Prenatal cytomegalovirus infection may cause pregnancy complications such as intrauterine growth restriction and birth defects. How virus from the mother traverses the placenta is unknown. PCR analysis of biopsy specimens of the maternal-fetal interface revealed that DNA sequences from cytomegalovirus were commonly found with those of herpes simplex viruses and pathogenic bacteria. Cytomegalovirus DNA and infected cell proteins were found more often in the decidua than in the placenta, suggesting that the uterus functions as a reservoir for infection. In women with low neutralizing titers, cytomegalovirus replicated in diverse decidual cells and placental trophoblasts and capillaries. In women with intermediate to high neutralizing titers, decidual infection was suppressed and the placenta was spared. Overall, cytomegalovirus virions and maternal immunoglobulin G were detected in syncytiotrophoblasts, villus core macrophages, and dendritic cells. These results suggest that the outcome of cytomegalovirus infection depends on the presence of other pathogens and coordinated immune responses to viral replication at the maternal-fetal interface.
authors.affiliation: Departments of Stomatology, University of California-San Francisco, San Francisco, California 94143-0512, USA. pereira@itsa.ucsf.edu
authors.forename: Lenore
authors.initials: L
authors.lastname: Pereira
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Maidji
authors.forename: Susan
authors.initials: S
authors.lastname: McDonagh
authors.forename: Olga
authors.initials: O
authors.lastname: Genbacev
authors.forename: Susan
authors.initials: S
authors.lastname: Fisher
mesh_terms: D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D001424:Bacterial Infections / Q000382:microbiology; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000276:immunology* / Q000635:transmission* / Q000821:virology; D003656:Decidua / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D010920:Placenta / Q000382:microbiology / Q000821:virology*; D010922:Placenta Diseases / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D014599:Uterus / Q000382:microbiology / Q000821:virology*