title: Cytomegalovirus impairs cytotrophoblast-induced lymphangiogenesis and vascular remodeling in an in vivo human placentation model.
abstract: We investigated human cytomegalovirus pathogenesis by comparing infection with the low-passage, endotheliotropic strain VR1814 and the attenuated laboratory strain AD169 in human placental villi as explants in vitro and xenografts transplanted into kidney capsules of SCID mice (ie, mice with severe combined immunodeficiency). In this in vivo human placentation model, human cytotrophoblasts invade the renal parenchyma, remodel resident arteries, and induce a robust lymphangiogenic response. VR1814 replicated in villous and cell column cytotrophoblasts and reduced formation of anchoring villi in vitro. In xenografts, infected cytotrophoblasts had a severely diminished capacity to invade and remodel resident arteries. Infiltrating lymphatic endothelial cells proliferated, aggregated, and failed to form lymphatic vessels. In contrast, AD169 grew poorly in cytotrophoblasts in explants, and anchoring villi formed normally in vitro. Likewise, viral replication was impaired in xenografts, and cytotrophoblasts retained invasive capacity, but some partially remodeled blood vessels incorporated lymphatic endothelial cells and were permeable to blood. The expression of both vascular endothelial growth factor (VEGF)-C and basic fibroblast growth factor increased in VR1814-infected explants, whereas VEGF-A and soluble VEGF receptor-3 increased in those infected with AD169. Our results suggest that viral replication and paracrine factors could undermine vascular remodeling and cytotrophoblast-induced lymphangiogenesis, contributing to bleeding, hypoxia, and edema in pregnancies complicated by congenital human cytomegalovirus infection.
authors.affiliation: Department of Cell and Tissue Biology, School of Dentistry, University of California, San Francisco, USA.
authors.forename: Takako
authors.initials: T
authors.lastname: Tabata
authors.forename: Matthew
authors.initials: M
authors.lastname: Petitt
authors.forename: June
authors.initials: J
authors.lastname: Fang-Hoover
authors.forename: Jose
authors.initials: J
authors.lastname: Rivera
authors.forename: Naoki
authors.initials: N
authors.lastname: Nozawa
authors.forename: Stephen
authors.initials: S
authors.lastname: Shiboski
authors.forename: Naoki
authors.initials: N
authors.lastname: Inoue
authors.forename: Lenore
authors.initials: L
authors.lastname: Pereira
mesh_terms: D000818:Animals; D001158:Arteries / Q000473:pathology; D001808:Blood Vessels / Q000473:pathology / Q000503:physiopathology*; D002465:Cell Movement; D049109:Cell Proliferation; D002824:Chorionic Villi / Q000254:growth & development / Q000473:pathology / Q000637:transplantation / Q000821:virology; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000473:pathology* / Q000503:physiopathology / Q000821:virology; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D042583:Lymphangiogenesis; D051379:Mice; D016513:Mice, SCID; D010929:Placentation; D011247:Pregnancy; D013234:Stem Cells / Q000473:pathology / Q000821:virology; D014327:Trophoblasts / Q000473:pathology* / Q000821:virology*; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism; D014779:Virus Replication
chemical_list: D042461:Vascular Endothelial Growth Factor A; D042582:Vascular Endothelial Growth Factor C; D016222:Fibroblast Growth Factor 2