title: Pathogenesis of Congenital Rubella Virus Infection in Human Fetuses: Viral Infection in the Ciliary Body Could Play an Important Role in Cataractogenesis.
abstract: BACKGROUND
  Development of congenital rubella syndrome associated with rubella virus infection during pregnancy is clinically important, but the pathogenicity of the virus remains unclear.
  
  
  METHODS
  Pathological examination was conducted on 3 aborted fetuses with congenital rubella infection.
  
  
  RESULTS
  At autopsy, all 3 aborted fetuses showed congenital cataract confirmed by gross observation. Rubella virus infection occurred via systemic organs including circulating hematopoietic stem cells confirmed by immunohistochemical and molecular investigations, and major histopathogical changes were found in the liver. It is noteworthy that the virus infected the ciliary body of the eye, suggesting a possible cause of cataracts.
  
  
  CONCLUSIONS
  Our study based on the pathological examination demonstrated that the rubella virus infection occurred via systemic organs of human fetuses. This fact was confirmed by immunohistochemistry and direct detection of viral RNA in multiple organs. To the best of our knowledge, this study is the first report demonstrating that the rubella virus infection occurred via systemic organs of the human body. Importantly, virus infection of the ciliary body could play an important role in cataractogenesis.
authors.affiliation: Department of Pathology, Cytology and Genetics, Hung Vuong Hospital, Ho Chi Minh City, Viet Nam.
authors.forename: Thong Van
authors.initials: TV
authors.lastname: Nguyen
authors.affiliation: Center for Molecular Biomedicine, School of Medicine, University of Medicine and Pharmacy in Ho Chi Minh City, Ho Chi Minh City, Viet Nam ; Molecular Diagnostics Section, Nam Khoa-Biotek Laboratory, Ho Chi Minh City, Viet Nam.
authors.forename: Van Hung
authors.initials: VH
authors.lastname: Pham
authors.affiliation: Center for Molecular Biomedicine, School of Medicine, University of Medicine and Pharmacy in Ho Chi Minh City, Ho Chi Minh City, Viet Nam ; Molecular Diagnostics Section, Nam Khoa-Biotek Laboratory, Ho Chi Minh City, Viet Nam ; Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Abe
mesh_terms: D002386:Cataract / Q000473:pathology / Q000821:virology*; D002924:Ciliary Body / Q000473:pathology / Q000821:virology*; D005260:Female; D005333:Fetus / Q000473:pathology / Q000821:virology*; D006801:Humans; D007150:Immunohistochemistry; D009928:Organ Specificity; D011247:Pregnancy; D012367:RNA, Viral / Q000235:genetics; D012409:Rubella / Q000151:congenital* / Q000473:pathology / Q000821:virology*; D012412:Rubella virus / Q000502:physiology*
chemical_list: D012367:RNA, Viral
keywords: Cataract; Congenital rubella infection (CRI); Congenital rubella syndrome (CRS); Pathogenesis of rubella virus; Pathology of rubella