title: Immunolocalization and Distribution of Rubella Antigen in Fatal Congenital Rubella Syndrome.
abstract: BACKGROUND
  An estimated 100,000 cases of congenital rubella syndrome (CRS) occur worldwide each year. The reported mortality rate for infants with CRS is up to 33%. The cellular mechanisms responsible for the multiple congenital defects in CRS are presently unknown. Here we identify cell types positive for rubella virus (RV) in CRS infants.
  
  
  METHODS
  Cells and organs involved in RV replication were identified in paraffin-embedded autopsy tissues from three fatal case-patients by histopathologic examination and immunohistochemical (IHC) staining using a rabbit polyclonal RV antibody. Normal rabbit antisera and RV antisera preabsorbed with highly purified RV served as negative controls.
  
  
  RESULTS
  RV antigen was found in interstitial fibroblasts in the heart, adventitial fibroblasts of large blood vessels, alveolar macrophages, progenitor cells of the outer granular layer of the brain, and in capillary endothelium and basal plate in the placenta. The antibody specificity was verified by IHC staining of multiple tissue sections from other infectious disease cases. RV infection of each cell type is consistent with abnormalities which have been identified in patients with CRS, in the heart, large blood vessels, and brain. Antigen distribution was consistent with inflammatory response to vascular injury and systemic spread of RV.
  
  
  CONCLUSIONS
  The identification of RV positive cell types in CRS is important to better understand the pathology and pathogenesis of CRS.
authors: Measles, Mumps, Rubella and Herpesvirus Laboratory Branch, Division of Viral Diseases, 1600 Clifton Rd, Atlanta, GA, USA; National Laboratory for Measles and Rubella, National Institute of Research-Development for Microbiology and Immunology "Cantacuzino", 103 Splaiul Independenței, Bucharest, Romania; Department of Biology, University of Bucharest, 4-12 Blvd. Regina Elisabeta, Bucharest, Romania.
authors: Mihaela
authors: M
authors: Lazar
authors: Measles, Mumps, Rubella and Herpesvirus Laboratory Branch, Division of Viral Diseases, 1600 Clifton Rd, Atlanta, GA, USA.
authors: Ludmila
authors: L
authors: Perelygina
authors: Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.
authors: Roosecelis
authors: R
authors: Martines
authors: Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.
authors: Patricia
authors: P
authors: Greer
authors: Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.
authors: Christopher D
authors: CD
authors: Paddock
authors: Filantropia Clinical Hospital, 11-13 Blvd. Ion Mihalache, Bucharest, Romania.
authors: Gheorghe
authors: G
authors: Peltecu
authors: National Laboratory for Measles and Rubella, National Institute of Research-Development for Microbiology and Immunology "Cantacuzino", 103 Splaiul Independenței, Bucharest, Romania.
authors: Emilia
authors: E
authors: Lupulescu
authors: Measles, Mumps, Rubella and Herpesvirus Laboratory Branch, Division of Viral Diseases, 1600 Clifton Rd, Atlanta, GA, USA. Electronic address: jci1@cdc.gov.
authors: Joseph
authors: J
authors: Icenogle
authors: Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.
authors: Sherif R
authors: SR
authors: Zaki
mesh_terms: D000956:Antigens, Viral / Q000276:immunology*; D001344:Autopsy; D001706:Biopsy; D002460:Cell Line; D002490:Central Nervous System / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008168:Lung / Q000276:immunology / Q000473:pathology / Q000821:virology; D008297:Male; D009206:Myocardium / Q000276:immunology / Q000473:pathology; D011247:Pregnancy; D012410:Rubella Syndrome, Congenital / Q000175:diagnosis / Q000276:immunology* / Q000635:transmission / Q000821:virology*; D012412:Rubella virus / Q000145:classification / Q000235:genetics / Q000276:immunology*; D014779:Virus Replication
chemical_list: D000956:Antigens, Viral
keywords: Autopsy; CRS pathology; Congenital rubella syndrome (CRS); Fatal cases; Immunohistochemistry