title: Salivary glands and human congenital cytomegalovirus infection: What happens in early fetal life?
abstract: Salivary glands are a site of human cytomegalovirus (CMV) replication, latency, and persistence. Prolonged secretion of virus in saliva for months following a primary infection contribute to horizontal transmission. In order to better understand the early effects of CMV on salivary glands and the mechanisms of viral persistent replication, submandibular glands of six CMV congenitally infected fetuses at 21 weeks gestation were studied. Three fetuses at the same gestational age from CMV-seronegative women were compared as negative controls. Tissue viral load and the type of inflammatory infiltrate were evaluated. Moreover, development and branching of salivary glands, the number of myoepithelial cells, cellular proliferation, and expression of secretory proteins of the saliva (Gross Cystic Disease Fluid Protein-15 and lysozyme) were studied. A low viral load and rare CMV-positive cells associated with T CD8 cytotoxic lymphocytes were observed. Branching was impaired with a decrease in terminal acinar structures, the number of myoepithelial cells, and cellular proliferation were reduced. In addition, a compromised secretion of defense proteins involved in the oral humoral immunity was observed. These findings suggest that CMV may affect salivary glands, impairing structure development and secretion of defense proteins, probably responsible for the prolonged viral shedding in saliva. J. Med. Virol. 89:318-323, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Gabrielli
authors.affiliation: Operative Unit of Pathology, Arcispedale St. Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Bonasoni
authors.affiliation: Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Chiereghin
authors.affiliation: Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Piccirilli
authors.affiliation: Operative Unit of Pathology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
authors.affiliation: Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pavia
authors.affiliation: Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Turello
authors.affiliation: Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Squarzoni
authors.affiliation: Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lazzarotto
mesh_terms: D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000473:pathology*; D005260:Female; D005333:Fetus; D015870:Gene Expression; D006801:Humans; D007962:Leukocytes / Q000276:immunology; D011247:Pregnancy; D012471:Salivary Proteins and Peptides / Q000096:biosynthesis; D013363:Submandibular Gland / Q000196:embryology / Q000473:pathology* / Q000821:virology*; D019562:Viral Load
chemical_list: D012471:Salivary Proteins and Peptides
keywords: cytomegalovirus; fetal infection; secretory proteins; submandibular glands