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Journal of Virology, May 2007, p. 4701-4712, Vol. 81, No. 9
0022-538X/07/$08.00+0 doi:10.1128/JVI.02748-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Department of Cell and Tissue Biology, University of California San Francisco, San Francisco, California
Received 13 December 2006/ Accepted 9 February 2007
Cytomegalovirus (CMV), the major viral cause of congenital disease, infects the uterus and developing placenta and spreads to the fetus throughout gestation. Virus replicates in invasive cytotrophoblasts in the decidua, and maternal immunoglobulin G (IgG)-CMV virion complexes, which are transcytosed by the neonatal Fc receptor across syncytiotrophoblasts, infect underlying cytotrophoblasts in chorionic villi. Immunity is central to protection of the placenta-fetal unit: infection can occur when IgG has a low neutralizing titer. Here we used immunohistochemical and function-blocking methods to correlate infection in the placenta with expression of potential CMV receptors in situ and in vitro. In placental villi, syncytiotrophoblasts express the virion receptor epidermal growth factor receptor (EGFR) but lack integrin coreceptors, and virion uptake occurs without replication. Focal infection can occur when transcytosed virions reach EGFR-expressing cytotrophoblasts that selectively initiate expression of
V integrin. In cell columns, proximal cytotrophoblasts lack receptors and distal cells express integrins
1ß1 and
Vß3, enabling virion attachment. In the decidua, invasive cytotrophoblasts expressing coreceptors upregulate EGFR, thereby dramatically increasing susceptibility to infection. Our findings indicate that virion interactions with cytotrophoblasts expressing receptors in the placenta (i) change as the cells differentiate and (ii) correlate with spatially distinct sites of CMV replication in maternal and fetal compartments.
Published ahead of print on 21 February 2007.
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