Project 1: Impact of sustained ZIKV viremia in pregnancy

项目1 -项目概要/摘要 寨卡病毒（ZIKV）感染与出生谱系的发病率增加有关 巴西的缺陷妊娠妇女的自然感染和恒河猴的实验感染 已经证明，与感染病毒相比，怀孕与长期病毒血症有关。 未怀孕的人。在我们已发表和未发表的研究中，我们发现母体感染- 在第一个三个月而不是第三个三个月使用ZIKV会导致视觉系统中的炎症组织损伤。 系统（脉络膜，视网膜，视神经），并在一个案例中，胎儿严重发育畸形 眼睛此外，无论感染的妊娠阶段，有垂直传播给胎儿 很常见因此，在ZIKV和mos的区域可能对胎儿有更大的风险。 传病媒介的地方性比目前认识到的要严重。 严格检查母体病毒血症和胎儿生长发育，并全面评估- 评估新生儿感觉神经特性和病毒负荷将不可能在人类临床 设置.非人类灵长类动物提供了一个绝佳的机会来深入了解病理生理学- ZIKV在胎儿感染中的作用我们的总体假设是母体病毒血症持续时间>28 提供了明确的证据，垂直传播与胎儿感染风险增加有关 从而影响胎儿的神经发育为了将母体病毒血症和胎儿ZIKV感染联系起来，我们支持 提出两个具体目标。 具体目标1。为了确定母体ZIKV病毒血症对子宫内胎儿发育的影响， 通过胎儿生长、垂直传播和组织损伤进行评估。 具体目标2。确定宫内ZIKV传播对出生缺陷发生率的影响。 我们将评估母体病毒血症和胎儿生长，并将母体病毒血症和母体 免疫反应对胎儿的影响，利用超声波监测胎儿发育。我们将 评估新生儿的畸形，并评估视觉、听觉和行为功能缺陷 容量将在尸检时确定病毒分布和组织组织病理学。发展 研究母体感染对新生儿感觉神经损伤的影响， 在建立非人灵长类动物平台以研究与DENV的相互作用方面向前迈进了一步 2，并在项目3中用抗体治疗测试这些胎儿效应的治疗中断。

Project 1 - Project Summary/Abstract Infection with Zika virus (ZIKV) has been associated with an increased incidence of a spectrum of birth defects in Brazil. Natural infection in pregnant women, and experimental infection in rhesus macaques has demonstrated that pregnancy is associated with prolonged viremia, in comparison with infection of nonpregnant individuals. In our published and unpublished studies, we have found that maternal infec- tion with ZIKV in the first but not the third trimester results in inflammation tissue damage in the visual system (choroid, retina, optic nerve), and in one case, severe developmental malformations of the fetal eye. In addition, regardless of the gestational stage of infection, there vertical transmission to the fetus was common. Thus, there may be a more significant risk to the fetus in areas where ZIKV and the mos- quito vector is endemic than is currently appreciated. Rigorous examination of maternal viremia and fetal growth and development, and comprehensive eval- uation of neonatal sensorineural characteristics and viral burden will not be possible in human clinical settings. The nonhuman primate offers an outstanding opportunity to gain insight into pathophysiologi- cal processes in fetal infection with ZIKV. Our overall hypothesis is that duration of maternal viremia >28 provides unequivocal evidence of vertical transmission is associated with elevated fetal risk for infection and thus, fetal neurodevelopmental impact. To link maternal viremia and fetal ZIKV infection, we pro- pose two Specific Aims. Specific Aim 1. To determine the impact of maternal ZIKV viremia on fetal development in utero, as assessed by fetal growth, vertical transmission, and tissue damage. Specific Aim 2. To define the impact of in utero ZIKV transmission on the incidence of birth defects. We will assess maternal viremia and fetal growth, and associate maternal viremia and the maternal immune response with the impact on the fetus, using ultrasound to monitor fetal development. We will evaluate neonates for malformations of, and assess functional deficits in visual, auditory, and behavioral capacity. Viral distribution and tissue histopathology will be determined at necropsy. The development of this model to study impact of maternal infection on neonatal sensorineural injury will be a valuable step forward in building the nonhuman primate platform for studying interactions with DENV in Project 2, and testing therapeutic interruption of these fetal effects with antibody treatments in Project 3.