Risk of Zika microcephaly correlates with features of maternal antibodies

Author:

Robbiani Davide F.1ORCID,Olsen Priscilla C.12,Costa Federico34,Wang Qiao5ORCID,Oliveira Thiago Y.1,Nery Nivison6,Aromolaran Adeolu3,do Rosário Mateus S.7,Sacramento Gielson A.6,Cruz Jaqueline S.6,Khouri Ricardo6,Wunder Elsio A.3ORCID,Mattos Adriana7,de Paula Freitas Bruno78,Sarno Manoel4,Archanjo Gracinda7,Daltro Dina7,Carvalho Gustavo B.S.7,Pimentel Kleber7,de Siqueira Isadora C.6ORCID,de Almeida João R.M.4ORCID,Henriques Daniele F.9,Lima Juliana A.9,Vasconcelos Pedro F.C.9,Schaefer-Babajew Dennis1,Azzopardi Stephanie A.10,Bozzacco Leonia10,Gazumyan Anna1,Belfort Rubens8ORCID,Alcântara Ana P.11,Carvalho Gustavo11,Moreira Licia11ORCID,Araujo Katiaci12,Reis Mitermayer G.634,Keesler Rebekah I.13,Coffey Lark L.14,Tisoncik-Go Jennifer151617,Gale Michael15161718ORCID,Rajagopal Lakshmi181920,Adams Waldorf Kristina M.15161821,Dudley Dawn M.22ORCID,Simmons Heather A.23,Mejia Andres23ORCID,O’Connor David H.22,Steinbach Rosemary J.24,Haese Nicole2526ORCID,Smith Jessica26,Lewis Anne27ORCID,Colgin Lois25,Roberts Victoria24,Frias Antonio2428,Kelleher Meredith24ORCID,Hirsch Alec2526,Streblow Daniel N.2526,Rice Charles M.10,MacDonald Margaret R.10ORCID,de Almeida Antonio R.P.4,Van Rompay Koen K.A.1314ORCID,Ko Albert I.63ORCID,Nussenzweig Michel C.129ORCID

Affiliation:

1. Laboratory of Molecular Immunology, The Rockefeller University, New York, NY

2. Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

3. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT

4. Faculdade de Medicina and Instituto da Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil

5. Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China

6. Instituto Gonçalo Moniz, Fundação Oswaldo Cruz/MS, Salvador, Bahia, Brazil

7. Hospital Geral Roberto Santos, Secretária da Saúde do Estado da Bahia, Salvador, Brazil

8. Universidade Federal de São Paulo, São Paulo, Brazil

9. Instituto Evandro Chagas, Ministério da Saúde Ananindeua, Pará, Brazil

10. Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY

11. Hospital Santo Amaro, Salvador, Bahia, Brazil

12. Hospital Aliança, Salvador, Bahia, Brazil

13. California National Primate Research Center, University of California, Davis, Davis, CA

14. Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA

15. Washington National Primate Research Center, Seattle, WA

16. Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA

17. Department of Immunology, University of Washington, Seattle, WA

18. Department of Global Health, University of Washington, Seattle, WA

19. Department of Pediatrics, University of Washington, Seattle, WA

20. Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA

21. Department of Obstetrics and Gynecology, University of Washington, Seattle, WA

22. Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI

23. Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, WI

24. Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR

25. Division of Pathobiology and Immunology, Oregon National Primate Research Center, Beaverton, OR

26. Vaccine and Gene Therapy Institute, Oregon Health and Science University, Portland, OR

27. Pathology Services Unit, Division of Comparative Medicine, Oregon National Primate Research Center, Beaverton, OR

28. Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR

29. Howard Hughes Medical Institute, The Rockefeller University, New York, NY

Abstract

Zika virus (ZIKV) infection during pregnancy causes congenital abnormalities, including microcephaly. However, rates vary widely, and the contributing risk factors remain unclear. We examined the serum antibody response to ZIKV and other flaviviruses in Brazilian women giving birth during the 2015–2016 outbreak. Infected pregnancies with intermediate or higher ZIKV antibody enhancement titers were at increased risk to give birth to microcephalic infants compared with those with lower titers (P < 0.0001). Similarly, analysis of ZIKV-infected pregnant macaques revealed that fetal brain damage was more frequent in mothers with higher enhancement titers. Thus, features of the maternal antibodies are associated with and may contribute to the genesis of ZIKV-associated microcephaly.

Funder

National Institutes of Health

Rockefeller University

Fundação de Amparo à Pesquisa do Estado da Bahia

Food and Drug Administration

Conselho Nacional de Desenvolvimento Cientifico e Tecnológico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Pew Latin American Fellows Program in the Biomedical Sciences

Studienstiftung des Deutschen Volkes

Wellcome Trust

Howard Hughes Medical Institute

Publisher

Rockefeller University Press

Subject

Immunology,Immunology and Allergy

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