{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:38:13Z","timestamp":1783114693411,"version":"3.54.6"},"reference-count":71,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["303822\/2015-5 and 155798\/2014-6"],"award-info":[{"award-number":["303822\/2015-5 and 155798\/2014-6"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006507","name":"Funda\u00e7\u00e3o Oswaldo Cruz","doi-asserted-by":"publisher","award":["407690\/2012\u20133"],"award-info":[{"award-number":["407690\/2012\u20133"]}],"id":[{"id":"10.13039\/501100006507","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["E-26\/202.003\/2016"],"award-info":[{"award-number":["E-26\/202.003\/2016"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Dengue virus (DENV) is an emerging virus involved in outbreaks in Brazil. The association between the virus and vertical transmission, with disorders in the placenta, has raised a worldwide concern. On the 29th gestational week, a pregnant woman presented severe complications due to a DENV infection leading to maternal and fetus death. Postmortem analysis of fetal organs demonstrated the presence of DENV using reverse transcriptase polymerase chain reaction (RT-PCR) in the fetal brain and DENV non-structural protein 3 (NS3) staining in placenta and several peripheral fetal tissues, such as the brain, liver, lungs, and spleen. Histological analysis of the placenta and fetal organs revealed different types of tissue abnormalities, which included inflammation, hemorrhage, edema, and necrosis in placenta and tissue disorganization in the fetus, such as spongiform parenchyma, microglial inflammation, steatosis, hyalinose arteriolar, inflammatory cells in the alveolar septa, and disorganization of the lymphoid follicle. Increased cellularity (macrophage, Hofbauer cells and TCD8+ lymphocytes) and up-regulation of inflammatory mediators such as IFN-\u03b3, TNF-\u03b1, RANTES\/CCL5, MCP1\/CCL2, and VEGF\/R2 were detected in the liver, lung, spleen, brain, and placenta, supporting placental and fetus peripheral tissues inflammation. Maternal infection leading to the production of those vascular mediators may alter the vascular permeability, facilitating the virus entry and tissue and barrier dysfunction.<\/jats:p>","DOI":"10.3390\/v11040319","type":"journal-article","created":{"date-parts":[[2019,4,3]],"date-time":"2019-04-03T03:39:28Z","timestamp":1554262768000},"page":"319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["A Stillborn Multiple Organs\u2019 Investigation from a Maternal DENV-4 Infection: Histopathological and Inflammatory Mediators Characterization"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4841-9308","authenticated-orcid":false,"given":"Priscila","family":"Nunes","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Imunologia Viral, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Flavivirus, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz\/FIOCRUZ, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Coelho","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Anatomia Patol\u00f3gica, Instituto Nacional de Infectologia, Funda\u00e7\u00e3o Oswaldo Cruz\/FIOCRUZ, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Anatomia Patol\u00f3gica, Instituto Nacional de Infectologia, Funda\u00e7\u00e3o Oswaldo Cruz\/FIOCRUZ, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nat\u00e1lia","family":"Salom\u00e3o","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Interdisciplinar de Pesquisas M\u00e9dicas, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz\/FIOCRUZ, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carollina","family":"Jos\u00e9","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Interdisciplinar de Pesquisas M\u00e9dicas, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz\/FIOCRUZ, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro\/UERJ, Rio de Janeiro 20551-030, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7579-7788","authenticated-orcid":false,"given":"K\u00edssila","family":"Rabelo","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro\/UERJ, Rio de Janeiro 20551-030, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elzinandes","family":"de Azeredo","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia Viral, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Bas\u00edlio-de-Oliveira","sequence":"additional","affiliation":[{"name":"Anatomia Patol\u00f3gica, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-901, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Bas\u00edlio-de-Oliveira","sequence":"additional","affiliation":[{"name":"Anatomia Patol\u00f3gica, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-901, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1309-5366","authenticated-orcid":false,"given":"Fl\u00e1via","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia Viral, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marciano","family":"Paes","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Interdisciplinar de Pesquisas M\u00e9dicas, Instituto Oswaldo Cruz, Funda\u00e7\u00e3o Oswaldo Cruz\/FIOCRUZ, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"743","DOI":"10.4269\/ajtmh.2012.12-0157","article-title":"The economic burden of dengue","volume":"86","author":"Gubler","year":"2012","journal-title":"Am. 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