Stress-induced unfolded protein response contributes to Zika virus–associated microcephaly

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Accumulating evidence support a causal link between Zika virus (ZIKV) infection during gestation and congenital microcephaly. However, the mechanism of ZIKV-associated microcephaly remains unclear. We combined analyses of ZIKV-infected human fetuses, cultured human neural stem cells and mouse embryos to understand how ZIKV induces microcephaly. We show that ZIKV triggers endoplasmic reticulum stress and unfolded protein response in the cerebral cortex of infected postmortem human fetuses as well as in cultured human neural stem cells. After intracerebral and intraplacental inoculation of ZIKV in mouse embryos, we show that it triggers endoplasmic reticulum stress in embryonic brains in vivo. This perturbs a physiological unfolded protein response within cortical progenitors that controls neurogenesis. Thus, ZIKV-infected progenitors generate fewer projection neurons that eventually settle in the cerebral cortex, whereupon sustained endoplasmic reticulum stress leads to apoptosis. Furthermore, we demonstrate that administration of pharmacological inhibitors of unfolded protein response counteracts these pathophysiological mechanisms and prevents microcephaly in ZIKV-infected mouse embryos. Such defects are specific to ZIKV, as they are not observed upon intraplacental injection of other related flaviviruses in mice.

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The authors are thankful for technical help from the GIGA-Imaging Platform of ULg; M. Leruez-Ville for human sample collection; P.V. Drion, E.D. Valentin and C. Grignet for the flaviviral facility; C. d’Alessandro, M. Sambon and M. Lavina for technical assistance; E. Simon-Loriere for sharing ZIKV quantification protocol; and E. Peyre for graphical assistance. L.N., I.G.-N. and C.C. receive financial support from F.R.S.-F.N.R.S. This work was supported by the European Union’s Horizon 2020 Research and Innovation Programme under ZIKAlliance Grant Agreement N° 734548 (to L.N. and M.L.) and by the European Virus Archives goes Global (EVAg) project under grant agreement N° 653316. M.L. is also funded by Institut Pasteur, Inserm and LabEx IBEID. L.N. and P.V. are funded by F.R.S.-F.N.R.S., the Fonds Léon Fredericq, the Fondation Médicale Reine Elisabeth, the Fondation Simone et Pierre Clerdent and the Belgian Science Policy (IAP-VII network P7/20). L.N. is funded by ARC (ARC11/16-01) and the ERANET Neuron STEM-MCD; P.V. is funded by the WELBIO Program of the Walloon Region, the AXA Research Fund, the Fondation ULB, ERANET Neuron Microkin, ERANET E-rare Euromicro and ERC-2013 ERC-2013-AG-340020.

Author information

Author notes

  1. Ivan Gladwyn-Ng, Lluis Cordon Barris, Christian Alfano, Catherine Creppe and Thérèse Couderc contributed equally to this work.


  1. GIGA-Neurosciences, Interdisciplinary Cluster for Applied Genoproteomics (GIGA-R), University of Liège, C.H.U. Sart Tilman, Liège, Belgium

    • Ivan Gladwyn-Ng
    • , Lluís Cordón-Barris
    • , Christian Alfano
    • , Catherine Creppe
    • , Giovanni Morelli
    • , Nicolas Thelen
    • , Michelle America
    • , Marc Thiry
    •  & Laurent Nguyen
  2. Institut Pasteur, Biology of Infection Unit, Paris, France

    • Thérèse Couderc
    •  & Marc Lecuit
  3. Inserm U1117, Paris, France

    • Thérèse Couderc
    •  & Marc Lecuit
  4. BIOMED - Hasselt University, Hasselt, Belgium

    • Giovanni Morelli
  5. Département d’Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfant Malades, Paris, France

    • Bettina Bessières
    • , Férechté Encha-Razavi
    •  & Maryse Bonnière
  6. Inserm U 1163 Institut Imagine, Paris, France

    • Bettina Bessières
  7. Université Libre de Bruxelles (ULB), Institute for Interdisciplinary Research in Human Biology (IRIBHM), and ULB Institute of Neuroscience (UNI), Brussels, Belgium

    • Ikuo K. Suzuki
    •  & Pierre Vanderhaeghen
  8. Institut Pasteur, Structural Virology Unit, Paris, France

    • Marie Flamand
  9. WELBIO, Université Libre de Bruxelles, Brussels, Belgium

    • Pierre Vanderhaeghen
  10. Paris Descartes University, Sorbonne Paris Cité, Division of Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Institut Imagine, Paris, France

    • Marc Lecuit


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I.G.-N., L.C.B., C.A., C.C., T.C., M.L. and L.N. designed the study. I.G.-N. set up animal models for ZIKV infection and, together with T.C., generated and analyzed in vivo data with help of G.M., L.C.B., M.A., C.A. and C.C. N.T. and M.T. performed and interpreted TEM analyses. L.C.B. generated data with hNSCs and performed analyses with help of C.A., I.G.-N. and C.C. C.A. and M.A. analyzed human brain samples provided by B.B., F.E.-R., M.B., I.S. and P.V. M.F. shared antibodies. L.N. contributed to data interpretation and wrote the manuscript with help from M.L. and input from all coauthors.

Competing interests

The authors declare no competing financial interests.

Corresponding authors

Correspondence to Marc Lecuit or Laurent Nguyen.

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