Practice question

Zika virus microcephaly pathogenesis involves selective infection of embryonic neuroepithelium. Flavivirus crosses placenta via trophoblast and infects radial glial progenitors expressing AXL receptor in ventricular zone. Viral nonstructural proteins NS4A and NS4B inhibit Akt-mTOR signaling, induce endoplasmic reticulum stress, cell cycle arrest and apoptosis, depleting stem pool. Additionally virus dysregulates host microRNAs and centrosomal proteins, causing premature differentiation. Adult neurons possess interferon responses limiting replication. Preferential targeting of cycling neural progenitor cells explains cortex-specific thinning and severe brain size reduction observed after gestational infection.