Dysregulated metabolism underpins Zika-virus-infection-associated impairment in fetal development
Clement Yau,
John Z.H. Low,
Esther S. Gan,
Swee Sen Kwek,
Liang Cui,
Hwee Cheng Tan,
Darren Z.L. Mok,
Candice Y.Y. Chan,
October M. Sessions,
Satoru Watanabe,
Subhash G. Vasudevan,
Yie Hou Lee,
Kuan Rong Chan,
Eng Eong Ooi
Affiliations
Clement Yau
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
John Z.H. Low
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
Esther S. Gan
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
Swee Sen Kwek
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
Liang Cui
Singapore-MIT Alliance in Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore 138602, Singapore
Hwee Cheng Tan
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
Darren Z.L. Mok
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
Candice Y.Y. Chan
Department of Infectious Diseases, Singapore General Hospital, Singapore 169854, Singapore
October M. Sessions
Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore; Department of Pharmacy, National University of Singapore, Singapore 117559, Singapore
Satoru Watanabe
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
Subhash G. Vasudevan
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore; Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
Yie Hou Lee
Singapore-MIT Alliance in Research and Technology, Critical Analytics for Manufacturing Personalized-Medicine, Singapore 138602, Singapore
Kuan Rong Chan
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore; Corresponding author
Eng Eong Ooi
Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore; Singapore-MIT Alliance in Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore 138602, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore; Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore; Viral Research and Experimental Medicine Centre, SingHealth Duke-NUS Academic Medical Centre, Singapore 169856, Singapore; Corresponding author
Summary: Zika virus (ZIKV) is an Aedes-mosquito-borne flavivirus that causes debilitating congenital and developmental disorders. Improved understanding of ZIKV pathogenesis could assist efforts to fill the therapeutic and vaccine gap. We use several ZIKV strains, including a pair differing by a single phenylalanine-to-leucine substitution (M-F37L) in the membrane (M) protein, coupled with unbiased genomics to demarcate the border between attenuated and pathogenic infection. We identify infection-induced metabolic dysregulation as a minimal set of host alterations that differentiates attenuated from pathogenic ZIKV strains. Glycolytic rewiring results in impaired oxidative phosphorylation and mitochondrial dysfunction that trigger inflammation and apoptosis in pathogenic but not attenuated ZIKV strains. Critically, pyruvate supplementation prevents cell death, in vitro, and rescues fetal development in ZIKV-infected dams. Our findings thus demonstrate dysregulated metabolism as an underpinning of ZIKV pathogenicity and raise the potential of pyruvate supplementation in expectant women as a prophylaxis against congenital Zika syndrome.