Placental cytotrophoblast microvillar stabilization is required for cell-cell fusion

The placenta is an essential organ of pregnancy required for maternal-fetal transport and communication. The surface of the placenta facing the maternal blood is formed by a single giant multinucleate cell: the syncytiotrophoblast. The syncytiotrophoblast is formed and maintained via fusion of progenitor cytotrophoblasts. Cell-cell fusion is a tightly regulated process, and in non-trophoblastic cells is accompanied by stereotypical alterations in cell shape by cells that have attained fusion-competence. The most prominent feature is the formation of actin-based membrane protrusions, but whether stereotypic morphological changes occur in fusion-competent cytotrophoblasts has not been characterized. Using a human placental explant model, we characterized cell shape factors associated with the attainment of cytotrophoblast fusion competence. We found that fusion-competent cytotrophoblasts are hypertrophic, elongated cells, that form microvilli at the apical membrane. The actin-membrane cross linker protein ezrin was found to have highly polarized expression within cytotrophoblast microvilli. Inhibition of ezrin activation destabilized cytotrophoblast microvilli and prevented cytotrophoblast fusion. Thus, we propose that the polarized activation of ezrin within apical microvilli and actin-mediated changes in membrane dynamics are necessary for cytotrophoblast fusion. ### Competing Interest Statement The authors have declared no competing interest.