Antibodies That Inhibit Plasmodium falciparum Adhesion to Chondroitin Sulfate A Are Associated with Increased Birth Weight and the Gestational Age of Newborns

Abstract

Antibodies that inhibit Plasmodium falciparum adhesion to the placental receptor chondroitin sulfate A are associated with a reduced risk of placental malaria, but whether these antibodies lead to improved pregnancy outcomes is unknown. We measured antiadhesion antibody levels in parturient women in western Kenya, where malaria transmission is intense. Secundigravid women with antiadhesion activity in their plasma delivered babies that were on average 398 g heavier (P ‫؍‬ 0.019) and 2 weeks more mature (P ‫؍‬ 0.002) than babies delivered to secundigravidas without antiadhesion activity. Our findings support the development of antiadhesion vaccines to prevent poor fetal outcomes due to pregnancy malaria.

Adhesion Specificities of Plasmodium falciparum-Infected Erythrocytes Involved in the Pathogenesis of Pregnancy-Associated Malaria

“…Rather, the parasites causing PAM express VSA (VSA PAM ), which is not expressed by parasites infecting nonpregnant individuals and to which primigravidae consequently have no pre-existing immunity. The observations that susceptibility to PAM falls with increasing parity and that levels of VSA PAM -specific antibodies correlate with plasma inhibition of IE adhesion to CSA 7 and with protective immunity to PAM 8,9 all support this scenario. Furthermore, they suggest that vaccination against PAM may be feasible, which is a highly attractive possibility both in its own right and as an important proof of concept for efforts to develop VSA-based vaccines against malaria in general.…”

Genome-Wide Expression Analysis of Placental Malaria Reveals Features of Lymphoid Neogenesis during Chronic Infection

“…These Abs are associated with a decreased risk of PM and increased birthweight and gestational age of the newborn (10). Abs that label laboratory parasites selected to bind chondroitin sulfate A also increase over successive pregnancies (11,12), are elevated during infection (11), and have been associated with protection against anemia in first time mothers with chronic PM (13).…”

Nonimmune immunoglobulin binding and multiple adhesion characterize Plasmodium falciparum -infected erythrocytes of placental origin

“…The adverse effects of PAM decrease with succeeding pregnancies and have been linked to the development of protective antibodies that recognize an antigenically and functionally distinct subpopulation of pRBCs (5)(6)(7). Whereas parasites from nonpregnant individuals interact with CD36 and several other receptors (8,9), the glycosaminoglycan (GAG) chondroitin sulfate A (CSA) has been described as the main placental receptor (5, 10).…”