Low Antibody Levels to Pregnancy-specific Malaria Antigens and Heightened Cytokine Responses Associated With Severe Malaria in Pregnancy

Chandrasiri, Upeksha P.; Randall, Louise M.; Saad, Alfarazdeg A.; Bashir, Ahmed Muhammad; Rogerson, Stephen J.; Adam, Ishag

doi:10.1093/infdis/jit646

Cited by 29 publications

(34 citation statements)

References 31 publications

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“…This was more marked in the primipara. These observations corroborate previous findings in Africa where high plasma levels of IL-10 were associated with malaria infection during pregnancy (Kabyemela et al, 2008;Nmorsi et al, 2010;Boström et al, 2012;Chandrasiri Upeksha et al, 2013;Chêne et al, 2014). High IL-10 levels have also been reported in mice models during pregnancy malaria (Megnekou et al, 2013).…”

Section: Discussionsupporting

confidence: 91%

Role of some biomarkers in placental malaria in women living in Yaoundé, Cameroon

Megnekou¹,

Djontu²,

Bigoga³

et al. 2015

Acta Tropica

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Section: Discussionsupporting

confidence: 91%

Role of some biomarkers in placental malaria in women living in Yaoundé, Cameroon

Megnekou¹,

Djontu²,

Bigoga³

et al. 2015

Acta Tropica

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“…Moreover, the maternal peripheral level of IL-17A and the placental and neonate IFN-γ levels were not signi cantly different due to the infection. Several previous studies have shown elevated levels of type 2 anti-in ammatory cytokines IL-10 and IL-4 in the malariainfected group [13,15,23,25,30,31]. Our ndings were different from those reported by Bayoumi et al [11] and Chêne and et al [12] who found higher levels of IL-4 and IL-10 in the non-infected group.…”

Section: Discussioncontrasting

confidence: 99%

“…The roles of IFN-γ and IL-10 in the malaria-infected women with maternal anemia and baby birth weight was controversially documented in a reviewed by Seitz et al [40]. Although Djontu et al [16] reported no signi cant association between IL-6 level, maternal hemoglobin and baby birth weight, an elevated level of IL-6 was associated with anemia in another study [30].…”

Section: Discussionmentioning

confidence: 98%

Impact of placental malaria on maternal, placental and foetal cord responses and its role in pregnancy outcomes in women from Blue Nile State, Sudan

Omer

Franco-Jarava²,

Noureldien

et al. 2020

Preprint

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Background Sequestration of Plasmodium falciparum infected cells in the placenta results in placental malaria (PM). It activates a mother's immune cells and induces secretion of inflammatory cytokines, which might influence pregnancy outcomes. This study aims to investigate the inflammatory environment in maternal peripheral, placental, and umbilical cord blood in response to PM and the extent to which this may influence maternal haemoglobin levels and birth weight Methods A total of 185 consenting Sudanese women from Blue Nile state were enrolled in a cross sectional conducted between Jan 2012-Dec2005. Malaria infection in the collected samples was determined microscopically, and ELISA was used to measure the plasma levels of the antibodies, IL-4, IL-6, IL-10, IL-17A, and INF γ in the collected positive and negative malaria samples. Results Elevated levels of antibodies, IL-4 and IL-10 and reduced levels of IL-6 were detected in the malaria positive samples in comparison to the negative ones in the three types of samples investigated. Maternal antibodies, IL-4 and IL-10 were significantly higher in the samples collected from the PM infected group compared to the non-infected control (P < 0.001). While the absence of PM was significantly associated with the IL-6 and maternal IFN-γ levels, maternal IL-17A, placental and umbilical cord IFN-γ levels showed no significant difference (P = 0.214, P = 0.065, P = 0.536 respectively) due to infection. Haemoglobin level and birth weight were increased in the group with high levels of IL-6 and IL-17A but not in the group with IL-4 and IL-10 levels. Only maternal peripheral FN-γ level was significantly positively correlated with maternal hemoglobin (r = 0.171, P = 0.020), and baby birth weight (r = 0.233, P = 0.001). Conclusion These results suggest that PM cross-reacts with the mother’s immune response and impairs her cytokine profile, which might alter maternal haemoglobin levels and the baby's birth weight.

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“…It is unknown if this is attributable to interactions between peripartum exposure to inflammatory cytokines, cardiovascular effects of pulmonary dysmaturity, and placental dysfunction (98–100). …”

Section: Resultsmentioning

confidence: 99%

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

2017

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Physiologic adaptations during pregnancy unmask a woman’s predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent’s risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms “fetal programming” and “pregnancy complications combined with maternal disease” until January 2017. Studies linking pregnancy complications to future cardiovascular, metabolic, and thrombotic risks for mother and offspring were reviewed. Women with a history of miscarriage, fetal growth restriction, preeclampsia, preterm delivery, obesity, excessive gestational weight gain, gestational diabetes, subfertility, and thrombophilia more frequently demonstrate with echocardiographic abnormalities, higher fasting insulin, deviating lipids or clotting factors and show defective endothelial function. Thrombophilia hints to thrombotic risks in later life. Pregnancy abnormalities correlate with future cardiovascular and metabolic complications and earlier mortality. Conversely, women with a normal pregnancy have lower rates of subsequent diseases than the general female population creating the term: “Pregnancy as a window for future health.” Although the placenta works as a gatekeeper, many pregnancy complications may lead to sickness and earlier death in later life when the child becomes an adult. The epigenetic mechanisms and the mismatch between pre- and postnatal life have created the term “fetal origin of adult disease.” Up to now, the impact of cardiovascular, metabolic, or thrombotic risk profiles has been investigated separately for mother and child. In this manuscript, we strive to illustrate the consequences for both, fetus and mother within a cohesive perspective and thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal–fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources.

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Low Antibody Levels to Pregnancy-specific Malaria Antigens and Heightened Cytokine Responses Associated With Severe Malaria in Pregnancy

Abstract: Pregnant women with SM lack pregnancy-specific malaria immunity, and this correlates with heightened inflammatory cytokine concentrations, low haemoglobin levels and high parasite density, suggesting that failure of antibody to control parasitaemia may contribute to SM pathogenesis.

Cited by 29 publications

References 31 publications

Role of some biomarkers in placental malaria in women living in Yaoundé, Cameroon

Role of some biomarkers in placental malaria in women living in Yaoundé, Cameroon

Impact of placental malaria on maternal, placental and foetal cord responses and its role in pregnancy outcomes in women from Blue Nile State, Sudan

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

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