Malaria in pregnancy: small babies, big problem

Umbers, Alexandra J.; Aitken, Elizabeth H.; Rogerson, Stephen J.

doi:10.1016/j.pt.2011.01.007

Cited by 184 publications

(192 citation statements)

References 72 publications

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…For instance, increased concentrations of circulating endoglin and CXCL9 have been associated with fetal growth restriction and low-birth-weight deliveries, respectively (21)(22)(23).…”

mentioning

confidence: 99%

Placental Cytokine and Chemokine Profiles Reflect Pregnancy Outcomes in Women Exposed to Plasmodium falciparum Infection

et al. 2014

View full text Add to dashboard Cite

g Pregnancy-associated malaria (PAM) can lead to severe complications for both mother and baby. Certain placental cytokine/ chemokine profiles have been shown to reflect poor pregnancy outcomes, including maternal anemia and low birth weight. In intervillous plasma samples from 400 Beninese women living in an area where Plasmodium falciparum is endemic, we quantified 16 cytokines/chemokines. We assessed their profiles in groups with PAM, with maternal anemia, with preterm births, or with a low birth weight for gestational age. Repeated ultrasound measurements ensured that prematurity and low birth weight were highly accurate. Preliminary analyses revealed trends for lower cytokine/chemokine concentrations in placental plasma associated both with babies with low birth weight for gestational age and with P. falciparum infection during pregnancy, while, as a function of the latter, the concentration of gamma interferon (IFN-␥)-inducible protein 10 (IP-10) was higher. Multivariate analyses showed that (i) higher placental plasma interleukin-10 (IL-10) levels were associated with P. falciparum infections and (ii) independently of P. falciparum infections, lower concentrations of both IFN-␥ and IL-5 were associated with low birth weight for gestational age. Our data further strengthen the idea that IL-10 and IP-10 could be useful diagnostic markers of P. falciparum infection during pregnancy. The concentrations of cytokines/chemokines in placental plasma may represent previously unrecognized markers of poor fetal growth.

show abstract

“…For instance, increased concentrations of circulating endoglin and CXCL9 have been associated with fetal growth restriction and low-birth-weight deliveries, respectively (21)(22)(23).…”

mentioning

confidence: 99%

Placental Cytokine and Chemokine Profiles Reflect Pregnancy Outcomes in Women Exposed to Plasmodium falciparum Infection

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In further support of this hypothesis, several inflammatory factors including IL-6, TNF and CRP that are implicated as mediators of maternal immune activation-related neuropsychiatric disorders [51,53,54,72] are increased in MIP [9,15,73,74].…”

Section: Malaria In Pregnancy and Neurocognitive Outcomesmentioning

confidence: 80%

“…Sequestration of parasitized erythrocytes in the intervillous space of the placenta triggers the secretion of chemotactic β-chemokines by mononuclear cells, resulting in an accumulation of monocytes and macrophages, and a deviation from the normal cytokine profile in the placenta [9,10]. For example, pro-inflammatory cytokines such as TNF are increased in PM and have been associated with poor birth outcomes [9,11].…”

Section: Adverse Birth Outcomes In Placental Malariamentioning

confidence: 99%

Malaria in Pregnancy: An Unrecognized Risk Factor for Neuropsychiatric Disease in Offspring?

Tran¹,

Weckman²,

Kain

2016

Pediatric Infect Dis

View full text Add to dashboard Cite

The in vitro environment has a profound effect on offspring neurodevelopment. Insults to the foetus during pregnancy can disrupt neurodevelopmental processes culminating in neurochemical and behavioural abnormalities. A growing body of evidence supports a role for maternal infection in precipitating neuropsychiatric disease in offspring. Sincẽ 60% of pregnancies globally are at risk of malaria infection annually, we hypothesize that in utero exposure to malaria in pregnancy (MIP) may be a neglected risk factor for mental illness. We propose that the host response to infection makes an important contribution to this risk. MIP may mediate neuropathology via immune activation and inflammation in the placenta and consequent dysregulation of processes critical to fetal neurodevelopment including cerebral angiogenesis, neurogenesis, synaptic pruning, and neurochemical regulation.

show abstract

“…It is difficult to calculate the true toll of PAM upon foetal and newborn morbidity and mortality since many deaths occur at home, in rural areas and may mimic the clinical features of other infectious diseases [70]. A very common manifestation of PAM is low birth weight (LBW) newborns (< 2500g).…”

Section: Clinical Consequences For the Foetus And Developing Childmentioning

confidence: 99%

Understanding How Plasmodium falciparum Binds to the Placenta and Produces Pathology Provides a Rationale for Pregnancy-Associated Malaria Vaccine Development

Morley¹

2012

TOVACJ

View full text Add to dashboard Cite

By adulthood repeated exposure to Plasmodium falciparum, the causative agent of the most severe form of malaria in humans, can induce semi-immunity to clinical infection. During pregnancy, however, there is a striking recurrence of severe disease, a syndrome described as pregnancy-associated malaria (PAM). This is caused by P. falciparum-infected erythrocytes binding to receptors on the placental endothelium that are expressed uniquely during pregnancy. This subset of parasites binds by virtue of expressing a cell surface antigen that is the ligand for the corresponding endothelial receptor, thereby providing a selective pressure for its clonal expansion. The antigen also triggers a protective antibody-mediated immune response. With subsequent pregnancies and further exposure to these variant parasites, antibodies develop earlier and women may experience milder infections. Women with PAM exhibit more severe malaria infections than do non-gravid women, with 2,500-10,000 deaths each year due to haemolytic anaemia. PAM also has a detrimental effect on the foetus, increasing the risk of low birth weight, which causes 60,000-200,000 infant deaths annually in sub-Saharan Africa. Current research aims to produce a vaccine to stimulate development of antibodies which would be protective against infection with wild-type parasites. This is hampered by significant diversity in variant surface antigens and available vaccine candidates may only protect women living in malaria-endemic areas. While placental-parasite interactions are not sufficiently understood, incremental progress is being made towards producing an effective vaccine. This review focuses on the molecular structures involved in binding to consider the prospects for a vaccine mimicking naturally-acquired immunity to PAM.

show abstract

Malaria in pregnancy: small babies, big problem

Cited by 184 publications

References 72 publications

Placental Cytokine and Chemokine Profiles Reflect Pregnancy Outcomes in Women Exposed to Plasmodium falciparum Infection

Placental Cytokine and Chemokine Profiles Reflect Pregnancy Outcomes in Women Exposed to Plasmodium falciparum Infection

Malaria in Pregnancy: An Unrecognized Risk Factor for Neuropsychiatric Disease in Offspring?

Understanding How Plasmodium falciparum Binds to the Placenta and Produces Pathology Provides a Rationale for Pregnancy-Associated Malaria Vaccine Development

Contact Info

Product

Resources

About