Placental Transfer and Maternally Acquired Neonatal IgG Immunity in Human Immunodeficiency Virus Infection

Moraes-Pinto, Maria Isabel de; Almeida, Ana Cristina; Kenj, Grecy; Filgueiras, Thomaz E.; Tobias, Wanda; Santos, Amélia Miyashiro Nunes dos; Carneiro‐Sampaio, Magda; Farhat, Calil Kairalla; Milligan, Paul; Johnson, Peter; Hart, C. A.

doi:10.1093/infdis/173.5.1077

Cited by 160 publications

(143 citation statements)

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“…To do this, we used a Luminex-bead-based assay that allowed us to measure antibodies to EBV lytic (e.g., VCA-p18, VCAgp125, EAd, and Zta) and latent (e.g., EBNA1) antigens as well as TT antigen (13). We included the TT antigen as a reference antigen, as there are numerous studies evaluating the transplacental transfer of anti-TT antibody (22,26,34,35). The levels of EBVspecific anti-VCA-p18, anti-VCA-gp125, and anti-TT antibodies were comparable in the mothers and their neonates irrespective of malaria exposure status (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Maternal factors such as placental malaria, human immunodeficiency virus (HIV) infection, maternal hypergammaglobulinemia, and preterm birth have been shown to inhibit the efficient mother-to-child transfer of pathogen-specific antibodies (22)(23)(24)(25)(26)(27). For example, in a study in the rural coastal area of Kenya, placental malaria infection as well as HIV infection was associated with a significant reduction in the transfer of anti-tetanus IgG antibodies to the neonates (26).…”

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confidence: 99%

“…In a rural Gambian population, placental malaria infection was associated with a significant reduction in transplacental transfer of antibodies against herpes simplex virus (HSV), varicella-zoster virus (VZV), and respiratory syncytial virus (RSV) (27). Maternal HIV infection was associated with reduced transplacental transfer of IgG antibodies against tetanus toxoid (TT), measles virus, and varicella-zoster virus (22). Together, these studies suggest that maternal infections during pregnancy can interfere with the efficient vertical transfer of pathogen-specific antibodies, potentially leaving infant susceptible to infections early in life.…”

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confidence: 99%

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Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy

Ogolla

Daud

Asito

et al. 2015

Clin Vaccine Immunol

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h Over 35% of children in a region of malaria endemicity are infected with Epstein-Barr virus (EBV) by 6 months of age. This susceptibility may be linked to impaired transplacental transfer of antibodies. In this study, we determined the effect of malaria exposure during pregnancy on the transfer of EBV-specific maternal antibodies in a region of western Kenya that experiences endemic malaria. Pregnant mothers were recruited and followed up until delivery to determine levels of neonatal malaria exposure. Levels of EBV lytic (viral capsid antigen [VCA], Z transcriptional activator [Zta], and early diffuse antigen complex [EAd]) and EBV latent (EBV nuclear antigen-1 (EBNA1]) and tetanus-specific IgG antibodies were measured in 70 paired maternal and cord blood samples using a Luminex-bead-based assay. A high proportion (63%) of the infants were exposed to malaria in utero. Levels of EBV-and tetanus-specific antibodies were similar in malaria-infected mothers and in mothers who had no detectable malaria infection. Malaria-exposed neonates had significantly lower levels of anti-EBNA1, anti-Zta, and anti-EAd antibodies than were seen in their mothers. In utero malaria exposure resulted in significant reductions in transplacental transfer of anti-VCA-p18 and anti-EBNA1 antibodies of 13% and 22%, respectively. Neonates received significantly low levels of anti-Zta and anti-EAd antibodies irrespective of malaria exposure levels. In multivariate analysis, in utero malaria exposure was associated with a significant reduction in the transfer of anti-VCA-p18 and anti-EBNA1 antibodies to the neonates (P ‫؍‬ 0.0234 and P ‫؍‬ 0.0017, respectively). Malaria during pregnancy results in differential levels of transfer of EBV-specific antibodies from the mother to the fetus. The impaired transplacental transfer of some antibodies may lead to the malaria-exposed neonates being susceptible to early EBV infection. E ndemic Burkitt's lymphoma (eBL) is a distinct form of nonHodgkin's lymphoma and is the most common pediatric malignancy in regions of malaria endemicity of sub-Saharan Africa (1). Both infection with Epstein-Barr virus (EBV) and repeated episodes of Plasmodium falciparum malaria are known risk factors for eBL (2), but the mechanism(s) by which these two agents interact to promote the emergence of malignant B cell clones has not been elucidated. Recently, we found that infants from a region of malaria endemicity of western Kenya were infected with EBV by 6 months of age (3). Living in regions of malaria endemicity was a predictor of this early age of primary infection. This aberrant primary EBV infection may set the stage for lymphoma development, as previously hypothesized (4-6).The lytic and latent phases of the EBV life cycle induce distinct antibodies in response to specific lytic and latent antigens. Anti-EBV nuclear antigen-1 (EBNA1) antibodies are produced against EBNA1, the only antigen expressed in latently infected memory B cells and in eBL tumors (7). Anti-viral capsid antigen (anti-VCA), anti-early antigen (ant...

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy

Ogolla

Daud

Asito

et al. 2015

Clin Vaccine Immunol

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“…The transplacental IgG transport involves a connection to the Fc receptor on the surface of syncytiotrophoblast [24], however, some clinical conditions such as maternal HIV infection, malaria, prematurity and maternal hypergammaglobulinemia may interfere with this transport, but we did not observe reports of changes in the placental passage of antibodies in malnourished pregnant women [25][26][27][28][29].…”

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confidence: 76%

Placental transfer of Haemophilus influenzae type b antibodies in malnourished pregnant women

Cavalcante¹,

Kopelman²,

Costa‐Carvalho³

2008

Braz J Infect Dis

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This study evaluated the vaccination response to Haemophilus influenzae type b (Hib) in malnourished pregnant women (MN), cord blood (CB) and in infants at two and six months of age for comparison with a control group (C). Twenty-eight malnourished pregnant women and 29 pregnant controls were immunized with conjugated Act-HIB® in the third trimester of pregnancy. Blood samples were collected from all before the immunization, during labor (post immunization), and from CB. All infants were immunized with Hib vaccine according to normal vaccine schedule and sera were collected at two and six months of age. Antibody levels to polyribosylribitol phosphate (PRP) were similar for both groups. Preimmunization: MN 1.94 μ μ μ μ μg/mL, C 1.68 μ μ μ μ μg/mL; post-vaccination: MN 18.53 μ μ μ μ μg/mL and C 17.55 μ μ μ μ μg/mL; in CB from MN 14.46 μ μ μ μ μg/mL and from C 17.04 μ μ μ μ μg/mL. Infants from MN and C mothers presented respectively at two months: 5.18 μ μ μ μ μg/mL and 8.60 μ μ μ μ μg/mL and at six months: MN 3.42 μ μ μ μ μg/mL and C 2.18 μ μ μ μ μg/mL.Antibody levels were similar in both groups studied (p = 0.485), however the vertical transmission rate was 14% lower in the MN pregnant group. Levels of antibodies ≥ ≥ ≥ ≥ ≥ 0.15 μ μ μ μ μg/mL were found in all newborns from the MN pregnant group. Pregnant MN presented an immunological response to Hib vaccine similar to group C, however, vertical transmission rate of antibodies to PRP in the MN pregnant group was 14% lower than that in C, suggesting a less efficient passage of antibodies within this group.

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“…Prematurity, severe maternal hypergammaglobulinaemia, and high maternal antitetanus IgG concentrations have been associated with reduced cord-maternal ratios of tetanus antibody, compared with controls, 90,111,112 although these findings have not been consistent. 103,104,111 Malaria, HIV, hypergammaglobulinaemia, and prematurity are factors that coexist in countries with a high burden of neonatal tetanus. Although the studies discussed above suggest that maternal tetanus antibody concentrations or placental transfer, or both, can be reduced in these conditions, in all but two studies 102,112 the relative reductions in tetanus antibody did not result in subprotective antibody concentrations in neonates.…”

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confidence: 99%

Maternal and Neonatal Tetanus

Roper

Vandelaer

Gasse

2008

Obstetric Anesthesia Digest

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Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus.Tetanus in the first 28 days of life (neonatal tetanus) was long recognised by clinicians in resource-poor settings as an important cause of neonatal death. However, since babies affected by this disease usually are born at home and die there without registration of either event, the true burden was unknown. In the 1970s and 1980s, community-based surveys about neonatal tetanus from more than 40 countries showed that fewer than 10% of tetanus-related cases and deaths were routinely reported in most countries: in some regions, the reporting fraction was as low as 2-5%. 1,2 Estimates based on the results of these surveys, and tetanus data routinely reported to WHO suggested that, in the 1980s, more than 1 million deaths every year were attributable to tetanus, with an estimated 787 000 deaths in 1988 from neonatal tetanus alone. 1,3 In 1989, the worldwide public-health community made a commitment to the elimination of neonatal tetanus (defined as fewer than one case of neonatal tetanus per 1000 livebirths in all districts) by 1995. 3,4 Maternal tetanus is defined as tetanus during pregnancy, or within 6 weeks of the end of pregnancy (whether pregnancy ended with birth, miscarriage, or abortion), and has the same risk factors and means of prevention as neonatal tetanus. In the early 1990s it was estimated to account for about 5% of maternal mortality, or 15 000-30 000 deaths every year. 5,6 In 1999, the elimination of maternal tetanus was added to the goals of the elimination programme for neonatal tetanus, and the initiative was renamed the Maternal and Neonatal Tetanus Elimination Program. 6 Good progress has been made in the 15 ...

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Placental Transfer and Maternally Acquired Neonatal IgG Immunity in Human Immunodeficiency Virus Infection

Cited by 160 publications

References 22 publications

Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy

Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy

Placental transfer of Haemophilus influenzae type b antibodies in malnourished pregnant women

Maternal and Neonatal Tetanus

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