Malaric Placentas

Leopardi, O; Naughten, W; Salvia, L; Colecchia, Maurizio; Matteelli, Alberto; Zucchi, A.; Shein, A; Muchi, J A; Carosi, Giampiero; Ghione, M

doi:10.1016/s0344-0338(96)80068-9

Cited by 58 publications

(15 citation statements)

References 16 publications

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“…Monocyte infiltration into the placental intervillous space has been associated with poor birth outcomes including the risk of low birth weight infants [15], [48], [49], [60], [61]. Chemokines function as specific chemoattractants for leukocytes.…”

Section: Discussionmentioning

confidence: 99%

C5a Enhances Dysregulated Inflammatory and Angiogenic Responses to Malaria In Vitro: Potential Implications for Placental Malaria

et al. 2009

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BackgroundPlacental malaria (PM) is a leading cause of maternal and infant mortality. Although the accumulation of parasitized erythrocytes (PEs) and monocytes within the placenta is thought to contribute to the pathophysiology of PM, the molecular mechanisms underlying PM remain unclear. Based on the hypothesis that excessive complement activation may contribute to PM, in particular generation of the potent inflammatory peptide C5a, we investigated the role of C5a in the pathogenesis of PM in vitro and in vivo.Methodology and Principal FindingsUsing primary human monocytes, the interaction between C5a and malaria in vitro was assessed. CSA- and CD36-binding PEs induced activation of C5 in the presence of human serum. Plasmodium falciparum GPI (pfGPI) enhanced C5a receptor expression (CD88) on monocytes, and the co-incubation of monocytes with C5a and pfGPI resulted in the synergistic induction of cytokines (IL-6, TNF, IL-1β, and IL-10), chemokines (IL-8, MCP-1, MIP1α, MIP1β) and the anti-angiogenic factor sFlt-1 in a time and dose-dependent manner. This dysregulated response was abrogated by C5a receptor blockade. To assess the potential role of C5a in PM, C5a plasma levels were measured in malaria-exposed primigravid women in western Kenya. Compared to pregnant women without malaria, C5a levels were significantly elevated in women with PM.Conclusions and SignificanceThese results suggest that C5a may contribute to the pathogenesis of PM by inducing dysregulated inflammatory and angiogenic responses that impair placental function.

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Section: Discussionmentioning

confidence: 99%

C5a Enhances Dysregulated Inflammatory and Angiogenic Responses to Malaria In Vitro: Potential Implications for Placental Malaria

et al. 2009

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“…The resulting features of parasite sequestration, increased presence of inflammatory cells, deposition of pigment (haemozoin), and fibrin characterize placental malaria and have been used to classify the chronology of placental infections [3,4]. The association between histologic grades of infection in P. falciparum infected placentas and low birth weight and maternal anaemia is well documented in high malaria endemic African regions [5-8], with reports of dense parasitaemia and occasional massive chronic intervillositis and monocyte infiltration mainly, but not exclusively from Africa [9,10]. This led to suggestions that the accumulation of parasites per se, with the corresponding inflammatory response to the sequestered parasites is associated with fetal growth restriction [11-13].…”

Section: Introductionmentioning

confidence: 99%

Placental infections with histologically confirmed Plasmodium falciparum are associated with adverse birth outcomes in India: a cross-sectional study

Ahmed

Singh

Kuile

et al. 2014

Malar J

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BackgroundFew studies have assessed placental malaria infections from low transmission areas by histopathology to define their impact and underlying mechanisms.MethodsPeripheral smears and rapid diagnostic tests (RDTs), placental smears and histological samples, birth weight and gestational age were collected from 2,282 deliveries in three hospitals during a one-year (2006–2007) continuous cross-sectional survey in Madhya Pradesh. Placental histopathology included all 50 cases positive by microscopy or RDT plus 456 randomly selected samples of women negative for malaria by microscopy or RDT. Histological examination included parasites, inflammatory cells, pigment in fibrin, and morphological changes.ResultsThere were 52 histology-positive cases; 38 (73.1%) active (acute and chronic) and 14 past infections. Intervillous parasitaemia was low (60% had < 1% parasitaemia) and monocytosis mostly mild (63%). Compared with uninfected placentas, acute Plasmodium falciparum infections were associated with stillbirth (RR 3.8, 95% CI 1.2-12.1), lower maternal haemoglobin (mean difference: 1.5 g/dL, 95% CI 0.5-2.5), lower birth weight (mean difference 451 g, 95% CI 169–609) and shorter gestation (mean difference 0.8 weeks, 95% CI 0.2-1.4). Chronic or past infections were not associated with these outcomes. Among the 11 peripheral Plasmodium vivax cases, placental parasites were absent, but they were associated with increased placental polymorphonuclear cells.ConclusionsMalaria associated stillbirth and low birth weight in women with low protective immunity may result, at least in part, from a shortened gestation triggered by acute infection, stressing the importance of early malaria detection.

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“…The inflammatory response is responsible for functional damage in placental villi, and disturbs feto-maternal exchange, leading to low birth weight [12,13]. Histological studies on malaria have shown that P. falciparum -infected placentae are characterized by an increase in inflammatory cells in the intervillous space [13,14]. The placental malaria parasite -related cell infiltrates are mainly monocytes and macrophages, with a smaller population of granulocytes and lymphocytes [14-17].…”

Section: Introductionmentioning

confidence: 99%

“…Histological studies on malaria have shown that P. falciparum -infected placentae are characterized by an increase in inflammatory cells in the intervillous space [13,14]. The placental malaria parasite -related cell infiltrates are mainly monocytes and macrophages, with a smaller population of granulocytes and lymphocytes [14-17]. Few studies addressed the characteristics of the immunological responses of these cell infiltrates [18].…”

Section: Introductionmentioning

confidence: 99%

Monocytes and macrophages and placental malaria infections in an area of unstable malaria transmission in eastern Sudan

et al. 2011

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BackgroundMaternal immunity is thought to play a major role in the increased susceptibility of pregnant women to Plasmodium falciparum malaria. Few studies exist on immunohistochemical characterization of the placental inflammatory infiltrate. The current study was conducted in Gadarif hospital in an area characterized by unstable malaria transmission in eastern Sudan.MethodNinety three placentae were investigated for malaria histological changes and immunohistochemical study for monocytes and macrophages (CD68).ResultsWhile 1(1.1%), 2(2.2%) and 20(21.5%) of the 93 placentae had acute, chronic and past malaria infections, 70(75.2%) had no malaria infections. Monocytes and macrophage (CD 68) were detected in 29 (31.2%) of these 93 placentae. Significantly higher rate of monocytes and macrophage were detected in placentae with malaria infections [11/23 (47.8%) vs. 18/70 (25.7%); P = 0.047] especially in placentae with past malaria infections. Placental malaria infections and monocytes and macrophages cells infiltration were not different between primiparae and multiparae. There was no significant difference in the birth weight between the women with placental malaria infections/monocytes and macrophages cells infiltration and those who had no placental malaria infections/cellular infiltrations.ConclusionSignificantly higher rate of monocytes and macrophage were detected in placentae with malaria infections. Neither placental malaria infections nor cellular infiltrates were associated with parity or lead to reduction of birth weight.

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Malaric Placentas

Cited by 58 publications

References 16 publications

C5a Enhances Dysregulated Inflammatory and Angiogenic Responses to Malaria In Vitro: Potential Implications for Placental Malaria

C5a Enhances Dysregulated Inflammatory and Angiogenic Responses to Malaria In Vitro: Potential Implications for Placental Malaria

Placental infections with histologically confirmed Plasmodium falciparum are associated with adverse birth outcomes in India: a cross-sectional study

Monocytes and macrophages and placental malaria infections in an area of unstable malaria transmission in eastern Sudan

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