The Immunology and Pathogenesis of Malaria During Pregnancy

Beeson, James G.; Duffy, Patrick E.

doi:10.1007/3-540-29967-x_6

Cited by 76 publications

(72 citation statements)

References 190 publications

(275 reference statements)

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“…The cells collected from women in their second pregnancy secreted high levels of IL-4 and IL-10 (43). Multigravidae have been shown to present higher levels of lymphocyte proliferation and natural killer cell cytotoxic activity in response to CSA-binding parasites than primigravidae women (10). These observations suggest that IFN-γ is involved in immunity to PAM.…”

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 94%

“…The inflammatory component, which may appear after parasite accumulation in the placenta, is associated with the immune-pathological consequences of PAM, such as cytotrophoblast proliferation and cytotrophoblast membrane thickening (10). This inflammatory process, characterized by massive cell deposition, is thought to alter local blood flow, disrupting metabolic pathways and hindering IgG transfer across the placenta and the exchange of nutrients between mother and fetus, resulting in placental lesions and LBW (10,11). However, the clinical outcomes of PAM, such as fetal growth restriction and preterm delivery, the strict association with LBW at term and placental parasitemia, have been observed in primigravidae (9).…”

Section: General Aspects Of Pammentioning

confidence: 99%

“…However, it has been shown that massive sequestration of the parasite in the placenta leads to a switch in the cell-mediated immune response, typically from T H 2 to T H 1, resulting in the clinical manifestation of PAM, characterized by an increase in the level of pro-inflammatory cytokine production (10). Several studies have shown that high levels of IFN-γ and TNF-α, mainly secreted by placental macrophages, are associated with poor clinical outcome in patients with PAM and with the concentration of hemozoin in the placenta (41).…”

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 99%

“…Several studies have shown that high levels of IFN-γ and TNF-α, mainly secreted by placental macrophages, are associated with poor clinical outcome in patients with PAM and with the concentration of hemozoin in the placenta (41). Placental infection increases the levels of α-and ß-chemokines, which, in turn, increase immune cell recruitment to the placenta (10,42).…”

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 99%

“…These observations suggest that IFN-γ is involved in immunity to PAM. Further evidence for the protective role of IFN-γ is provided by the higher susceptibility to PAM of women with both malaria and HIV infection (10). Indeed, it has been recently shown that neonates born to mothers with active placental infection have lower levels of PAM-parasite antigen-specific IFN-γ T cells and higher levels of IL-10 CD4 T cells than do pregnant infected women treated for malaria (44).…”

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 99%

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Cytoadhesion of Plasmodium falciparum-infected erythrocytes and the infected placenta: a two-way pathway

Costa

Avril

Nogueira³

et al. 2006

Braz J Med Biol Res

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Malaria is undoubtedly the world's most devastating parasitic disease, affecting 300 to 500 million people every year. Some cases of Plasmodium falciparum infection progress to the deadly forms of the disease responsible for 1 to 3 million deaths annually. P. falciparum-infected erythrocytes adhere to host receptors in the deep microvasculature of several organs. The cytoadhesion of infected erythrocytes to placental syncytiotrophoblast receptors leads to pregnancy-associated malaria (PAM). This specific maternal-fetal syndrome causes maternal anemia, low birth weight and the death of 62,000 to 363,000 infants per year in sub-Saharan Africa, and thus has a poor outcome for both mother and fetus. However, PAM and non-PAM parasites have been shown to differ antigenically and genetically. After multiple pregnancies, women from different geographical areas develop adhesionblocking antibodies that protect against placental parasitemia and clinical symptoms of PAM. The recent description of a new parasite ligand encoded by the var2 CSA gene as the only gene up-regulated in PAM parasites renders the development of an anti-PAM vaccine more feasible. The search for a vaccine to prevent P. falciparum sequestration in the placenta by eliciting adhesion-blocking antibodies and a cellular immune response, and the development of new methods for evaluating such antibodies should be key priorities in mother-child health programs in areas of endemic malaria. This review summarizes the main molecular, immunological and physiopathological aspects of PAM, including findings related to new targets in the P. falciparum var gene family. Finally, we focus on a new methodology for mimicking cytoadhesion under blood flow conditions in human placental tissue.

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Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 94%

Section: General Aspects Of Pammentioning

confidence: 99%

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 99%

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 99%

Section: Is the Cell-mediated Immune Response Involved In Pam Pathogementioning

confidence: 99%

See 3 more Smart Citations

Cytoadhesion of Plasmodium falciparum-infected erythrocytes and the infected placenta: a two-way pathway

Costa

Avril

Nogueira³

et al. 2006

Braz J Med Biol Res

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Maternal capital and the metabolic ghetto: An evolutionary perspective on the transgenerational basis of health inequalities

Wells¹

2009

American J Hum Biol

232

253

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There is particular interest in understanding socioeconomic and ethnic variability in health status. The developmental origins of disease hypothesis emphasize the importance of growth patterns across the life-course in relation to noncommunicable disease risk. The physiological components of cardiovascular risk, collectively termed the metabolic syndrome, derive in part from a disparity between the homeostatic "metabolic capacity" of vital organs and the "metabolic load" induced by large tissue masses, a rich diet and sedentary behavior. From an evolutionary perspective, the risk of such disparity is decreased by maternal physiology regulating offspring growth trajectory during gestation and lactation. Maternal capital, defined as phenotypic resources enabling investment in the offspring, allows effective buffering of the offspring from nutritional perturbations and represents the environmental niche initially occupied by the offspring. Offspring growth patterns are sensitive to the magnitude of maternal capital during early windows of plasticity. Offspring life-history strategy can then respond adaptively to further factors across the life-course, but only within the context of this initial maternal influence on growth. Maternal somatic capital is primarily gained or lost across generations, through variable rates of fetal and infant growth. I argue that the poor nutritional experience of populations subjected to colonialism resulted in a systematic loss of maternal capital, reflected in downward secular trends in stature. Accelerating the recovery of somatic capital within generations overloads metabolic capacity and exacerbates cardiovascular risk, reflected in increased disease rates in urbanizing and emigrant populations. Public health policies need to benefit metabolic capacity without exacerbating metabolic load.

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Diagnosis and Treatment of Malaria in Pregnancy

Ades

2013

Around the Globe for Women's Health

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The Immunology and Pathogenesis of Malaria During Pregnancy

Cited by 76 publications

References 190 publications

Cytoadhesion of Plasmodium falciparum-infected erythrocytes and the infected placenta: a two-way pathway

Cytoadhesion of Plasmodium falciparum-infected erythrocytes and the infected placenta: a two-way pathway

Maternal capital and the metabolic ghetto: An evolutionary perspective on the transgenerational basis of health inequalities

Diagnosis and Treatment of Malaria in Pregnancy

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