New Insights into Acquisition, Boosting, and Longevity of Immunity to Malaria in Pregnant Women
| Autor: | Robin F. Anders, Nadia Cross, Julie A. Simpson, Takafumi Tsuboi, François Nosten, Mirja Hommel, David L. Narum, Freya J. I. Fowkes, Jack S. Richards, Kurt Lackovic, Rose McGready, Salenna R. Elliott, Jacher Viladpai-nguen, James G. Beeson |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Plasmodium falciparum 030231 tropical medicine Plasmodium vivax Antibodies Protozoan Parasitemia Biology Antimalarials Young Adult 03 medical and health sciences Major Articles and Brief Reports 0302 clinical medicine Pregnancy Chloroquine Immunity parasitic diseases Malaria Vivax medicine Humans Immunology and Allergy Parasites Malaria Falciparum 030304 developmental biology 0303 health sciences Thailand medicine.disease Acquired immune system biology.organism_classification 3. Good health Infectious Diseases Case-Control Studies Immunoglobulin G Pregnancy Complications Parasitic Immunology Female Malaria medicine.drug |
| Zdroj: | The Journal of Infectious Diseases |
| DOI: | 10.1093/infdis/jis566 |
| Popis: | How the immune system responds to exposure to infections during pregnancy is poorly understood. Antibody-mediated immunity is essential for protection against many important pathogens, but how antibodies are acquired, maintained, and boosted after re-exposure during pregnancy remains unknown. This knowledge is critical to understanding why pregnant women are more susceptible to and more severely affected by numerous infectious diseases [1] and has translational implications for the development and use of vaccines to protect pregnant women and their babies. In this study, we aimed to address these key questions by studying responses to one of the most important human pathogens during pregnancy: malaria. It is estimated that every year 125 million women living in areas where malaria is endemic become pregnant [2]. Infection with Plasmodium falciparum and Plasmodium vivax during pregnancy contributes to maternal anemia, can cause severe illness and death, and leads to low infant birth weight, which is a major risk factor for infant mortality and morbidity [3, 4]. At the time of their first pregnancy, women living in areas where malaria is endemic may have developed substantial acquired immunity to malaria, which does not prevent infection per se, but controls high-density parasitemia and associated clinical symptoms [5]. Antibodies against the disease-causing blood stage of malaria have a significant role in protection and target antigens on the surface of merozoites and infected erythrocytes (IE) [6, 7]. Despite pre-existing immunity, pregnant women develop placental and peripheral infections at higher parasite densities, compared with nonpregnant adults [8]. This susceptibility has been attributed to immune modulation resulting in an impaired ability to limit parasite replication during pregnancy and the emergence of specific antigenic variants of P. falciparum that evade existing immunity and accumulate in the placenta [9, 10]. The expression by P. falciparum IEs of the VAR2CSA protein, a specific variant of P. falciparum erythrocyte membrane protein (PfEMP1) that is exposed on the surface of IEs, facilitates the sequestration of IEs in the placenta by mediating adhesion to chondroitin sulfate A and, possibly, other receptors in the intervillous space [9–11]. Levels of antibodies to surface antigens of placental-binding IEs, and VAR2CSA specifically, are generally low before pregnancy and are higher in multigravida women exposed to P. falciparum [9–12]. Little is known about the maintenance and boosting of antimalarial responses over time, particularly during pregnancy, and there is a paucity of studies with repeated sampling over time or studies examining responses to multiple infections. Furthermore, very little is known about antibody responses to non–P. falciparum malaria during pregnancy, particularly P. vivax, which is widespread in Asia and South America. To advance our knowledge on the acquisition and boosting of antibody responses to infections in pregnant women and the maintenance of antibodies in the absence of reinfection, we studied antimalarial responses throughout pregnancy among women exposed to P. falciparum and P. vivax infection in a region of Southeast Asia where malaria is endemic. |
| Databáze: | OpenAIRE |
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