Malaria in pregnancy: pathogenesis and immunity

TY - JOUR

T1 - Malaria in pregnancy: pathogenesis and immunity

AU - Rogerson, Stephen J

AU - Hviid, Lars

AU - Duffy, Patrick E

AU - Leke, Rose F G

AU - Taylor, Diane W

N1 - Keywords: Animals; Antibodies, Protozoan; Erythrocytes; Female; Humans; Immunity, Cellular; Malaria, Falciparum; Placenta; Placenta Diseases; Plasmodium falciparum; Pregnancy; Pregnancy Complications, Parasitic

PY - 2007

Y1 - 2007

N2 - Understanding of the biological basis for susceptibility to malaria in pregnancy was recently advanced by the discovery that erythrocytes infected with Plasmodium falciparum accumulate in the placenta through adhesion to molecules such as chondroitin sulphate A. Antibody recognition of placental infected erythrocytes is dependent on sex and gravidity, and could protect from malaria complications. Moreover, a conserved parasite gene-var2csa-has been associated with placental malaria, suggesting that its product might be an appropriate vaccine candidate. By contrast, our understanding of placental immunopathology and how this contributes to anaemia and low birthweight remains restricted, although inflammatory cytokines produced by T cells, macrophages, and other cells are clearly important. Studies that unravel the role of host response to malaria in pathology and protection in the placenta, and that dissect the relation between timing of infection and outcome, could allow improved targeting of preventive treatments and development of a vaccine for use in pregnant women.

AB - Understanding of the biological basis for susceptibility to malaria in pregnancy was recently advanced by the discovery that erythrocytes infected with Plasmodium falciparum accumulate in the placenta through adhesion to molecules such as chondroitin sulphate A. Antibody recognition of placental infected erythrocytes is dependent on sex and gravidity, and could protect from malaria complications. Moreover, a conserved parasite gene-var2csa-has been associated with placental malaria, suggesting that its product might be an appropriate vaccine candidate. By contrast, our understanding of placental immunopathology and how this contributes to anaemia and low birthweight remains restricted, although inflammatory cytokines produced by T cells, macrophages, and other cells are clearly important. Studies that unravel the role of host response to malaria in pathology and protection in the placenta, and that dissect the relation between timing of infection and outcome, could allow improved targeting of preventive treatments and development of a vaccine for use in pregnant women.

U2 - 10.1016/S1473-3099(07)70022-1

DO - 10.1016/S1473-3099(07)70022-1

M3 - Journal article

C2 - 17251081

SN - 1473-3099

VL - 7

SP - 105

EP - 117

JO - The Lancet Infectious Diseases

JF - The Lancet Infectious Diseases

IS - 2

ER -