TY - JOUR
T1 - Protective antibodies against placental malaria and poor outcomes during pregnancy, Benin
AU - Ndam, Nicaise Tuikue
AU - Denoeud-Ndam, Lise
AU - Doritchamou, Justin
AU - Viwami, Firmine
AU - Salanti, Ali
AU - Nielsen, Morten A
AU - Fievet, Nadine
AU - Massougbodji, Achille
AU - Luty, Adrian J F
AU - Deloron, Philippe
PY - 2015
Y1 - 2015
N2 - Placental malaria is caused by Plasmodium falciparum-infected erythrocytes that bind to placental tissue. Binding is mediated by VAR2CSA, a parasite antigen coded by the var gene, which interacts with chondroitin sulfate A (CSA). Consequences include maternal anemia and fetal growth retardation. Antibody-mediated immunity to placental malaria is acquired during successive pregnancies, but the target of VAR2CSA-specific protective antibodies is unclear. We assessed VAR2CSA-specific antibodies in pregnant women and analyzed their relationships with protection against placental infection, preterm birth, and low birthweight. Antibody responses to the N-terminal region of VAR2CSA during early pregnancy were associated with reduced risks for infections and low birthweight. Among women infected during pregnancy, an increase in CSA binding inhibition was associated with reduced risks for placental infection, preterm birth, and low birthweight. These data suggest that antibodies against VAR2CSA N-terminal region mediate immunity to placental malaria and associated outcomes. Our results validate current vaccine development efforts with VAR2CSA N-terminal constructs.
AB - Placental malaria is caused by Plasmodium falciparum-infected erythrocytes that bind to placental tissue. Binding is mediated by VAR2CSA, a parasite antigen coded by the var gene, which interacts with chondroitin sulfate A (CSA). Consequences include maternal anemia and fetal growth retardation. Antibody-mediated immunity to placental malaria is acquired during successive pregnancies, but the target of VAR2CSA-specific protective antibodies is unclear. We assessed VAR2CSA-specific antibodies in pregnant women and analyzed their relationships with protection against placental infection, preterm birth, and low birthweight. Antibody responses to the N-terminal region of VAR2CSA during early pregnancy were associated with reduced risks for infections and low birthweight. Among women infected during pregnancy, an increase in CSA binding inhibition was associated with reduced risks for placental infection, preterm birth, and low birthweight. These data suggest that antibodies against VAR2CSA N-terminal region mediate immunity to placental malaria and associated outcomes. Our results validate current vaccine development efforts with VAR2CSA N-terminal constructs.
U2 - 10.3201/eid2105.141626
DO - 10.3201/eid2105.141626
M3 - Journal article
C2 - 25898123
SN - 1080-6040
VL - 21
SP - 813
EP - 823
JO - Emerging Infectious Diseases (Print Edition)
JF - Emerging Infectious Diseases (Print Edition)
IS - 5
ER -