Protective antibodies against placental malaria and poor outcomes during pregnancy, Benin

Nicaise Tuikue Ndam; Lise Denoeud-Ndam; Justin Doritchamou; Firmine Viwami; Ali Salanti; Morten A Nielsen; Nadine Fievet; Achille Massougbodji; Adrian J F Luty; Philippe Deloron

doi:10.3201/eid2105.141626

Protective antibodies against placental malaria and poor outcomes during pregnancy, Benin

Nicaise Tuikue Ndam, Lise Denoeud-Ndam, Justin Doritchamou, Firmine Viwami, Ali Salanti, Morten A Nielsen, Nadine Fievet, Achille Massougbodji, Adrian J F Luty, Philippe Deloron

49 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Emerging Infectious Diseases (Print Edition)
Volume	21
Issue number	5
Pages (from-to)	813-823
Number of pages	11
ISSN	1080-6040
DOIs	https://doi.org/10.3201/eid2105.141626
Publication status	Published - 2015

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title = "Protective antibodies against placental malaria and poor outcomes during pregnancy, Benin",

abstract = "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.",

author = "Ndam, {Nicaise Tuikue} and Lise Denoeud-Ndam and Justin Doritchamou and Firmine Viwami and Ali Salanti and Nielsen, {Morten A} and Nadine Fievet and Achille Massougbodji and Luty, {Adrian J F} and Philippe Deloron",

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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.

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DO - 10.3201/eid2105.141626

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SN - 1080-6040

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EP - 823

JO - Emerging Infectious Diseases

JF - Emerging Infectious Diseases

IS - 5

ER -

Protective antibodies against placental malaria and poor outcomes during pregnancy, Benin

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