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Prasetyorini N, Erwan NE, Sardjono TW, Nurseta T, Utomo RP, Nugraha RYB, Cahayani WA, Rukmigarsari E, Arinugraha LN, Fitri LE. HIF-1α regulated pathomechanism of low birth weight through angiogenesis factors in placental Plasmodium vivax infection. F1000Res 2024; 11:131. [PMID: 38884107 PMCID: PMC11179053 DOI: 10.12688/f1000research.73820.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2024] [Indexed: 06/18/2024] Open
Abstract
Background Malaria in pregnancy leads to placental malaria. The primary pathogenesis of the complex fetal implications in placental malaria is tissue hypoxia due to sequestrations of Plasmodium falciparum-infected erythrocytes in the placenta. However, the pathomechanism of placental Plasmodium vivax infection has not been thoroughly investigated. Hypoxia-inducible factor-1α (HIF-1α) is a key transcriptional mediator of the response to hypoxic conditions, which interacts with the change and imbalances of many chemical mediators, including angiogenic factors, leading to fetal growth abnormality. Methods This study was conducted cross-sectionally in Maumere, Sikka Regency, East Nusa Tenggara Province, previously known as one of the malaria endemic areas with a high incidence of low birth weight (LBW) cases. This study collected peripheral and umbilical blood samples and placental tissues from mothers who delivered their babies with LBW at the TC Hiller Regional Hospital. All of the blood samples were examined for parasites by microscopic and PCR techniques, while the plasma levels of VEGF, PlGF, VEGFR-1, VEGFR-2, and HIF-1α were determined using ELISA. The sequestration of infected erythrocytes and hemozoin was determined from placental histological slides, and the expression of placenta angiogenic factors was observed using the immunofluorescent technique. Results In this study, 33 cases had complete data to be analyzed. Of them, 19 samples were diagnosed as vivax malaria and none of falciparum malaria. There were significant differences in Δ 10th percentile growth curve of baby's body weights and also all angiogenic factors in placental tissues {VEGF, PlGF, and VEGFR-1, VEGFR-2, and HIF-1α} between those infected and not infected cases (p<0.05), but not for VEGF and VEGFR-2 in the plasma. Conclusion This study indicated that Plasmodium vivax sequestration may promote LBW through alterations and imbalances in angiogenic factors led by HIF-1α.
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Affiliation(s)
- Nugrahanti Prasetyorini
- Doctoral Program in Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Department of Obstetrics & Gynecology, Faculty of Medicine Universitas Brawijaya/dr Saiful Anwar Hospital, Malang, Indonesia
| | - Nabila Erina Erwan
- Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Master Program in Biomedical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Teguh Wahju Sardjono
- Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Tatit Nurseta
- Department of Obstetrics & Gynecology, Faculty of Medicine Universitas Brawijaya/dr Saiful Anwar Hospital, Malang, Indonesia
| | - Rudi Priyo Utomo
- Department of Obstetrics & Gynecology, dr T.C. Hillers Regional Hospital, Maumere, Sikka Regency, NTT, Indonesia
| | - Rivo Yudhinata Brian Nugraha
- Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Wike Astrid Cahayani
- Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Department of Anatomy and Histology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Ettie Rukmigarsari
- Mathematics Education Study Program, Faculty of Teacher Training and Education, University of Islam Malang, Malang, Indonesia
| | | | - Loeki Enggar Fitri
- Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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Kabalu Tshiongo J, Zola Matuvanga T, Mitashi P, Maketa V, Schallig HDFH, Mens PF, Muhindo Mavoko H, Matangila Rika J. Prevention of Malaria in Pregnant Women and Its Effects on Maternal and Child Health, the Case of Centre Hospitalier de Kingasani II in the Democratic Republic of the Congo. Trop Med Infect Dis 2024; 9:92. [PMID: 38787025 PMCID: PMC11125851 DOI: 10.3390/tropicalmed9050092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
This study aimed to evaluate scientific evidence of the benefit of the use of insecticide-treated nets (ITNs) and Intermittent preventive treatment (IPT) on the birth weight of newborns and the hemoglobin level of the mother when used to prevent malaria during pregnancy. This cross-sectional analytical study was conducted on 467 hospitalized women in the Maternity Ward of Centre Hospitalier de Kingasani II, in the Democratic Republic of the Congo. Data were collected using a structured questionnaire that was pre-tested during a face-to-face interview. Apart from basic statistics, the chi-square test was used to compare proportions. Multivariate analysis (logistic regression) was used to identify variables significantly associated with the 95% confidence interval (CI). The ITN ownership rate was 81% (95% CI: 77-84) and the ITN use rate was 66% (95% CI: 62-70). Sixty-five percent (95% CI: 60-69) reported having received at least three doses of IPT during pregnancy with sulfadoxine-pyramethemine (IPTp-SP). There was a statistically significant difference in hemoglobin levels between hospitalized women who did not use the ITN (9.4 g/dL IIQ: 8.7-9.9) and those who did (11 g/dL IIQ: 9.8-12.2). The non-use of the ITN was associated with low birth weight (aOR = 3.6; 95% CI: 2.1-6.2; p < 0.001) and anemia in pregnant women (cOR = 2.41; 95% CI: 1.16-5.01; p = 0.018). The use of ITN and taking at least three doses of ITP during pregnancy are associated with good birth weight. The number of doses of IPTp received during antenatal care is associated with the maternal hemoglobin level in the third trimester of pregnancy.
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Affiliation(s)
- Japhet Kabalu Tshiongo
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa 01306, Democratic Republic of the Congo; (T.Z.M.); (P.M.); (V.M.); (H.M.M.); (J.M.R.)
- Laboratory for Experimental Parasitology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands; (H.D.F.H.S.); (P.F.M.)
- Amsterdam Institute for Immunology and Infectious Diseases, 1105 AZ Amsterdam, The Netherlands
| | - Trésor Zola Matuvanga
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa 01306, Democratic Republic of the Congo; (T.Z.M.); (P.M.); (V.M.); (H.M.M.); (J.M.R.)
| | - Patrick Mitashi
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa 01306, Democratic Republic of the Congo; (T.Z.M.); (P.M.); (V.M.); (H.M.M.); (J.M.R.)
| | - Vivi Maketa
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa 01306, Democratic Republic of the Congo; (T.Z.M.); (P.M.); (V.M.); (H.M.M.); (J.M.R.)
| | - Henk D. F. H. Schallig
- Laboratory for Experimental Parasitology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands; (H.D.F.H.S.); (P.F.M.)
| | - Petra F. Mens
- Laboratory for Experimental Parasitology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands; (H.D.F.H.S.); (P.F.M.)
| | - Hypolite Muhindo Mavoko
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa 01306, Democratic Republic of the Congo; (T.Z.M.); (P.M.); (V.M.); (H.M.M.); (J.M.R.)
| | - Junior Matangila Rika
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa 01306, Democratic Republic of the Congo; (T.Z.M.); (P.M.); (V.M.); (H.M.M.); (J.M.R.)
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John L, Vijay R. Role of TAM Receptors in Antimalarial Humoral Immune Response. Pathogens 2024; 13:298. [PMID: 38668253 PMCID: PMC11054553 DOI: 10.3390/pathogens13040298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 04/29/2024] Open
Abstract
Immune response against malaria and the clearance of Plasmodium parasite relies on germinal-center-derived B cell responses that are temporally and histologically layered. Despite a well-orchestrated germinal center response, anti-Plasmodium immune response seldom offers sterilizing immunity. Recent studies report that certain pathophysiological features of malaria such as extensive hemolysis, hypoxia as well as the extrafollicular accumulation of short-lived plasmablasts may contribute to this suboptimal immune response. In this review, we summarize some of those studies and attempt to connect certain host intrinsic features in response to the malarial disease and the resultant gaps in the immune response.
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Affiliation(s)
- Lijo John
- Department of Veterinary Biochemistry, Kerala Veterinary and Animal Sciences University, Pookode 673576, Kerala, India
- Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60047, USA
| | - Rahul Vijay
- Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60047, USA
- Department of Microbiology and Immunology, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60047, USA
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Jain V, Sharma RK, Shukla MM, Khosla KK, Singh N, Shanmugam R. Burden of malaria during pregnancy in perennial transmission settings of two densely forested and remote blocks (Baihar and Birsa) of district Balaghat, Madhya Pradesh, central India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 36:351-357. [PMID: 38909309 DOI: 10.25259/nmji_535_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Background Malaria in pregnancy (MIP) is a major public health problem due to the vulnerability of pregnant women to infections, resulting in adverse maternal/foetal outcomes in endemic areas. Methods We did a field-based study to assess the burden of MIP (prevalence at the time of enrolment and follow-up) and to identify risk factors for MIP in the Birsa and Baihar blocks of district Balaghat in Madhya Pradesh, which have perennial malaria transmission. Malaria screening (during 2015-2017) was done by microscopy and bivalent rapid diagnostic test (SD Bioline RDT, malaria antigen Plasmodium falciparum/Plasmodium vivax Pf/Pv). Dried blood spots were used for haemoglobin estimation. Sociodemographic details with past and present pregnancy status were obtained. A subset of pregnant women were followed up for malaria during pregnancy. Women were also screened for malaria post delivery. Malaria treatment was given as per the National Guidelines of 2013. Multivariate analysis was done to assess independent risk factors for malaria. Results A total of 1728 pregnant women were screened, of which 1651 were included in the final analysis. Malaria prevalence at first screening was 23.4% (Pf 88%). Prevalence and Pf parasitaemia both were significantly higher among primigravid (G1) compared to multigravid (G>2; p value 0.012 and 0.019, respectively). Pregnant women of the Baiga ethnic group were more likely to have malaria compared to those belonging to the Gond group (OR [95% CI]; 2.4 [1.7-3.4]; p<0.00001) and non-indigenous group (OR [95% CI]; 8.3 [3.9-19.7]; p<0.00001). Primigravid status of women, first and second trimester of pregnancy, women belonging to indigenous ethnic tribal group and cash crop insufficiency for whole year (a socioeconomic indicator) in the family were the independent risk factors for malaria. Conclusion MIP is a major public health problem in forested tribal settlements of Birsa and Baihar blocks of Balaghat district in Madhya Pradesh and requires immediate intervention.
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Affiliation(s)
- Vidhan Jain
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
| | - Ravendra Kumar Sharma
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
| | - Man Mohan Shukla
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
| | | | - Neeru Singh
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
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DeMichele E, Sosnowski O, Buret AG, Allain T. Regulatory Functions of Hypoxia in Host-Parasite Interactions: A Focus on Enteric, Tissue, and Blood Protozoa. Microorganisms 2023; 11:1598. [PMID: 37375100 PMCID: PMC10303274 DOI: 10.3390/microorganisms11061598] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Body tissues are subjected to various oxygenic gradients and fluctuations and hence can become transiently hypoxic. Hypoxia-inducible factor (HIF) is the master transcriptional regulator of the cellular hypoxic response and is capable of modulating cellular metabolism, immune responses, epithelial barrier integrity, and local microbiota. Recent reports have characterized the hypoxic response to various infections. However, little is known about the role of HIF activation in the context of protozoan parasitic infections. Growing evidence suggests that tissue and blood protozoa can activate HIF and subsequent HIF target genes in the host, helping or hindering their pathogenicity. In the gut, enteric protozoa are adapted to steep longitudinal and radial oxygen gradients to complete their life cycle, yet the role of HIF during these protozoan infections remains unclear. This review focuses on the hypoxic response to protozoa and its role in the pathophysiology of parasitic infections. We also discuss how hypoxia modulates host immune responses in the context of protozoan infections.
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Affiliation(s)
- Emily DeMichele
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada; (E.D.); (O.S.); (A.G.B.)
- Inflammation Research Network, University of Calgary, Calgary, AB T2N 1N4, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Olivia Sosnowski
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada; (E.D.); (O.S.); (A.G.B.)
- Inflammation Research Network, University of Calgary, Calgary, AB T2N 1N4, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Andre G. Buret
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada; (E.D.); (O.S.); (A.G.B.)
- Inflammation Research Network, University of Calgary, Calgary, AB T2N 1N4, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Thibault Allain
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada; (E.D.); (O.S.); (A.G.B.)
- Inflammation Research Network, University of Calgary, Calgary, AB T2N 1N4, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, AB T2N 1N4, Canada
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Mardhiyyah K, Hariyanto T, Sardjono TW, Winarsih S, Nurseta T, Fitri LE. Fetal Growth Retardation is Associated with High Apoptotic Cells and Low VEGF Expression in Placenta of Malarial Pregnant Mice. Med Arch 2023; 77:258-262. [PMID: 37876558 PMCID: PMC10591248 DOI: 10.5455/medarh.2023.77.258-262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/05/2023] [Indexed: 10/26/2023] Open
Abstract
Background During pregnancy, pregnant women are susceptible to malaria, contributing significantly to maternal and infant mortality. Objective This research was conducted to study the effect of Plasmodium berghei infection in pregnant mice on fetal growth retardation through placental cell apoptosis and the change of local vascularization. Methods Eighteen pregnant Balb/c strain mice resulting from simultanously mating were divided into two groups those were nine pregnant mice used as non infected group and nine pregnant mice infected with Plasmodium berghei on day 9th post mating used as infected group respectively. On day 15th of post mating, all of the pregnant mice were killed. Fetal weights were measured using analytic balance. Apoptosis of placental cells and VEGF expression in the placental tissue were measured using immunohistochemistry. Results Result showed that there was sequestration of parasite-infected red blood cells (PRBCs) in intervillous space. Statistical analysis showed that the fetal weights in infected pregnant mice group was significantly lower than non infected one (p = 0.01), and the placental cell apoptosis in placental tissue of infected pregnant mice was significantly higher than the non infected one (p=0.00).There was also a significant difference on VEGF expression between infected group and non infected group (p= 0,00). Conclusion Plasmodium berghei infection in pregnant Balb/c mice can cause fetal growth retardation due to high of placental cell apoptosis and low VEGF expression.
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Affiliation(s)
- Kana Mardhiyyah
- Doctoral Program in Medical Science Faculty of Medicine Universitas Brawijaya, Malang, Indonesia
- Department of Biochemistry and Biomolecular Faculty of Medicine Universitas Brawijaya, Malang, Indonesia
| | - Tanto Hariyanto
- Department of Nursery Polytechnic Program Ministry of Health, Malang, Indonesia
| | - Teguh Wahju Sardjono
- Department of Parasitology Faculty of Medicine Universitas Brawijaya Malang, Indonesia
| | - Sri Winarsih
- Department of Pharmacy, Faculty of Medicine Universitas Brawijaya, Malang, Indonesia
| | - Tatit Nurseta
- Department of Obstetric and Gynaecology, Faculty of Medicine Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia
| | - Loeki Enggar Fitri
- Department of Parasitology Faculty of Medicine Universitas Brawijaya Malang, Indonesia
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Saghian R, Cahill LS, Debebe SK, Rahman A, Serghides L, McDonald CR, Weckman AM, Kain KC, Sled JG. Allometric scaling relationships in mouse placenta. J R Soc Interface 2022; 19:20220579. [PMID: 36349448 PMCID: PMC9653247 DOI: 10.1098/rsif.2022.0579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/19/2022] [Indexed: 08/29/2023] Open
Abstract
Fetal growth and maturation are highly intertwined with placental development during pregnancy. Here we used placental vascular morphology measurements (depth and span) as well as the umbilical artery (UA) diameter of previously published studies on three different mouse strains (C57BL6/J, CD-1 and BALB/c), which were exposed to different conditions (combination antiretroviral therapy, chronic maternal hypoxia and malaria infection) at different embryonic days, to test the hypothesis that placental vascularization and specifically the UA size affect conceptus weight. Interaction of each study parameter with embryonic day, strain and exposure to treatments are studied to investigate the stability of the scaling relationships across and/or within strains and conditions. In addition, the effect of UA diameter on the placental growth measurements (depth and span) is studied. These results show that the power-law scaling relationship of conceptus weight and placental depth with the UA diameter is conserved across strains and conditions with the scaling exponent of approximately 3/8 and 5/8, respectively. By contrast, the relationship between conceptus weight and either the placental span or depth is different between strains and conditions, suggesting multiple mechanisms of vascular adaptation.
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Affiliation(s)
- Rojan Saghian
- Mouse Imaging Centre, 25 Orde Street, Toronto, Ontario, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lindsay S. Cahill
- Mouse Imaging Centre, 25 Orde Street, Toronto, Ontario, Canada
- Department of Chemistry, Memorial University of Newfoundland, Newfoundland and Labrador, St John’s, Canada
| | - Sarah K. Debebe
- Mouse Imaging Centre, 25 Orde Street, Toronto, Ontario, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Biophysics, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
| | - Anum Rahman
- Mouse Imaging Centre, 25 Orde Street, Toronto, Ontario, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Biophysics, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
| | - Lena Serghides
- Department of Immunology and Institute of Medical Sciences, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Chloe R. McDonald
- Institute of Medical Science, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
- Sandra A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
| | - Andrea M. Weckman
- Sandra A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kevin C. Kain
- Institute of Medical Science, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
- Sandra A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John G. Sled
- Mouse Imaging Centre, 25 Orde Street, Toronto, Ontario, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Biophysics, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
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Naheda A, Aqeel S, Khan K, Khan W, Khan T. Immunohistopathological changes in the placenta of malaria-infected women in unstable transmission setting of Aligarh. Placenta 2022; 127:52-61. [PMID: 35970103 DOI: 10.1016/j.placenta.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/16/2022] [Accepted: 07/24/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Pregnant women are more susceptible to malaria due to a combination of physiological and immunological changes. The infection may even affect the growth and survival of the foetus, which mainly occur when parasite enters the placenta. The sequestration of infected erythrocytes may trigger the host response, leading to placental inflammation and altered development, affecting the structure and nutrient transport of placenta. These factors collectively impair placental functions and affect foetal growth. METHODS Pregnant women with peripheral parasitaemia for P. falciparum and P. vivax (20 each) were included in the present study, along with 15 age-matched uninfected healthy pregnant women. Placentae were analysed for the presence of local parasitaemia along with pathological lesions caused due to the parasite. Immunohistochemical staining for CD20, CD45 and CD68 cells was performed for examining the specific leucocytes in the intervillous space of the placenta. RESULTS Of the 20 individuals with P. falciparum, only seven placentae showed parasitaemia, whereas individuals with P. vivax showed no placental infection. The pathological changes observed in the P. falciparum-infected placenta include syncytial knotting, excess fibrinoid deposition, syncytiotrophoblast necrosis, syncytial rupture, thickening of trophoblast basement membrane and increased collagen deposition. Immunohistochemical staining showed a significant increase in B cells (CD20), leucocytes (CD45) and monocytes and macrophages (CD68) in the P. falciparum-infected placenta (p < 0.0001). DISCUSSION The result implies that P. falciparum is responsible for pathological alterations in placenta, affecting the nutrient transport across placenta and foetal growth. The immune cells also migrate to the placenta and accumulate in the intervillous space to show humoral and cell-mediated immunity against the parasite.
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Affiliation(s)
- Ansari Naheda
- Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, 202002, India.
| | - Sana Aqeel
- Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, 202002, India
| | - Khadija Khan
- Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, 202002, India
| | - Wajihullah Khan
- Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, 202002, India.
| | - Tamkin Khan
- Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College & Hospital, Aligarh Muslim University, Aligarh, 202002, India
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Ribeiro IM, Souto PCS, Borbely AU, Tanabe ELL, Cadavid A, Alvarez AM, Bueno J, Agudelo O, Robles RG, Ayala-Ramírez P, Sacerdoti F, Szasz T, Damiano AE, Ibarra C, Escudero C, Lima VV, Giachini FR. The limited knowledge of placental damage due to neglected infections: ongoing problems in Latin America. Syst Biol Reprod Med 2021; 66:151-169. [PMID: 32482148 DOI: 10.1080/19396368.2020.1753850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The placenta works as a selective barrier, protecting the fetus from potential infections that may affect the maternal organism during pregnancy. In this review, we will discuss several challenging infections that are common within Latin American countries and that may affect the maternal-fetal interface and pose risks to fetal development. Specifically, we will focus on emerging infectious diseases including the arboviruses, malaria, leishmaniasis, and the bacterial foodborne disease caused by Shiga toxin-producing Escherichia coli. We will also highlight some topics of interest currently being studied by research groups that comprise an international effort aimed at filling the knowledge gaps in this field. These topics address the relationship between exposure to microorganisms and placental abnormalities, congenital anomalies, and complications of pregnancy. ABBREVIATIONS ADE: antibody-dependent enhancement; CCL2: monocyte chemoattractant protein-1; CCL3: macrophage inflammatory protein-1 α; CCL5: chemokine (C-C motif) ligand 5; CHIKV: chikungunya virus; DCL: diffuse cutaneous leishmaniasis; DENV: dengue virus; Gb3: glycolipid globotriaosylceramyde; HIF: hypoxia-inducible factor; HUS: hemolytic uremic syndrome; IFN: interferon; Ig: immunoglobulins; IL: interleukin; IUGR: intrauterine growth restriction; LCL: localized cutaneous leishmaniasis; LPS: lipopolysaccharid; MCL: mucocutaneous leishmaniasis; NO: nitric oxide; PCR: polymerase chain reaction; PGF: placental growth factor; PM: placental malaria; RIVATREM: Red Iberoamericana de Alteraciones Vasculares em transtornos del Embarazo; sVEGFR: soluble vascular endothelial growth factor receptor; STEC: shiga toxin-producing Escherichia coli; stx: shiga toxin protein; TNF: tumor necrosis factor; TOAS: T cell original antigenic sin; Var2CSA: variant surface antigen 2-CSA; VEGF: vascular endothelial growth factor; VL: visceral leishmaniasis; WHO: world health organization; YFV: yellow fever virus; ZIKV: Zika virus.
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Affiliation(s)
- Isabela Moreti Ribeiro
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
| | - Paula Cristina Souza Souto
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
| | - Alexandre U Borbely
- Cell Biology Laboratory, Institute of Health and Biological Sciences, Federal University of Alagoas , Alagoas, Brazil
| | - Eloiza Lopes Lira Tanabe
- Cell Biology Laboratory, Institute of Health and Biological Sciences, Federal University of Alagoas , Alagoas, Brazil
| | - Angela Cadavid
- Grupo Reproducción, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Angela M Alvarez
- Grupo Reproducción, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Julio Bueno
- Grupo Reproducción, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Olga Agudelo
- Grupo Salud Y Comunidad, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Reggie García Robles
- Physiological Sciences Department, Faculty of Medicine, Pontificia Universidad Javeriana , Bogotá, Colombia
| | - Paola Ayala-Ramírez
- Human Genetics Institute, Facultad De Medicina, Pontificia Universidad Javeriana , Bogotá, Colombia
| | - Flavia Sacerdoti
- Laboratorio De Fisiopatogenia, Instituto De Fisiología Y Biofísica Bernardo Houssay (IFIBIO)- CONICET- Departamento De Fisiología, Facultad De Medicina, Universidad De Buenos Aires . Buenos Aires, Argentina
| | - Theodora Szasz
- Departamento of Physiology, Augusta University , Augusta, USA
| | - Alicia E Damiano
- Cátedra De Biología Celular Y Molecular, Departamento De Ciencias Biológicas, Facultad De Farmacia Y Bioquímica, Universidad De Buenos Aires . Buenos Aires, Argentina.,Laboratorio De Biología De La Reproducción, Instituto De Fisiología Y Biofísica Bernardo Houssay (IFIBIO)- CONICET- Facultad De Medicina, Universidad De Buenos Aires . Buenos Aires, Argentina
| | - Cristina Ibarra
- Cátedra De Biología Celular Y Molecular, Departamento De Ciencias Biológicas, Facultad De Farmacia Y Bioquímica, Universidad De Buenos Aires . Buenos Aires, Argentina
| | - Carlos Escudero
- Vascular Physiology Laboratory, Group of Research and Innovation in Vascular Health (GRIVAS Health), Basic Sciences Department Faculty of Sciences, Universidad Del Bio-Bio , Chillan, Chile
| | - Victor V Lima
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
| | - Fernanda R Giachini
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
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Omer SA, Sulaiman SM. The Placenta and Plasmodium Infections: a Case Study from Blue Nile State, Sudan. CURRENT TROPICAL MEDICINE REPORTS 2020. [DOI: 10.1007/s40475-020-00214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lawford HLS, Lee AC, Kumar S, Liley HG, Bora S. Establishing a conceptual framework of the impact of placental malaria on infant neurodevelopment. Int J Infect Dis 2019; 84:54-65. [PMID: 31028878 DOI: 10.1016/j.ijid.2019.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 01/11/2023] Open
Abstract
A novel conceptual framework to describe the relationship between placental malaria and adverse infant neurodevelopmental outcomes is proposed. This conceptual framework includes three distinct stages: (1) maternal and environmental risk factors for the development of placental malaria; (2) placental pathology and inflammation associated with placental malaria infection; and (3) postnatal impacts of placental malaria. The direct, indirect, and bidirectional effects of these risk factors on infant neurodevelopment across the three stages were critically examined. These factors ultimately culminate in an infant phenotype that not only leads to adverse birth outcomes, but also to increased risks of neurological, cognitive, and behavioural deficits that may impact the quality of life in this high-risk population. Multiple risk factors were identified in this conceptual framework; nonetheless, based on current evidence, a key knowledge gap is the uncertainty regarding which are the most important and how exactly they interact.
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Affiliation(s)
- Harriet L S Lawford
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | - Anne Cc Lee
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sailesh Kumar
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | - Helen G Liley
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia.
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Park MK, Ko EJ, Jeon KY, Kim H, Jo JO, Baek KW, Kang YJ, Choi YH, Hong Y, Ock MS, Cha HJ. Induction of Angiogenesis by Malarial Infection through Hypoxia Dependent Manner. THE KOREAN JOURNAL OF PARASITOLOGY 2019; 57:117-125. [PMID: 31104403 PMCID: PMC6526210 DOI: 10.3347/kjp.2019.57.2.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/23/2022]
Abstract
Malarial infection induces tissue hypoxia in the host through destruction of red blood cells. Tissue hypoxia in malarial infection may increase the activity of HIF1α through an intracellular oxygen-sensing pathway. Activation of HIF1α may also induce vascular endothelial growth factor (VEGF) to trigger angiogenesis. To investigate whether malarial infection actually generates hypoxia-induced angiogenesis, we analyzed severity of hypoxia, the expression of hypoxia-related angiogenic factors, and numbers of blood vessels in various tissues infected with Plasmodium berghei. Infection in mice was performed by intraperitoneal injection of 2×106 parasitized red blood cells. After infection, we studied parasitemia and survival. We analyzed hypoxia, numbers of blood vessels, and expression of hypoxia-related angiogenic factors including VEGF and HIF1α. We used Western blot, immunofluorescence, and immunohistochemistry to analyze various tissues from Plasmodium berghei-infected mice. In malaria-infected mice, parasitemia was increased over the duration of infection and directly associated with mortality rate. Expression of VEGF and HIF1α increased with the parasitemia in various tissues. Additionally, numbers of blood vessels significantly increased in each tissue type of the malaria-infected group compared to the uninfected control group. These results suggest that malarial infection in mice activates hypoxia-induced angiogenesis by stimulation of HIF1α and VEGF in various tissues.
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Affiliation(s)
- Mi-Kyung Park
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
| | - Eun-Ji Ko
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
- Department of Biological Science, Pusan National University, Busan 46241, Korea
| | - Kyung-Yoon Jeon
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
| | - Hyunsu Kim
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
- Department of Biological Science, Pusan National University, Busan 46241, Korea
| | - Jin-Ok Jo
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
| | - Kyung-Wan Baek
- Department of Parasitology, College of Medicine, Pusan National University, Busan 50612, Korea
| | - Yun-Jeong Kang
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
| | - Yung Hyun Choi
- Anti-Aging Research Center and Department of Biochemistry, Dongeui University College of Korean Medicine, Busan 47227, Korea
| | - Yeonchul Hong
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu 41944, Korea
| | - Mee Sun Ock
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
| | - Hee-Jae Cha
- Department of Parasitology and Genetics, Kosin University College of Medicine, Busan 49267, Korea
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Seitz J, Morales-Prieto DM, Favaro RR, Schneider H, Markert UR. Molecular Principles of Intrauterine Growth Restriction in Plasmodium Falciparum Infection. Front Endocrinol (Lausanne) 2019; 10:98. [PMID: 30930847 PMCID: PMC6405475 DOI: 10.3389/fendo.2019.00098] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 02/01/2019] [Indexed: 12/21/2022] Open
Abstract
Malaria in pregnancy still constitutes a particular medical challenge in tropical and subtropical regions. Of the five Plasmodium species that are pathogenic to humans, infection with Plasmodium falciparum leads to fulminant progression of the disease with massive impact on pregnancy. Severe anemia of the mother, miscarriage, stillbirth, preterm delivery and intrauterine growth restriction (IUGR) with reduced birth weight are frequent complications that lead to more than 10,000 maternal and 200,000 perinatal deaths annually in sub-Saharan Africa alone. P. falciparum can adhere to the placenta via the expression of the surface antigen VAR2CSA, which leads to sequestration of infected erythrocytes in the intervillous space. This process induces a placental inflammation with involvement of immune cells and humoral factors. Especially, monocytes get activated and change the release of soluble mediators, including a variety of cytokines. This proinflammatory environment contributes to disorders of angiogenesis, blood flow, autophagy, and nutrient transport in the placenta and erythropoiesis. Collectively, they impair placental functions and, consequently, fetal growth. The discovery that women in endemic regions develop a certain immunity against VAR2CSA-expressing parasites with increasing number of pregnancies has redefined the understanding of malaria in pregnancy and offers strategies for the development of vaccines. The following review gives an overview of molecular processes in P. falciparum infection in pregnancy which may be involved in the development of IUGR.
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Affiliation(s)
- Johanna Seitz
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | | | - Rodolfo R. Favaro
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Henning Schneider
- Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
- Department of Obstetrics and Gynecology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Udo Rudolf Markert
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
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Fleiss B, Wong F, Brownfoot F, Shearer IK, Baud O, Walker DW, Gressens P, Tolcos M. Knowledge Gaps and Emerging Research Areas in Intrauterine Growth Restriction-Associated Brain Injury. Front Endocrinol (Lausanne) 2019; 10:188. [PMID: 30984110 PMCID: PMC6449431 DOI: 10.3389/fendo.2019.00188] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/06/2019] [Indexed: 12/16/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is a complex global healthcare issue. Concerted research and clinical efforts have improved our knowledge of the neurodevelopmental sequelae of IUGR which has raised the profile of this complex problem. Nevertheless, there is still a lack of therapies to prevent the substantial rates of fetal demise or the constellation of permanent neurological deficits that arise from IUGR. The purpose of this article is to highlight the clinical and translational gaps in our knowledge that hamper our collective efforts to improve the neurological sequelae of IUGR. Also, we draw attention to cutting-edge tools and techniques that can provide novel insights into this disorder, and technologies that offer the potential for better drug design and delivery. We cover topics including: how we can improve our use of crib-side monitoring options, what we still need to know about inflammation in IUGR, the necessity for more human post-mortem studies, lessons from improved integrated histology-imaging analyses regarding the cell-specific nature of magnetic resonance imaging (MRI) signals, options to improve risk stratification with genomic analysis, and treatments mediated by nanoparticle delivery which are designed to modify specific cell functions.
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Affiliation(s)
- Bobbi Fleiss
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- NeuroDiderot, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom
- *Correspondence: Bobbi Fleiss
| | - Flora Wong
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Monash Newborn, Monash Children's Hospital, Clayton, VIC, Australia
| | - Fiona Brownfoot
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC, Australia
| | - Isabelle K. Shearer
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Olivier Baud
- NeuroDiderot, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- Division of Neonatal Intensive Care, University Hospitals of Geneva, Children's Hospital, University of Geneva, Geneva, Switzerland
| | - David W. Walker
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Pierre Gressens
- NeuroDiderot, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom
- PremUP, Paris, France
| | - Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
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RAHMAH Z, WAHJU-SARDJONO T, ENGGAR-FITRI L, ULFIATI A, UNGU B, ZULHAIDAH-ARTHAMIN M, NORAHMAWATI E. Accumulation of CD4 and CD8 T Cells in Placenta of Malaria Infected Mice Induces the Expression of Hypoxia Inducible Factor-1α (HIF-1α) and Low Birth Weight (LBW) of the Fetus. IRANIAN JOURNAL OF PARASITOLOGY 2019; 14:604-613. [PMID: 32099563 PMCID: PMC7028234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Placental malaria involves the sequestration of infected erythrocytes and infiltration of monocytes, helper T cells (CD4), cytotoxic T cells (CD8) as well as T-cell intracellular antigen-1 (TIA-1) in placental intervillous space. These may interferes the nutrient and oxygen transport, causing placental hypoxia and insufficiency that may affect the fetal growth. This study aimed to prove whether the infiltration of lymphocytes in placental malaria mice increases the expression of HIF-1α thus causes fetal Low Birth Weight (LBW). METHODS Nine pregnant BALB/c mice that infected with Plasmodium berghei ANKA strain on day 9 post mating were used as treatment group and 8 non infected pregnant mice were used as control group. The mice were sacrificed on day 18 post mating; then the fetus was weighed individually and the placentas were isolated separately. Expression of CD4, CD8 and HIF-1α were counted by immunohistochemistry using CD4 monoclonal Ab (Santa cruz, sc-59031 CD4) and CD 8 monoclonal Ab (NeoMarker RM-9116-S0) as well as anti-HIF-1α antibody (H1α67) ChIP Grade from Abcam. RESULTS There was a higher expression of CD8, CD4 and HIF-1α in infected placenta compare to normal placenta. Analysis using Structural Equation Modeling (SEM) showed expression CD8 and CD4 caused an increase expression of HIF-1α in placenta (t ≥1.96). Expression of HIF-1α caused low fetal weight (t ≥1.96). CONCLUSION In placental malaria, the expression of CD4 and CD8 induce placental hypoxia characterized by increased expression of HIF-1α that causes LBW.
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Affiliation(s)
- Zainabur RAHMAH
- Laboratory of Parasitology, Faculty of Medicine and Health Sciences, Universitas Islam Negeri Maulana Malik Ibrahim, Malang, Indonesia
| | - Teguh WAHJU-SARDJONO
- Department of Parasitology, Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Loeki ENGGAR-FITRI
- Department of Parasitology, Malaria Research Group, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia,Correspondence Email:
| | - Adilah ULFIATI
- Master Program in Biomedical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Bougenvil UNGU
- Medicine Study Program, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Maimun ZULHAIDAH-ARTHAMIN
- Department of Clinical Pathology, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Eviana NORAHMAWATI
- Department of Pathology, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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Sacerdoti F, Scalise ML, Burdet J, Amaral MM, Franchi AM, Ibarra C. Shiga Toxin-Producing Escherichia coli Infections during Pregnancy. Microorganisms 2018; 6:E111. [PMID: 30360505 PMCID: PMC6313425 DOI: 10.3390/microorganisms6040111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 01/08/2023] Open
Abstract
Gastrointestinal infection with Shiga toxin-producing Escherichia coli (STEC) causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS), characterized by hemolytic anemia, thrombocytopenia and acute renal failure. The main virulence factor of STEC is Shiga toxin (Stx), which is responsible for HUS development. STEC can produce Stx type 1 and/or 2 (Stx1, Stx2) and their variants, Stx2 being more frequently associated with severe cases of HUS. This pathology occurs in 5⁻15% of cases with STEC infection when Stx gain access to the bloodstream and causes damage in the target organs such as the kidney and brain. STEC infections affect mainly young children, although the large HUS outbreak with a new Stx2-producing STEC O104:H4 in Europe in 2011 involved more adults than children, and women were over-represented. Maternal infections during pregnancy are associated with adverse pregnancy outcomes. Studies in rats showed that Stx2 binds to the utero-placental unit and causes adverse pregnancy outcomes. In this article, we provide a brief overview of Stx2 action on placental tissues and discuss whether they might cause pregnancy loss or preterm birth.
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Affiliation(s)
- Flavia Sacerdoti
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO Houssay-CONICET), Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Buenos Aires 1121, Argentina.
| | - María Luján Scalise
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO Houssay-CONICET), Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Buenos Aires 1121, Argentina.
| | - Juliana Burdet
- Laboratorio de Hematología, Hospital Universitario Austral, Pilar, Buenos Aires 1629, Argentina.
| | - María Marta Amaral
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO Houssay-CONICET), Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Buenos Aires 1121, Argentina.
| | - Ana María Franchi
- CEFYBO-CONICET, Universidad de Buenos Aires, Buenos Aires 1121, Argentina.
| | - Cristina Ibarra
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO Houssay-CONICET), Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Buenos Aires 1121, Argentina.
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Harrington WE, Kanaan SB, Muehlenbachs A, Morrison R, Stevenson P, Fried M, Duffy PE, Nelson JL. Maternal Microchimerism Predicts Increased Infection but Decreased Disease due to Plasmodium falciparum During Early Childhood. J Infect Dis 2017; 215:1445-1451. [PMID: 28329160 DOI: 10.1093/infdis/jix129] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/08/2017] [Indexed: 11/13/2022] Open
Abstract
Background A mother's infection with placental malaria (PM) can affect her child's susceptibility to malaria, although the mechanism remains unclear. The fetus acquires a small amount of maternal cells and DNA known as maternal microchimerism (MMc), and we hypothesized that PM increases MMc and that MMc alters risk of Plasmodium falciparum malaria during infancy. Methods In a nested cohort from Muheza, Tanzania, we evaluated the presence and level of cord blood MMc in offspring of women with and without PM. A maternal-specific polymorphism was identified for each maternal-infant pair, and MMc was assayed by quantitative polymerase chain reaction. The ability of MMc to predict malaria outcomes during early childhood was evaluated in longitudinal models. Results Inflammatory PM increased the detection rate of MMc among offspring of primigravidae and secundigravidae, and both noninflammatory and inflammatory PM increased the level of MMc. Detectable MMc predicted increased risk of positive blood smear but, interestingly, decreased risk of symptomatic malaria and malaria hospitalization. Conclusions The acquisition of MMc may result in increased malaria infection but protection from malaria disease. Future studies should be directed at the cellular component of MMc, with attention to its ability to directly or indirectly coordinate anti-malarial immune responses in the offspring.
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Affiliation(s)
- Whitney E Harrington
- Department of Pediatrics, University of Washington School of Medicine/Seattle Children's Hospital, Washington
| | - Sami B Kanaan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Atis Muehlenbachs
- Department of Pathology, University of Washington, Seattle, Washington
| | - Robert Morrison
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Philip Stevenson
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - J Lee Nelson
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Division of Rheumatology, University of Washington, Seattle
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Mphande FA. Infectious Diseases. INFECTIOUS DISEASES AND RURAL LIVELIHOOD IN DEVELOPING COUNTRIES 2016. [PMCID: PMC7120015 DOI: 10.1007/978-981-10-0428-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Livelihoods play a role in the infectious diseases that a population can be exposed to and the risk attached to it. Poor living conditions, lack of income and other basic amenities such as safe drinking water and toilets, poor healthcare facilities and low literacy levels have contributed to the spread of infectious diseases in rural communities. Depending on the mode of transmission these diseases can spread from one person, to communities, to a country, across borders and a whole region. This makes infectious diseases one of the most dangerous threats to the global population. There are still millions of people affected by infectious diseases worldwide, most of which live in poor rural regions of developing countries. These rural communities, which depend on livelihoods such as farming, fishing, livestock rearing, hunting and so on, are vulnerable to infectious diseases and their livelihoods are affected by the impact of these diseases.
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CAHAYANI WA, NORAHMAWATI E, BUDIARTI N, FITRI LE. Increased CD11b and Hypoxia-Inducible Factors-1alpha Expressions in the Lung Tissue and Surfactant Protein-D Levels in Serum Are Related with Acute Lung Injury in Severe Malaria of C57BL/6 Mice. IRANIAN JOURNAL OF PARASITOLOGY 2016; 11:303-315. [PMID: 28127335 PMCID: PMC5256046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We aimed to reveal the role of CD11b and hypoxia-inducible factors-1alpha (HIF-1α) expressions on monocytes and alveolar macrophages of lung tissue, and the levels of serum surfactant protein-D (SP-D) in severe malaria-associated acute lung injury (ALI). METHODS The C57BL/6 mice were divided into control group, renal malaria group (inoculated with 106Plasmodium berghei ANKA), and cerebral malaria group (inoculated with 107P. berghei ANKA). The expressions of CD11b and HIF-1α in lung tissue were observed by immunohistochemistry, and serum SP-D levels were measured by ELISA. This study was conducted from June 2014 to February 2015 in the Laboratory of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang. RESULTS The CD11b expression on pulmonary tissue of renal and cerebral malaria mice were significantly higher than control mice (P=0.002; P=0.002), as well as the HIF-1α expression on pulmonary tissue (P=0.002; P=0.002). The level of serum SP-D in renal malaria and cerebral malaria mice were significantly higher than control mice (P=0.002; P=0.002). We found a strong correlation between the expression of CD11b and HIF-1α in lung tissue (r=0.937, P=0.000), as well as between CD11b expression and serum SP-D levels (r=0.907, P=0.000) and between HIF-1α expression and serum SP-D levels (r=0.913, P=0.000). CONCLUSION Severe malaria-associated ALI increased the expression of CD11b and HIF-1α in the lung tissue and increased serum SP-D levels of C57BL/6 mice significantly.
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Affiliation(s)
- Wike Astrid CAHAYANI
- Master Program in Biomedical Sciences, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Eviana NORAHMAWATI
- Dept. of Anatomic Pathology, Dr. Saiful Anwar Hospital/Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Niniek BUDIARTI
- Division of Tropical Infection, Dept. of Internal Medicine, Dr. Saiful Anwar Hospital/Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Loeki Enggar FITRI
- Dept. of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia,Correspondence
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Ruizendaal E, van Leeuwen E, Mens PF. Peripheral and placental biomarkers in women with placental malaria: a systematic review. Biomark Med 2015; 9:217-39. [PMID: 25731209 DOI: 10.2217/bmm.14.117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Placental malaria (PM) causes significant morbidity in mothers and infants. Diagnosis of PM during pregnancy is however problematic due to placental sequestration of parasites. Host biomarkers may therefore be used as a diagnostic method. In this systematic review most studies focused on inflammatory markers. A trend was observed for increased IL-10 and TNF-α in PM positives. These markers are however unspecific, thus a combination of multiple biomarkers involved in different pathophysiological pathways of PM is indicated. Of interest are inflammatory markers (TNF-R2, CXCL-13), markers of lipid metabolism (APO-B), angiogenesis (sFlt-1) and hormones (estradiol). As the majority of published studies tested biomarker levels only at delivery, more longitudinal cohort studies will be necessary to detect biomarkers during pregnancy that can predict PM.
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Affiliation(s)
- Esmée Ruizendaal
- KIT Biomedical Research, Royal Tropical Institute (KIT), Amsterdam, The Netherlands
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21
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Syncytiotrophoblast Functions and Fetal Growth Restriction during Placental Malaria: Updates and Implication for Future Interventions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:451735. [PMID: 26587536 PMCID: PMC4637467 DOI: 10.1155/2015/451735] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/08/2015] [Accepted: 10/04/2015] [Indexed: 01/06/2023]
Abstract
Syncytiotrophoblast lines the intervillous space of the placenta and plays important roles in fetus growth throughout gestation. However, perturbations at the maternal-fetal interface during placental malaria may possibly alter the physiological functions of syncytiotrophoblast and therefore growth and development of the embryo in utero. An understanding of the influence of placental malaria on syncytiotrophoblast function is paramount in developing novel interventions for the control of placental pathology associated with placental malaria. In this review, we discuss how malaria changes syncytiotrophoblast function as evidenced from human, animal, and in vitro studies and, further, how dysregulation of syncytiotrophoblast function may impact fetal growth in utero. We also formulate a hypothesis, stemming from epidemiological observations, that nutrition may override pathogenesis of placental malaria-associated-fetal growth restriction. We therefore recommend studies on nutrition-based-interventional approaches for high placental malaria-risk women in endemic areas. More investigations on the role of nutrition on placental malaria pathogenesis are needed.
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Fitri LE, Sardjono TW, Rahmah Z, Siswanto B, Handono K, Dachlan YP. Low Fetal Weight is Directly Caused by Sequestration of Parasites and Indirectly by IL-17 and IL-10 Imbalance in the Placenta of Pregnant Mice with Malaria. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:189-96. [PMID: 25925177 PMCID: PMC4416375 DOI: 10.3347/kjp.2015.53.2.189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 11/10/2014] [Accepted: 01/10/2015] [Indexed: 01/05/2023]
Abstract
The sequestration of infected erythrocytes in the placenta can activate the syncytiotrophoblast to release cytokines that affect the micro-environment and influence the delivery of nutrients and oxygen to fetus. The high level of IL-10 has been reported in the intervillous space and could prevent the pathological effects. There is still no data of Th17 involvement in the pathogenesis of placental malaria. This study was conducted to reveal the influence of placental IL-17 and IL-10 levels on fetal weights in malaria placenta. Seventeen pregnant BALB/C mice were divided into control (8 pregnant mice) and treatment group (9 pregnant mice infected by Plasmodium berghei). Placental specimens stained with hematoxylin and eosin were examined to determine the level of cytoadherence by counting the infected erythrocytes in the intervillous space of placenta. Levels of IL-17 and IL-10 in the placenta were measured using ELISA. All fetuses were weighed by analytical balance. Statistical analysis using Structural Equation Modeling showed that cytoadherence caused an increased level of placental IL-17 and a decreased level of placental IL-10. Cytoadherence also caused low fetal weight. The increased level of placental IL-17 caused low fetal weight, and interestingly low fetal weight was caused by a decrease of placental IL-10. It can be concluded that low fetal weight in placental malaria is directly caused by sequestration of the parasites and indirectly by the local imbalance of IL-17 and IL-10 levels.
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Affiliation(s)
- Loeki Enggar Fitri
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia
| | - Teguh Wahju Sardjono
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia
| | - Zainabur Rahmah
- Reproductive Biology Doctoral Program in Medical Science, Faculty of Medicine, Universitas Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia
| | - Budi Siswanto
- Department of Obstetrics and Gynecology, dr. Saiful Anwar Hospital/Faculty of Medicine, Universitas Brawijaya, Jalan Jaksa Agung Suprapto No.2, Malang, East Java 65122, Indonesia
| | - Kusworini Handono
- Department Clinical Pathology, Faculty of Medicine, Universitas Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia
| | - Yoes Prijatna Dachlan
- Department of Parasitology, Faculty of Medicine, Universitas Airlangga, Jalan Mayjen Prof. Dr. Moestopo No. 47 Surabaya, East Java, Indonesia
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Agudelo OM, Aristizabal BH, Yanow SK, Arango E, Carmona-Fonseca J, Maestre A. Submicroscopic infection of placenta by Plasmodium produces Th1/Th2 cytokine imbalance, inflammation and hypoxia in women from north-west Colombia. Malar J 2014; 13:122. [PMID: 24673747 PMCID: PMC3972514 DOI: 10.1186/1475-2875-13-122] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 03/22/2014] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND A large-scale study was set up in order to study the epidemiology, clinical aspects, and immunopathology of gestational and placental malaria in north-west Colombia. In this region, recent reports using a qPCR technique, confirmed frequencies of infection, by Plasmodium falciparum or Plasmodium vivax, up to 45%. Given the high rates of infection observed both in mother and placenta, a first exploratory study was proposed in order to characterize the effect on the inflammation status, tissue damage and hypoxia in Plasmodium spp. infected placentas. METHODS A descriptive, prospective, cross-sectional design was applied to pregnant women with (PM+) and without (PM-) placental malaria. Messenger RNA expression of Fas, FasL; COX-1, COX-2, HIF, VEGF, and the cytokines IL-2, IL-4, IL-10, IFN-γ and TNF, were measured in peripheral and placental blood using a quantitative PCR. The percentage of apoptotic cells was determined with a TUNEL assay. RESULTS In total 50 placentas were studied: 25 were positive for submicroscopic infection and 25 were negative for Plasmodium infection. Expression of IL-4 and IL-10 was observed high in placental tissue of PM+, while IL-2 was high in peripheral blood of the same group. Expression of TNF and IFNγ in peripheral blood of the PM + group was high. Similarly, the apoptotic index and Fas expression were significantly high in PM+. However, FasL expression was observed low in PM + compared to PM-. Inflammation markers (HIF, VEGF) and hypoxia markers (COX-1, COX-2) were high in the PM + group. CONCLUSION During placental malaria expression of some pro-inflammatory cytokines is up-regulated and markers of hypoxia and tissue damage are increased in cases of submicroscopic infection.
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Affiliation(s)
| | | | | | | | | | - Amanda Maestre
- Grupo "Salud y Comunidad-César Uribe Piedrahita", Universidad de Antioquia, Medellin, Colombia.
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Malek A, Mattison DR. Drug development for use during pregnancy: impact of the placenta. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.10.29] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Chandrasiri UP, Chua CLL, Umbers AJ, Chaluluka E, Glazier JD, Rogerson SJ, Boeuf P. Insight Into the Pathogenesis of Fetal Growth Restriction in Placental Malaria: Decreased Placental Glucose Transporter Isoform 1 Expression. J Infect Dis 2013; 209:1663-7. [DOI: 10.1093/infdis/jit803] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Placental histopathological changes associated with Plasmodium vivax infection during pregnancy. PLoS Negl Trop Dis 2013; 7:e2071. [PMID: 23459254 PMCID: PMC3573078 DOI: 10.1371/journal.pntd.0002071] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 01/08/2013] [Indexed: 12/30/2022] Open
Abstract
Histological evidence of Plasmodium in the placenta is indicative of placental malaria, a condition associated with severe outcomes for mother and child. Histological lesions found in placentas from Plasmodium-exposed women include syncytial knotting, syncytial rupture, thickening of the placental barrier, necrosis of villous tissue and intervillositis. These histological changes have been associated with P. falciparum infections, but little is known about the contribution of P. vivax to such changes. We conducted a cross-sectional study with pregnant women at delivery and assigned them to three groups according to their Plasmodium exposure during pregnancy: no Plasmodium exposure (n = 41), P. vivax exposure (n = 59) or P. falciparum exposure (n = 19). We evaluated their placentas for signs of Plasmodium and placental lesions using ten histological parameters: syncytial knotting, syncytial rupture, placental barrier thickness, villi necrosis, intervillous space area, intervillous leucocytes, intervillous mononucleates, intervillous polymorphonucleates, parasitized erythrocytes and hemozoin. Placentas from P. vivax-exposed women showed little evidence of Plasmodium or hemozoin but still exhibited more lesions than placentas from women not exposed to Plasmodium, especially when infections occurred twice or more during pregnancy. In the Brazilian state of Acre, where diagnosis and primary treatment are readily available and placental lesions occur in the absence of detected placental parasites, relying on the presence of Plasmodium in the placenta to evaluate Plasmodium-induced placental pathology is not feasible. Multivariate logistic analysis revealed that syncytial knotting (odds ratio [OR], 4.21, P = 0.045), placental barrier thickness (OR, 25.59, P = 0.021) and mononuclear cells (OR, 4.02, P = 0.046) were increased in placentas from P. vivax-exposed women when compared to women not exposed to Plasmodium during pregnancy. A vivax-score was developed using these three parameters (and not evidence of Plasmodium) that differentiates between placentas from P. vivax-exposed and unexposed women. This score illustrates the importance of adequate management of P. vivax malaria during pregnancy. Malaria during pregnancy remains a risk for approximately 125 million women each year. Adverse outcomes of malaria during pregnancy include maternal anemia and low infant birth weight. Additionally, the presence of malaria parasites, namely Plasmodium falciparum, has been associated with the occurrence of placental lesions. In the Amazonian region of Brazil Plasmodium vivax is the primary parasite species. To date, little is known about the capacity of this parasite to induce placental lesions. In this study we have used ten histological parameters to evaluate the effect of exposure to Plasmodium vivax during pregnancy on the occurrence of placental lesions when compared to placentas from non-exposed women. Placentas from women exposed to Plasmodium falciparum were used as controls. Placentas from Plasmodium vivax-exposed placentas did not have strong evidence of placental parasites but had increased syncytial knotting, thickness of the placental barrier and mononuclear cells when compared to non-exposed women. We developed a score based on these three parameters and not on the presence of placental parasites that enables us to visualize the effect that Plasmodium vivax has on placentas from women infected during pregnancy.
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Boeuf P, Aitken EH, Chandrasiri U, Chua CLL, McInerney B, McQuade L, Duffy M, Molyneux M, Brown G, Glazier J, Rogerson SJ. Plasmodium falciparum malaria elicits inflammatory responses that dysregulate placental amino acid transport. PLoS Pathog 2013; 9:e1003153. [PMID: 23408887 PMCID: PMC3567154 DOI: 10.1371/journal.ppat.1003153] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 11/21/2012] [Indexed: 01/09/2023] Open
Abstract
Placental malaria (PM) can lead to poor neonatal outcomes, including low birthweight due to fetal growth restriction (FGR), especially when associated with local inflammation (intervillositis or IV). The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplacental amino acid transport, especially through the system A group of amino acid transporters, has been implicated. We hypothesized that PM-associated FGR could result from impairment of transplacental amino acid transport triggered by IV. In a cohort of Malawian women and their infants, the expression and activity of system A (measured by Na+-dependent 14C-MeAIB uptake) were reduced in PM, especially when associated with IV, compared to uninfected placentas. In an in vitro model of PM with IV, placental cells exposed to monocyte/infected erythrocytes conditioned medium showed decreased system A activity. Amino acid concentrations analyzed by reversed phase ultra performance liquid chromatography in paired maternal and cord plasmas revealed specific alterations of amino acid transport by PM, especially with IV. Overall, our data suggest that the fetoplacental unit responds to PM by altering its placental amino acid transport to maintain adequate fetal growth. However, IV more profoundly compromises placental amino acid transport function, leading to FGR. Our study offers the first pathogenetic explanation for FGR in PM. Malaria infection during pregnancy can cause fetal growth restriction and low birthweight associated with high infant mortality and morbidity rates. The pathogenesis of fetal growth restriction in placental malaria is largely unknown, but in other pathological pregnancies, impaired transplacental amino acid transport has been implicated. In a cohort of Malawian women and their infants, we found that placental malaria, especially when associated with local inflammation, was associated with decreased expression and activity of an important group of amino acid placental transporters. Using an in vitro model of placental malaria with local inflammation, we discovered that maternal monocyte products could impair the activity of amino acid transporters on placental cells. Amino acid concentrations in paired maternal and cord plasmas revealed specific alterations of amino acid transport by placental malaria, especially with local inflammation. Overall, our data suggest that, more than malaria infection per se, the local inflammation it triggers compromises placental amino acid transport function, leading to fetal growth restriction. Greater understanding of the mechanisms involved, combined with interventions to improve fetal growth in malaria, are important priorities in areas of the world where the co-existence of malaria and maternal malnutrition threatens the health and lives of millions of young babies.
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Affiliation(s)
- Philippe Boeuf
- The University of Melbourne, Department of Medicine-RMH, Parkville, Victoria, Australia.
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CHIABI A, NGUEFACK S, MAH E, NODEM S, MBUAGBAW L, MBONDA E, TCHOKOTEU PF, DOH FRCOG A. Risk factors for birth asphyxia in an urban health facility in cameroon. IRANIAN JOURNAL OF CHILD NEUROLOGY 2013; 7:46-54. [PMID: 24665306 PMCID: PMC3943072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates. MATERIALS & METHODS This study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors. RESULTS The prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour, prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% had a satisfactory outcome. CONCLUSION The incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal visits through informing and communicating with pregnant women should be reinforced.
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Affiliation(s)
- Andreas CHIABI
- Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Seraphin NGUEFACK
- Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Evelyne MAH
- Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | | | - Lawrence MBUAGBAW
- Centre for the Development of Best Practices in Health, Yaounde Central Hospital, Avenue Henri Dunant, PO Box 87, Messa, Yaoundé, Cameroon
| | - Elie MBONDA
- Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Pierre-Fernand TCHOKOTEU
- Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Anderson DOH FRCOG
- Yaounde Gynaeco-Obstetric and Pediatric Hospital,Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
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Manirakiza A, Serdouma E, Heredeïbona LS, Djalle D, Madji N, Moyen M, Soula G, Le Faou A, Delmont J. Rational case management of malaria with a rapid diagnostic test, Paracheck Pf®, in antenatal health care in Bangui, Central African Republic. BMC Public Health 2012; 12:482. [PMID: 22734602 PMCID: PMC3681256 DOI: 10.1186/1471-2458-12-482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 06/26/2012] [Indexed: 11/24/2022] Open
Abstract
Background Both treatment and prevention strategies are recommended by the World Health
Organization for the control of malaria during pregnancy in tropical areas.
The aim of this study was to assess use of a rapid diagnostic test for
prompt management of malaria in pregnancy in Bangui, Central African
Republic. Methods A cohort of 76 pregnant women was screened systematically for malaria with
ParacheckPf® at each antenatal visit. The usefulness of
the method was analysed by comparing the number of malaria episodes
requiring treatment in the cohort with the number of prescriptions received
by another group of pregnant women followed-up in routine antenatal
care. Results In the cohort group, the proportion of positive ParacheckPf®
episodes during antenatal clinics visits was 13.8%, while episodes of
antimalarial prescriptions in the group which was followed-up routinely by
antenatal personnel was estimated at 26.3%. Hence, the relative risk of the
cohort for being prescribed an antimalarial drug was 0.53. Therefore, the
attributable fraction of presumptive treatment avoided by systematic
screening with ParacheckPf® was 47%. Conclusions Use of a rapid diagnostic test is useful, affordable and easy for adequate
treatment of malaria in pregnant women. More powerful studies of the
usefulness of introducing the test into antenatal care are needed in all
heath centres in the country and in other tropical areas.
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30
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Rijken MJ, Moroski WE, Kiricharoen S, Karunkonkowit N, Stevenson G, Ohuma EO, Noble JA, Kennedy SH, McGready R, Papageorghiou AT, Nosten FH. Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study. Malar J 2012; 11:5. [PMID: 22222152 PMCID: PMC3317826 DOI: 10.1186/1475-2875-11-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 01/05/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency. METHODS Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intra-observer reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared. RESULTS Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks' gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively. CONCLUSION The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy.
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Affiliation(s)
- Marcus J Rijken
- Shoklo Malaria Research Unit (SMRU), PO Box 46, Mae Sot, Tak 63110, Thailand
| | - William E Moroski
- Shoklo Malaria Research Unit (SMRU), PO Box 46, Mae Sot, Tak 63110, Thailand
| | - Suporn Kiricharoen
- Shoklo Malaria Research Unit (SMRU), PO Box 46, Mae Sot, Tak 63110, Thailand
| | | | - Gordon Stevenson
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Eric O Ohuma
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK
| | - J Alison Noble
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Stephen H Kennedy
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK
| | - Rose McGready
- Shoklo Malaria Research Unit (SMRU), PO Box 46, Mae Sot, Tak 63110, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UK
| | - Aris T Papageorghiou
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK
| | - François H Nosten
- Shoklo Malaria Research Unit (SMRU), PO Box 46, Mae Sot, Tak 63110, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UK
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Jain V, Lucchi NW, Wilson NO, Blackstock AJ, Nagpal AC, Joel PK, Singh MP, Udhayakumar V, Stiles JK, Singh N. Plasma levels of angiopoietin-1 and -2 predict cerebral malaria outcome in Central India. Malar J 2011; 10:383. [PMID: 22192385 PMCID: PMC3286486 DOI: 10.1186/1475-2875-10-383] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 12/23/2011] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The mechanisms underlying the pathogenesis of cerebral malaria (CM) syndrome are not well understood. Previous studies have shown a strong association of inflammatory chemokines, apoptotic markers and angiogenic molecules with CM associated mortality. Recognizing the importance of angiopoietins (ANG) in the pathogenesis of CM, a retrospective investigation was carried out in a hospital cohort of malaria patients with Plasmodium infection in central India to determine if these factors could be suitable markers of CM associated severity. METHODS Patients enrolled in the study were clinically characterized as healthy controls (HC), mild malaria (MM), CM survivors (CMS) and CM non-survivors (CMNS) based on their malaria status and hospital treatment outcome. Plasma ANG-1 and ANG-2 levels were assessed using sandwich ELISA. Receiver operating characteristic (ROC) curve analysis was used to calculate area under the curve (AUC) for each biomarker in order to assess predictive accuracy of individual biomarkers. RESULTS The plasma levels of ANG-1 were lower in CMS and CMNS compared to control groups (mild malaria and healthy controls) at the time of hospital admission. On the contrary, ANG-2 levels positively correlated with malaria severity and were significantly higher in CMNS. The ratio of ANG-2/ANG-1 was highest in CMNS compared to other groups. Receiver operating characteristic curves revealed that compared to ANG-1 (AUC = 0.35), ANG-2 (AUC = 0.95) and ratio of ANG-2/ANG-1 (AUC = 0.90) were better markers to discriminate CMNS from MM cases. However, they were less specific in predicting fatal outcome amongst CM cases at the time of hospital admission. CONCLUSION These results suggest that at the time of admission plasma levels of ANG-2 and ratio of ANG-2/ANG-1 are clinically informative biomarkers to predict fatal CM from MM cases while they have limited usefulness in discriminating fatal CM outcomes in a pool of CM cases in endemic settings of Central India.
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Affiliation(s)
- Vidhan Jain
- Regional Medical Research Center for Tribals (ICMR), Nagpur Road, Garha, 482003 Jabalpur, Madhya Pradesh, India
| | - Naomi W Lucchi
- Atlanta Research and Education foundation Decatur, GA, USA
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Nana O Wilson
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Anna J Blackstock
- Atlanta Research and Education foundation Decatur, GA, USA
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Avinash C Nagpal
- Nethaji Subhash Chandra Bose Medical College Hospital, Jabalpur, Madhya Pradesh, India
| | - Pradeep K Joel
- Nethaji Subhash Chandra Bose Medical College Hospital, Jabalpur, Madhya Pradesh, India
| | - Mrigendra P Singh
- National Institute of Malaria Research Field Unit (ICMR), Jabalpur, Madhya Pradesh, India
| | - Venkatachalam Udhayakumar
- Atlanta Research and Education foundation Decatur, GA, USA
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Jonathan K Stiles
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Neeru Singh
- Regional Medical Research Center for Tribals (ICMR), Nagpur Road, Garha, 482003 Jabalpur, Madhya Pradesh, India
- National Institute of Malaria Research Field Unit (ICMR), Jabalpur, Madhya Pradesh, India
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Umbers AJ, Aitken EH, Rogerson SJ. Malaria in pregnancy: small babies, big problem. Trends Parasitol 2011; 27:168-75. [PMID: 21377424 DOI: 10.1016/j.pt.2011.01.007] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 01/24/2011] [Accepted: 01/27/2011] [Indexed: 11/28/2022]
Abstract
Placental malaria is hypothesized to lead to placental insufficiency, which causes fetal growth restriction (FGR). In this review, recent discoveries regarding the mechanisms of pathogenesis by which malaria causes FGR are discussed in the wider context of placental function and fetal growth. Placental malaria and associated host responses can induce changes in placental structure and function, affecting pregnancy-associated growth-regulating hormones and predisposing the offspring to hypertension and vascular dysfunction. Risk factors associated with FGR are highlighted, and potential interventions and studies to uncover remaining mechanisms of pathogenesis are proposed. Together, these strategies aim to decrease the burden of FGR associated with malaria in pregnancy.
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Affiliation(s)
- Alexandra J Umbers
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Post Office Royal Melbourne Hospital, Parkville, VIC 3050, Australia
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Umbers AJ, Boeuf P, Clapham C, Stanisic DI, Baiwog F, Mueller I, Siba P, King CL, Beeson JG, Glazier J, Rogerson SJ. Placental malaria-associated inflammation disturbs the insulin-like growth factor axis of fetal growth regulation. J Infect Dis 2011; 203:561-9. [PMID: 21216864 DOI: 10.1093/infdis/jiq080] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The pathogenetic mechanisms of fetal growth restriction associated with placental malaria are largely unknown. We sought to determine whether placental malaria and related inflammation were associated with disturbances in the insulin-like growth factor (IGF) axis, a major regulator of fetal growth. METHOD We measured IGF-1 and IGF-2 concentrations in plasma from 88 mother-neonate pairs at delivery and IGF binding proteins 1 and 3 (IGFBP-1 and IGFBP-3, respectively) in cord plasma from a cohort of Papua New Guinean women with and without placental malaria. Messenger RNA levels of IGF-1, IGF-2, and the IGF receptors were measured in matched placental biopsy specimens. RESULTS Compared with those for uninfected pregnancies, IGF-1 levels were reduced by 28% in plasma samples from women with placental Plasmodium falciparum infection and associated inflammation (P = .007) and by 25% in their neonates (P = .002). Levels of fetal IGFBP-1 were elevated in placental malaria with and without inflammation (P = .08 and P = .006, respectively) compared with uninfected controls. IGF-2 and IGFBP-3 plasma concentrations and placental IGF ligand and receptor messenger RNA transcript levels were similar across groups. CONCLUSION Placental malaria-associated inflammation disturbs maternal and fetal levels of IGFs, which regulate fetal growth. This may be one mechanism by which placental malaria leads to fetal growth restriction.
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Affiliation(s)
- Alexandra J Umbers
- Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Royal Parade, Parkville Victoria 3050, Australia.
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Recrudescent Plasmodium berghei from pregnant mice displays enhanced binding to the placenta and induces protection in multigravida. PLoS One 2009; 4:e5630. [PMID: 19461965 PMCID: PMC2680968 DOI: 10.1371/journal.pone.0005630] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 04/27/2009] [Indexed: 11/19/2022] Open
Abstract
Pregnancy-associated malaria (PAM) is associated with placenta pathology and poor pregnancy outcome but the mechanisms that control the malaria parasite expansion in pregnancy are still poorly understood and not amenable for study in human subjects. Here, we used a set of new tools to re-visit an experimental mouse model of pregnancy-induced malaria recrudescence, BALB/c with chronic Plasmodium berghei infection. During pregnancy 60% of the pre-exposed primiparous females showed pregnancy-induced malaria recrudescence and we demonstrated that the recrudescent P. berghei show an unexpected enhancement of the adherence to placenta tissue sections with a marked specificity for CSA. Furthermore, we showed that the intensity of parasitemia in primigravida was quantitatively correlated with the degree of thickening of the placental tissue and up-regulation of inflammation-related genes such as IL10. We also confirmed that the incidence of pregnancy-induced recrudescence, the intensity of the parasitemia peak and the impact on the pregnancy outcome decreased gradually from the first to the third pregnancy. Interestingly, placenta pathology and fetal impairment were also observed at low frequency among non-recrudescent females. Together, the data raise the hypothesis that recrudescent P. berghei displays selected specificity for the placenta tissue enabling on one hand, the triggering of the pathological process underlying PAM and on the other hand, the induction of PAM protection mechanisms that are revealed in subsequent pregnancies. Thus, by exploiting P. berghei pregnancy-induced recrudescence, this experimental system offers a mouse model to study the susceptibility to PAM and the mechanisms of disease protection in multigravida.
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