Ordi J, Menendez C, Ismail M R, Ventura P J, Palacín A, Kahigwa E, Ferrer B, Cardesa A, Alonso P L
Department of Pathology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)/Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain.
J Infect Dis. 2001 Apr 1;183(7):1100-7. doi: 10.1086/319295. Epub 2001 Mar 8.
Immunosuppression, particularly of cell-mediated responses, has classically been thought to play a major role in the increased susceptibility to malaria observed in pregnant women. An immunohistochemical characterization of the inflammatory infiltrate in a group of 41 placentas from women living in a Plasmodium falciparum-hyperendemic area in Tanzania revealed a marked increase in the number of monocytes and macrophages and cytotoxic T cells in the intervillous space of placentas with active malaria infection, compared with noninfected placentas, placentas from women with past infection, and a control group of placentas from Spain. This increase was associated with the severity of the infection. High numbers of monocytes and macrophages were associated with low birth weight. We also detected a complete absence of NK cells in the intervillous space in all placentas. This apparently physiological absence of NK cells may contribute to hindering the clearance of the parasite. These results indicate that placental malaria does not appear to be associated with cell-mediated immunosuppression. The role of the absence of NK cells in increased susceptibility to malaria needs to be further elucidated.
免疫抑制，尤其是细胞介导的免疫反应抑制，传统上被认为在孕妇对疟疾易感性增加中起主要作用。对坦桑尼亚恶性疟原虫高度流行地区41名妇女的一组胎盘进行的炎症浸润免疫组织化学特征分析显示，与未感染胎盘、既往感染妇女的胎盘以及来自西班牙的胎盘对照组相比，活跃疟疾感染胎盘的绒毛间隙中单核细胞、巨噬细胞和细胞毒性T细胞数量显著增加。这种增加与感染的严重程度相关。大量单核细胞和巨噬细胞与低出生体重相关。我们还检测到所有胎盘的绒毛间隙中完全没有自然杀伤细胞（NK细胞）。这种明显生理性的NK细胞缺失可能有助于阻碍寄生虫的清除。这些结果表明，胎盘疟疾似乎与细胞介导的免疫抑制无关。NK细胞缺失在疟疾易感性增加中的作用需要进一步阐明。
