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加蓬女性外周血、胎盘血和脐带血配对样本中的亚显微恶性疟原虫感染及感染多样性

Submicroscopic Plasmodium falciparum infections and multiplicity of infection in matched peripheral, placental and umbilical cord blood samples from Gabonese women.

作者信息

Mayengue Pembe Issamou, Rieth Horst, Khattab Ayman, Issifou Saadou, Kremsner Peter G, Klinkert Mo-Quen, Ntoumi Francine

机构信息

Unité de Recherches Médicales, Hôpital Albert Schweitzer, Lambaréné, Gabon.

出版信息

Trop Med Int Health. 2004 Sep;9(9):949-58. doi: 10.1111/j.1365-3156.2004.01294.x.

Abstract

Summary In malaria-endemic regions, pregnant women are more susceptible to malarial infections than non-pregnant women. The main objective of this study, which was conducted in the malaria hyperendemic town of Lambaréné (Gabon, Central Africa), was to characterize Plasmodium falciparum infections in peripheral, placental and cord blood from women of different gravidities with submicroscopic infections. Using the P. falciparum merozoite surface protein 2 (MSP 2)* gene as a polymorphic marker in polymerase chain reactions, we analysed genetic diversity and multiplicity of infection in isolates from all three kinds of samples of 184 pregnant women at delivery. We detected infection in 44% of the women who were originally negative by microscopy. Equally important was the finding that the placenta had the highest prevalence of infection (P < 0.001). There was no correlation with gravidity status or age of the patients. The multiplicities of infection in the peripheral and placental blood samples did not differ and single infection was observed in cord blood, independently of the gravidity. The FC27/MSP 2 was the predominant allelic family. The major FC27 alleles detected in the peripheral, placental and cord blood were sequenced and found to be closely related to the published K1 form sequence. Below microscopy level, the placenta remains the most infected organ and this submicroscopic carriage of parasites may contribute to the development and maintenance of immunity to malaria during pregnancy.

摘要

摘要 在疟疾流行地区,孕妇比非孕妇更容易感染疟疾。本研究在疟疾高度流行的兰巴雷内镇(加蓬,中非)开展,主要目的是对不同妊娠阶段且存在亚显微感染的女性外周血、胎盘血和脐带血中的恶性疟原虫感染进行特征分析。在聚合酶链反应中,使用恶性疟原虫裂殖子表面蛋白2(MSP 2)*基因作为多态性标记,我们分析了184名分娩期孕妇上述三种样本分离株的遗传多样性和感染多重性。我们在最初显微镜检查为阴性的女性中检测到44%的感染率。同样重要的是,发现胎盘感染率最高(P < 0.001)。这与患者的妊娠状态或年龄无关。外周血和胎盘血样本中的感染多重性没有差异,脐带血中观察到单一感染,与妊娠情况无关。FC27/MSP 2是主要的等位基因家族。对在外周血、胎盘血和脐带血中检测到的主要FC27等位基因进行测序,发现它们与已发表的K1型序列密切相关。在显微镜检测水平以下,胎盘仍然是感染最严重的器官,这种亚显微水平的寄生虫携带可能有助于孕期疟疾免疫力的发展和维持。

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