ABO血型表型影响马拉维女性对恶性疟原虫疟疾的特定胎次免疫力。
ABO blood group phenotypes influence parity specific immunity to Plasmodium falciparum malaria in Malawian women.
作者信息
Senga Edward, Loscertales Maria-Paz, Makwakwa K E B, Liomba George N, Dzamalala Charles, Kazembe Peter N, Brabin Bernard J
机构信息
Department of Biochemistry, University of Malawi College of Medicine, Blantyre, Malawi.
出版信息
Malar J. 2007 Aug 3;6:102. doi: 10.1186/1475-2875-6-102.
BACKGROUND
Blood group O has been significantly associated with increased placental malaria infection in primiparae and reduced risk of infection in multiparae in the Gambia, an area with markedly seasonal malaria transmission. This study analyses the association between ABO blood group phenotypes in relation to placental malaria pathology and birth outcomes in southern Malawi, an area with perennial malaria transmission.
METHODS
A cross-sectional study of 647 mother/child pairs delivering in Montfort Hospital, Chikwawa District between February-June 2004 and January-July 2005 was undertaken. Maternal peripheral and cord blood samples were obtained at delivery. Placental tissue was obtained and malaria histology classified as active, past or no malaria infection. Birth anthropometry was recorded. ABO blood group was measured by agglutination.
RESULTS
In primiparae, blood group O was significantly associated with increased risk of active placental infection (OR 2.18, 95% CI 1.15-4.6, p = 0.02) and an increased foetal-placental weight ratio compared to non-O phenotypes (5.68 versus 5.45, p = 0.03) In multiparae blood group O was significantly associated with less frequent active placental infection (OR 0.59, 95% CI 0.36-0.98, p = 0.04), and a higher newborn ponderal index compared to non-O phenotypes (2.65 versus 2.55, p = 0.007). In multivariate regression parity was independently associated with increased risk of placental malaria (active andpast infection) in primiparae with blood group O (p = 0.034) and reduced risk in multiparae with the same phenotype (p = 0.015).
CONCLUSION
Parity related susceptibility to placental malaria is associated with the mothers ABO phenotype. This interaction influences foetal and placental growth and could be an important modifying factor for pregnancy outcomes. The biological explanation could relate to sialic acid dependent placental membrane differences which vary with ABO blood group.
背景
在冈比亚这个疟疾传播具有明显季节性的地区，O血型与初产妇胎盘疟疾感染增加以及经产妇感染风险降低显著相关。本研究分析了在疟疾常年传播的马拉维南部地区，ABO血型表型与胎盘疟疾病理及出生结局之间的关联。
方法
对2004年2月至6月以及2005年1月至7月期间在奇夸瓦区蒙特福特医院分娩的647对母婴进行了一项横断面研究。在分娩时采集产妇外周血和脐带血样本。获取胎盘组织并将疟疾组织学分类为活动性、既往性或无疟疾感染。记录出生时的人体测量数据。通过凝集法测定ABO血型。
结果
在初产妇中，与非O血型表型相比，O血型与活动性胎盘感染风险增加显著相关（比值比2.18，95%可信区间1.15 - 4.6，p = 0.02），且胎儿 - 胎盘重量比增加（5.68对5.45，p = 0.03）。在经产妇中，与非O血型表型相比，O血型与活动性胎盘感染频率较低显著相关（比值比0.59，95%可信区间0.36 - 0.98，p = 0.04），且新生儿体重指数较高（2.65对2.55，p = 0.007）。在多因素回归分析中，胎次与O血型初产妇胎盘疟疾（活动性和既往感染）风险增加独立相关（p = 0.034），而与相同表型的经产妇风险降低独立相关（p = 0.015）。
结论
胎次相关的胎盘疟疾易感性与母亲的ABO表型有关。这种相互作用影响胎儿和胎盘生长，可能是妊娠结局的一个重要调节因素。生物学解释可能与依赖唾液酸的胎盘膜差异有关，这种差异随ABO血型而变化。
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