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[磺胺多辛-乙胺嘧啶间歇推定治疗对塞内加尔低流行地区孕妇抗VAR2CSA抗体获得情况的影响]

[Effect of intermittent presumptive treatment with sulfadoxine-pyrimethamine on the acquisition of anti-VAR2CSA antibodies in pregnant women living in a hypoendemic area in Senegal].

作者信息

Diouf I, Tine R C K, Ndiaye J L, Sylla K, Faye B, Mengue M L, Faye O, Dieng Y, Gaye A, Gaye O

机构信息

Service de parasitologie médicale, faculté de médecine de l'université Cheikh-Anta-Diop de Dakar, Dakar Fann, Sénégal.

出版信息

Bull Soc Pathol Exot. 2011 Oct;104(4):277-83. doi: 10.1007/s13149-011-0153-5. Epub 2011 Aug 4.

DOI:10.1007/s13149-011-0153-5
PMID:21818679
Abstract

The impact of intermittent presumptive treatment (IPT) on the immunity of pregnant women in Senegal is still not very well known. We conducted a prospective study at the Roi-Baudouin maternity of Guediawaye in Senegal to assess IgG antibodies production against MSP1, GLURP and DBL5 in pregnant women under IPT. Blood samples were collected from the participating women at inclusion and delivery. Samples were analyzed after centrifugation for the detection of IgG antibodies in sera by Elisa. Informed consent was given by each study participant prior to their inclusion. A total of 101 eligible women aged from 18 to 44 were included in this study. Multigravidae women represented 70.3% of the study population, whereas primigravidae accounted for 29.7%. The IgG level decreased slightly from inclusion to delivery for the women with regard to anti-MSP1 (83.1at inclusion versus 79.5 at delivery, p = 0.52) as well as anti-GLURP-R2 (84.1 at inclusion versus 75.9 at delivery, p = 0.16). After adjustment for number of pregnancies, there was a significant decrease in the production of anti-VAR2CSA between inclusion and delivery (p < 0.05). By reducing the incidence of malaria during pregnancy, IPT reduced the acquisition of placental parasites antibodies suppressors which could delay the development of protective immunity against malaria. The application of IPT in pregnant women would thus be more appropriate in hypoendemic areas where malaria exposure is lower.

摘要

间歇性推定治疗(IPT)对塞内加尔孕妇免疫力的影响仍不太为人所知。我们在塞内加尔盖迪亚韦的罗伊 - 博杜安妇产医院进行了一项前瞻性研究,以评估接受IPT治疗的孕妇中针对疟原虫裂殖子表面蛋白1(MSP1)、谷氨酸富蛋白(GLURP)和DBL5结构域的IgG抗体产生情况。在纳入研究和分娩时从参与研究的妇女身上采集血样。离心后对样本进行分析,通过酶联免疫吸附测定(ELISA)检测血清中的IgG抗体。每位研究参与者在纳入研究前均已签署知情同意书。本研究共纳入了101名年龄在18至44岁之间的符合条件的妇女。经产妇占研究人群的70.3%,而初产妇占29.7%。就抗MSP1而言,从纳入研究到分娩,妇女的IgG水平略有下降(纳入时为83.1,分娩时为79.5,p = 0.52),抗GLURP - R2也是如此(纳入时为84.1,分娩时为75.9,p = 0.16)。在对妊娠次数进行调整后,纳入研究和分娩之间抗VAR2CSA的产生有显著下降(p < 0.05)。通过降低孕期疟疾发病率,IPT减少了胎盘寄生虫抗体抑制剂的获得,而这些抑制剂可能会延迟针对疟疾的保护性免疫的发展。因此,IPT在疟疾暴露较低的低流行地区应用于孕妇可能更为合适。

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