Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
Mem Inst Oswaldo Cruz. 2011 Aug;106 Suppl 1(Suppl 1):64-9. doi: 10.1590/s0074-02762011000900008.
Malaria during pregnancy can be severe in non-immune women, but in areas of stable transmission, where women are semi-immune and often asymptomatic during infection, malaria is an insidious cause of disease and death for mothers and their offspring. Sequelae, such as severe anaemia and hypertension in the mother and low birth weight and infant mortality in the offspring, are often not recognised as consequences of infection. Pregnancy malaria, caused by Plasmodium falciparum, is mediated by infected erythrocytes (IEs) that bind to chondroitin sulphate A and are sequestered in the placenta. These parasites have a unique adhesion phenotype and distinct antigenicity, which indicates that novel targets may be required for development of an effective vaccine. Women become resistant to malaria as they acquire antibodies against placental IE, which leads to higher haemoglobin levels and heavier babies. Proteins exported from the placental parasites have been identified, including both variant and conserved antigens, and some of these are in preclinical development for vaccines. A vaccine that prevents P. falciparum malaria in pregnant mothers is feasible and would potentially save hundreds of thousands of lives each year.
妊娠期间的疟疾对于非免疫的女性可能很严重，但在稳定传播的地区，由于女性处于半免疫状态，且在感染期间常常无症状，因此疟疾是母亲及其后代疾病和死亡的一个隐匿病因。后遗症，如母亲的严重贫血和高血压以及后代的低出生体重和婴儿死亡率，往往不被认为是感染的后果。由恶性疟原虫引起的妊娠疟疾是由感染的红细胞（IE）介导的，这些红细胞与硫酸软骨素 A 结合并在胎盘内被隔离。这些寄生虫具有独特的粘附表型和独特的抗原性，这表明开发有效疫苗可能需要新的靶标。女性在获得针对胎盘 IE 的抗体后会对疟疾产生抵抗力，从而导致血红蛋白水平升高和婴儿体重增加。已经鉴定出从胎盘寄生虫中输出的蛋白质，包括变异和保守抗原，其中一些正在进行临床前开发以用于疫苗。预防孕妇感染恶性疟原虫的疫苗是可行的，每年可能会挽救数十万人的生命。
