Babakhanyan Anna, Tutterrow Yeung L, Bobbili Naveen, Salanti Ali, Wey Andrew, Fogako Josephine, Leke Robert J, Leke Rose G F, Taylor Diane Wallace
Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark; The Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé I, Yaoundé, Cameroon.
Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark; The Biotechnology Center, Faculty of Medicine and Biomedical Research, University of Yaoundé I, Yaoundé, Cameroon
Am J Trop Med Hyg. 2016 Mar;94(3):640-9. doi: 10.4269/ajtmh.15-0521. Epub 2015 Dec 28.
Intermittent preventive treatment (IPT) and insecticide-treated bed nets are the standard of care for preventing malaria in pregnant women. Since these preventive measures reduce exposure to malaria, their influence on the antibody (Ab) response to the parasite antigen VAR2CSA was evaluated in pregnant Cameroonian women exposed to holoendemic malaria. Ab levels to full-length VAR2CSA (FV2), variants of the six Duffy binding like (DBL) domains, and proportion of high avidity Ab to FV2 were measured longitudinally in 92 women before and 147 women after IPT. As predicted, reduced exposure interfered with acquisition of Ab in primigravidae, with 71% primigravidae being seronegative to FV2 at delivery. Use of IPT for > 13 weeks by multigravidae resulted in 26% of women being seronegative at delivery and a significant reduction in Ab levels to FV2, DBL5, DBL6, proportion of high avidity Ab to FV2, and number of variants recognized. Thus, in women using IPT important immune responses were not acquired by primigravidae and reduced in a portion of multigravidae, especially women with one to two previous pregnancies. Longitudinal data from individual multigravidae on IPT suggest that lower Ab levels most likely resulted from lack of boosting of the VAR2CSA response and not from a short-lived Ab response.
间歇性预防治疗（IPT）和经杀虫剂处理的蚊帐是预防孕妇疟疾的标准治疗方法。由于这些预防措施可减少疟疾暴露，因此在暴露于高度流行疟疾的喀麦隆孕妇中评估了它们对寄生虫抗原VAR2CSA抗体（Ab）反应的影响。在92名接受IPT前的妇女和147名接受IPT后的妇女中，纵向测量了针对全长VAR2CSA（FV2）、六个达菲结合样（DBL）结构域变体的Ab水平以及针对FV2的高亲和力Ab比例。正如预期的那样，暴露减少干扰了初产妇Ab的获得，71%的初产妇在分娩时对FV2呈血清阴性。经产妇使用IPT超过13周导致26%的妇女在分娩时血清阴性，并且FV2、DBL5、DBL6的Ab水平、针对FV2的高亲和力Ab比例以及识别的变体数量显著降低。因此，在使用IPT的妇女中，初产妇未获得重要的免疫反应，部分经产妇的免疫反应降低，尤其是有一到两次既往妊娠的妇女。来自个体经产妇关于IPT的纵向数据表明，较低的Ab水平很可能是由于VAR2CSA反应缺乏增强，而不是由于短暂的Ab反应。
