Gueneuc Alexandra, Deloron Philippe, Bertin Gwladys I
Institute of Research for Development (IRD), UMR216-MERIT, Paris, France.
ComUE Sorbonne Paris Cité, Paris, France.
Malar J. 2017 Jan 3;16(1):11. doi: 10.1186/s12936-016-1664-0.
In most tropical areas, pregnant women are at increased risk of malaria, as a consequence of the massive sequestration of parasitized red blood cells in the placenta. The placenta plays a key role in embryonic and fetal development as well as in maternal-fetal exchanges, and pregnancy-associated malaria may alter selected placenta functions that lead to stillbirth and low birth weight. Although there are several tools (blood smear examination, RDT, PCR) to diagnose malaria infection during pregnancy, there is currently no test to assess placenta dysfunction in the framework of pregnancy-associated malaria. Pregnancy-associated malaria shares many features with preeclampsia, an extensively studied disease. Various biomarkers associated with placental dysfunction have been identified as associated with preeclampsia. Several of these are inflammatory markers that lack of specificity. A few seem more specific of placenta dysfunction, including s-endoglin and sFlt1, increased in the peripheral blood during preeclampsia. The predictive value of these biomarkers should be studied in the context of pregnancy-associated malaria to evaluate their usefulness in identifying placental dysfunction during malaria. These biomarkers should be considered to improve the diagnosis of placental dysfunction during malaria and pregnant women monitoring.
在大多数热带地区，由于被寄生的红细胞大量滞留于胎盘，孕妇感染疟疾的风险增加。胎盘在胚胎和胎儿发育以及母胎物质交换中起着关键作用，妊娠相关疟疾可能会改变某些胎盘功能，进而导致死产和低出生体重。尽管有多种工具（血涂片检查、快速诊断试验、聚合酶链反应）可用于诊断孕期疟疾感染，但目前尚无检测方法来评估妊娠相关疟疾背景下的胎盘功能障碍。妊娠相关疟疾与子痫前期有许多共同特征，子痫前期是一种经过广泛研究的疾病。已确定多种与胎盘功能障碍相关的生物标志物与子痫前期有关。其中一些是缺乏特异性的炎症标志物。有几种似乎对胎盘功能障碍更具特异性，包括s-内皮糖蛋白和可溶性血管内皮生长因子受体1（sFlt1），在子痫前期外周血中含量升高。应在妊娠相关疟疾背景下研究这些生物标志物的预测价值，以评估它们在识别疟疾期间胎盘功能障碍方面的有用性。应考虑利用这些生物标志物来改善疟疾期间胎盘功能障碍的诊断以及对孕妇的监测。
