Department of Medicine, Stanford University, Stanford, USA.
BMC Med. 2018 Nov 20;16(1):212. doi: 10.1186/s12916-018-1210-8.
Malaria in pregnancy not only exerts profound negative consequences on the health of the mother and developing fetus, but may also alter the risk of malaria during infancy. Although mechanisms driving this altered risk remain unclear, in utero exposure to malaria antigens may impact the development of fetal and infant innate immunity. In an article in BMC Medicine, Natama et al. describe an ambitious analysis of basal and TLR-stimulated cord blood responses among a birth cohort in Burkina Faso. Basal levels of several cytokines, chemokines, and growth factors were shown to be significantly lower in cord blood with histopathologic evidence of placental malaria. Additionally, following TLR7/8 stimulation, samples obtained from infants of mothers with placental malaria were hyper-responsive compared to those without evidence of prenatal malaria exposure. Furthermore, several responses impacted by placental malaria were associated with differential malaria risk in infancy. Understanding how malaria in pregnancy shapes immune responses in infants will provide critical insight into the rational design of malaria control strategies during pregnancy, including intermittent preventative treatment in pregnancy and vaccines.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1187-3.
妊娠疟疾不仅对母亲和胎儿的健康产生深远的负面影响，还可能改变婴儿期疟疾的风险。尽管导致这种风险改变的机制尚不清楚，但母体在子宫内暴露于疟原虫抗原可能会影响胎儿和婴儿固有免疫的发育。在《BMC 医学》的一篇文章中，Natama 等人描述了对布基纳法索一个出生队列的脐带血基础和 TLR 刺激反应的一项雄心勃勃的分析。有组织病理学证据表明胎盘疟疾的脐带血中，几种细胞因子、趋化因子和生长因子的基础水平显著降低。此外，在 TLR7/8 刺激后，来自胎盘疟疾母亲的婴儿的样本与没有产前疟疾暴露证据的样本相比表现出过度反应。此外，胎盘疟疾影响的几种反应与婴儿期疟疾风险的差异有关。了解妊娠疟疾如何塑造婴儿的免疫反应，将为在妊娠期间制定疟疾控制策略提供重要的见解，包括妊娠期间的间歇性预防治疗和疫苗。请参阅相关文章：https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1187-3。
