Institute of Biomedical Sciences, Department of Parasitology, University of São Paulo, São Paulo, Brazil.
School of Pharmaceutical Sciences, Department of Clinical and Toxicological Analysis, University of São Paulo, São Paulo, Brazil.
Front Immunol. 2022 Jul 11;13:931034. doi: 10.3389/fimmu.2022.931034. eCollection 2022.
Malaria represents a significant public health burden to populations living in developing countries. The disease takes a relevant toll on pregnant women, who are more prone to developing severe clinical manifestations. Inflammation triggered in response to sequestration inside the placenta leads to physiological and structural changes in the organ, reflecting locally disrupted homeostasis. Altogether, these events have been associated with poor gestational outcomes, such as intrauterine growth restriction and premature delivery, contributing to the parturition of thousands of African children with low birth weight. Despite significant advances in the field, the molecular mechanisms that govern these outcomes are still poorly understood. Herein, we discuss the idea of how some housekeeping molecular mechanisms, such as those related to autophagy, might be intertwined with the outcomes of malaria in pregnancy. We contextualize previous findings suggesting that placental autophagy is dysregulated in -infected pregnant women with complementary research describing the importance of autophagy in healthy pregnancies. Since the functional role of autophagy in pregnancy outcomes is still unclear, we hypothesize that autophagy might be essential for circumventing inflammation-induced stress in the placenta, acting as a cytoprotective mechanism that attempts to ensure local homeostasis and better gestational prognosis in women with malaria in pregnancy.
疟疾对生活在发展中国家的人群的公共卫生造成了重大负担。这种疾病对孕妇的影响尤其大,孕妇更容易出现严重的临床症状。疟原虫在胎盘内被隔离后引发的炎症会导致器官的生理和结构发生变化,反映出局部平衡被打破。所有这些事件都与不良的妊娠结局有关,如宫内生长受限和早产,导致成千上万的非洲低出生体重儿童分娩。尽管在该领域取得了重大进展,但仍不清楚控制这些结果的分子机制。在这里,我们讨论了一些管家分子机制(如与自噬相关的机制)如何与妊娠期间疟疾的结果交织在一起的观点。我们将以前的研究结果放在上下文中,这些结果表明,感染疟疾的孕妇的胎盘自噬受到了调节,同时还有补充研究描述了自噬在健康妊娠中的重要性。由于自噬在妊娠结局中的功能作用仍不清楚,我们假设自噬可能对于避免胎盘炎症诱导的应激至关重要,它作为一种细胞保护机制,试图确保患有疟疾的孕妇局部平衡和更好的妊娠预后。