Multidisciplinary Center, Federal University of Acre, Acre, Brazil.
Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
PLoS Negl Trop Dis. 2024 Nov 4;18(11):e0012636. doi: 10.1371/journal.pntd.0012636. eCollection 2024 Nov.
Plasmodium vivax infection, when it occurs during pregnancy, has often been associated with serious adverse pregnancy outcomes. However, immunological alterations in pregnancy and their consequences have been little explored. We characterized the humoral immune response in pregnant women exposed to malaria by P. vivax antigens and its association with the maternal inflammatory profile and poor pregnancy outcomes.
An observational cohort study in the Brazilian Amazon was conducted between 2013 and 2015. After applying exclusion criteria, 242 mother-child pairs were included in the analysis. Data on maternal infection, gestational outcomes, and inflammatory factors were evaluated in the maternal peripheral plasma. In samples from the first infection, the presence of total IgG and its subclasses in plasma against PvMSP119 protein were also quantified.
Previous exposure to malaria, observed by anti-total IgG antibodies to the PvMSP119 antigen, increased the inflammatory response to infection when the pregnant woman had malaria during pregnancy. IL-6 and IL-10 levels were positively correlated with parasitemia and with total IgG levels; but they were negatively correlated with the gestational age at delivery from Pv-infected woman. In multivariate linear regression analyses, IgG 1, 2 and 4 was negatively and positively associated with cytokines IL-6 and IL-10, respectively, in P. vivax-infection.
An association between the humoral immune response and the peripheral inflammatory cytokine profile with the adverse outcomes in malaria in pregnancy by P. vivax was observed. Previous exposure to the parasite can influence the IL-6 and IL-10 response, which is associated with increased parasitemia, reduced maternal weight gain and premature delivery.
当疟原虫感染发生在怀孕期间时，通常与严重的不良妊娠结局有关。然而，妊娠期间的免疫改变及其后果尚未得到充分探讨。我们通过疟原虫 vivax 抗原来描述暴露于疟疾的孕妇的体液免疫反应，及其与母体炎症特征和不良妊娠结局的关系。
在巴西亚马逊地区进行了一项观察性队列研究，时间为 2013 年至 2015 年。在应用排除标准后，对 242 对母婴进行了分析。在母亲外周血浆中评估了与母体感染、妊娠结局和炎症因子相关的数据。在首次感染的样本中，还定量了血浆中针对 PvMSP119 蛋白的总 IgG 及其亚类的存在。
先前对疟疾的暴露，通过抗 PvMSP119 抗原的总 IgG 抗体观察到，当孕妇在怀孕期间感染疟疾时，增加了感染的炎症反应。IL-6 和 IL-10 水平与寄生虫血症呈正相关，与从 Pv 感染的孕妇的分娩时的孕龄呈负相关。在多元线性回归分析中，IgG1、2 和 4 分别与细胞因子 IL-6 和 IL-10 呈负相关和正相关。
在疟原虫感染的妊娠中，体液免疫反应与外周炎症细胞因子谱与不良结局之间存在关联。寄生虫的先前暴露可以影响 IL-6 和 IL-10 反应，这与寄生虫血症增加、母体体重增加减少和早产有关。
