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Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?

Pregnancy-associated malaria (PAM) caused by Plasmodium falciparum can result in detrimental outcomes for both mother and infant, including low infant birth weight, preterm birth, maternal anemia, spontaneous abortion, and maternal and/or infant mortality. Maternal anemia is a particularly complex o...

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Detalles Bibliográficos
Autores principales: Wiebe, Madeleine C., Yanow, Stephanie K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775498/
https://www.ncbi.nlm.nih.gov/pubmed/33391279
http://dx.doi.org/10.3389/fimmu.2020.609957
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author Wiebe, Madeleine C.
Yanow, Stephanie K.
author_facet Wiebe, Madeleine C.
Yanow, Stephanie K.
author_sort Wiebe, Madeleine C.
collection PubMed
description Pregnancy-associated malaria (PAM) caused by Plasmodium falciparum can result in detrimental outcomes for both mother and infant, including low infant birth weight, preterm birth, maternal anemia, spontaneous abortion, and maternal and/or infant mortality. Maternal anemia is a particularly complex outcome, as the body must both maintain erythropoiesis and tolerance of the growing fetus, while directing a Th1 response against the parasite. Underlying the pathogenesis of PAM is the expression of variant surface antigens (VSA(PAM)) on the surface of infected red blood cells (iRBC) that mediate sequestration of the iRBC in the placenta. Naturally acquired antibodies to VSA(PAM) can block sequestration and activate opsonic phagocytosis, both associated with improved pregnancy outcomes. In this review, we ask whether VSA(PAM) antibodies can also protect mothers against malarial anemia. Studies were identified where VSA(PAM) antibody titres and/or function were associated with higher maternal hemoglobin levels, thus supporting additional protective mechanisms for these antibodies against PAM. Yet these associations were not widely observed, and many studies reported no association between protection from maternal anemia and VSA(PAM) antibodies. We discuss the epidemiological, biological and technical factors that may explain some of the variability among these studies. We appraise the current evidence of these complex interactions between PAM-specific immunity and maternal anemia, propose potential mechanisms, and discuss knowledge gaps.
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spelling pubmed-77754982021-01-02 Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia? Wiebe, Madeleine C. Yanow, Stephanie K. Front Immunol Immunology Pregnancy-associated malaria (PAM) caused by Plasmodium falciparum can result in detrimental outcomes for both mother and infant, including low infant birth weight, preterm birth, maternal anemia, spontaneous abortion, and maternal and/or infant mortality. Maternal anemia is a particularly complex outcome, as the body must both maintain erythropoiesis and tolerance of the growing fetus, while directing a Th1 response against the parasite. Underlying the pathogenesis of PAM is the expression of variant surface antigens (VSA(PAM)) on the surface of infected red blood cells (iRBC) that mediate sequestration of the iRBC in the placenta. Naturally acquired antibodies to VSA(PAM) can block sequestration and activate opsonic phagocytosis, both associated with improved pregnancy outcomes. In this review, we ask whether VSA(PAM) antibodies can also protect mothers against malarial anemia. Studies were identified where VSA(PAM) antibody titres and/or function were associated with higher maternal hemoglobin levels, thus supporting additional protective mechanisms for these antibodies against PAM. Yet these associations were not widely observed, and many studies reported no association between protection from maternal anemia and VSA(PAM) antibodies. We discuss the epidemiological, biological and technical factors that may explain some of the variability among these studies. We appraise the current evidence of these complex interactions between PAM-specific immunity and maternal anemia, propose potential mechanisms, and discuss knowledge gaps. Frontiers Media S.A. 2020-12-18 /pmc/articles/PMC7775498/ /pubmed/33391279 http://dx.doi.org/10.3389/fimmu.2020.609957 Text en Copyright © 2020 Wiebe and Yanow http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Wiebe, Madeleine C.
Yanow, Stephanie K.
Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?
title Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?
title_full Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?
title_fullStr Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?
title_full_unstemmed Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?
title_short Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?
title_sort do antibodies to malaria surface antigens play a role in protecting mothers from maternal anemia?
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775498/
https://www.ncbi.nlm.nih.gov/pubmed/33391279
http://dx.doi.org/10.3389/fimmu.2020.609957
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