Document Detail


Antibodies to chondroitin sulfate A-binding infected erythrocytes: dynamics and protection during pregnancy in women receiving intermittent preventive treatment.
MedLine Citation:
PMID:  20350189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Plasmodium falciparum parasites that cause malaria in pregnancy express unique variant surface antigens (VSAs). Levels of immunoglobulin G (IgG) antibody to pregnancy-associated VSAs measured at delivery are gravidity dependent, and they have been associated with protection from disease. It is not known how these IgG responses develop in pregnant women receiving intermittent preventive treatment during pregnancy (IPTp) or whether IgG levels in early pregnancy predict pregnancy outcomes. METHODS: We performed longitudinal measurements of IgG antibody to VSAs by flow cytometric analysis of serum samples obtained from 549 Malawian women receiving IPTp. We examined fluctuations in IgG levels over time and associated the IgG levels noted at study enrollment with clinical outcomes. RESULTS: Levels of IgG antibody to pregnancy-associated VSAs were gravidity dependent. Overall, levels decreased while women were receiving IPTp, but the levels of the individuals were highly dynamic. Primigravidae developed low levels of pregnancy-specific IgG, which were often boosted during second pregnancies. The prevalence of parasites was low (8.4% at enrollment and 2.4% in late pregnancy). Antibody levels at enrollment did not predict birth weight, duration of gestation at delivery, or the maternal hemoglobin level in late pregnancy. CONCLUSION: Levels of IgG antibody to pregnancy-specific VSAs decrease during receipt of IPTp. Antibody levels in early pregnancy did not predict clinical outcome. IPTp and decreasing malaria prevalence pose challenges for the evaluation of novel interventions for malaria during pregnancy.
Authors:
Elizabeth H Aitken; Bernard Mbewe; Mari Luntamo; Ken Maleta; Teija Kulmala; Marc-James Friso; Freya J I Fowkes; James G Beeson; Per Ashorn; Stephen J Rogerson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  201     ISSN:  1537-6613     ISO Abbreviation:  J. Infect. Dis.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-06     Completed Date:  2010-04-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1316-25     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Royal Parade, Parkville, Victoria 3052, Australia. e.aitken@ugrad.unimelb.edu.au
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00131235
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antibodies, Protozoan / blood*,  immunology
Antigens, Surface / immunology
Antimalarials / administration & dosage,  therapeutic use*
Chondroitin Sulfates / metabolism*
Drug Combinations
Erythrocytes / immunology,  parasitology
Female
Humans
Immunoglobulin G / blood
Longitudinal Studies
Malaria, Falciparum / immunology,  prevention & control*
Malawi
Parity
Plasmodium falciparum / immunology*
Pregnancy
Pregnancy Complications, Parasitic / immunology,  prevention & control*
Pyrimethamine / administration & dosage,  therapeutic use*
Sulfadoxine / administration & dosage,  therapeutic use*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Antibodies, Protozoan; 0/Antigens, Surface; 0/Antimalarials; 0/Drug Combinations; 0/Immunoglobulin G; 2447-57-6/Sulfadoxine; 37338-39-9/sulfadoxine-pyrimethamine; 58-14-0/Pyrimethamine; 9007-28-7/Chondroitin Sulfates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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