Impact of Placental Malaria and Hypergammaglobulinemia on Transplacental Transfer of Respiratory Syncytial Virus Antibody in Papua New Guinea
Impact of Placental Malaria and Hypergammaglobulinemia on Transplacental Transfer of Respiratory Syncytial Virus Antibody in Papua New Guinea
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DOI：
10.1093/infdis/jiv401
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发表时间：
2016-02-01
影响因子：
6.4
通讯作者：
Karron, Ruth A.
中科院分区：
文献类型：
--
作者：
Atwell, Jessica E.;Thumar, Bhagvanji;Karron, Ruth A.
背景被动获得性呼吸道合胞病毒（RSV）中和抗体可预防RSV相关的下呼吸道感染，但胎盘疟疾（PM）和母体高丙种球蛋白血症可能会干扰经胎盘免疫球蛋白转运。方法：我们在疟疾流行的巴布亚新几内亚的2个队列中测定了300例足月母体/脐带血清对的RSV空斑减少中和（PRN）抗体：Alexishafen（2005-2008）和胎儿免疫研究（FIS）（2011-2013）。我们将运输受损定义为脐带与母体滴度比值< 1.0和保护性RSV PRN滴度（PRNT）1：200。结果：PM和高丙种球蛋白血症分别发生在Alexishafen组的60%和54%与FIS组的8%和9%。34%的Alexishafen和32%的FIS对表现出运输受损。多变量建模显示，母体IgG（log（2））增加与转运受损之间存在显著相关性（校正OR，Alexishafen：2.68 [1.17-6.14]，FIS：6.94 [1.94-24.8]），但与PM无关。34%的Alexishafen和31%的FIS脐带PRNT < 1：200。结论：在大约三分之一的母体/脐带对中观察到RSV抗体转运受损。高丙种球蛋白血症，而不是PM，与运输受损，特别是在妇女与低RSV PRNT。在三分之一的脐带血清中检测到RSV PRNT < 1：200，证实需要通过母体免疫提高孕妇的RSV中和抗体水平。
Background. Passively acquired respiratory syncytial virus (RSV) neutralizing antibody protects against RSV-associated lower respiratory infections, but placental malaria (PM) and maternal hypergammaglobulinemia might interfere with transplacental immunoglobulin transport.Methods.We measured RSV plaque-reduction neutralization (PRN) antibody in 300 full-term maternal/cord serum pairs in 2 cohorts in malaria-endemic Papua New Guinea: Alexishafen (2005-2008) and the Fetal Immunity Study (FIS) (2011-2013). We defined impaired transport as a cord-to-maternal titer ratio < 1.0 and a protective RSV PRN titer (PRNT) 1:200.Results.PM and hypergammaglobulinemia occurred in 60% and 54% of Alexishafen mothers versus 8% and 9% of FIS mothers, respectively. 34% of Alexishafen and 32% of FIS pairs demonstrated impaired transport. Multivariate modeling revealed significant associations between increasing maternal IgG (log(2)) and impaired transport (adjusted OR, Alexishafen: 2.68 [1.17-6.14], FIS: 6.94 [1.94-24.8]) but no association with PM. 34% of Alexishafen and 31% of FIS cord PRNTs were < 1:200.Conclusions.Impaired RSV antibody transport was observed in approximately one-third of maternal/cord pairs. Hypergammaglobulinemia, but not PM, was associated with impaired transport, particularly among women with low RSV PRNT. Detection of RSV PRNT < 1:200 in one-third of cord sera confirms the need to increase levels of RSV neutralizing antibody in pregnant women through maternal immunization.