Submicroscopic Infections with Plasmodium falciparum during Pregnancy and Their Association with Circulating Cytokine, Chemokine, and Cellular Profiles
Submicroscopic Infections with Plasmodium falciparum during Pregnancy and Their Association with Circulating Cytokine, Chemokine, and Cellular Profiles
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DOI：
10.1128/cvi.00009-14
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发表时间：
2014-06-01
影响因子：
--
通讯作者：
Luty, Adrian J. F.
中科院分区：
文献类型：
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作者：
Ibitokou, Samad A.;Bostrom, Stephanie;Luty, Adrian J. F.
恶性疟原虫引起的妊娠相关疟疾 (PAM) 的免疫学后果已在分娩时进行的横断面研究中得到广泛研究，但对妊娠期间 PAM 引起的变化的纵向研究却很少。我们在贝宁进行了一项前瞻性研究，调查了 131 名和 111 名妇女在妊娠中期和分娩时与 PAM 相关的变化。通过标准的血涂片显微镜检查和定量 PCR (qPCR) 测定来识别感染的妇女，并根据年龄、胎龄和妊娠与未感染的对照妇女进行匹配。我们量化了一组可溶性免疫介质和其他介质的血浆水平，以及外周血单核细胞类型的频率。使用多变量分析对感染和未感染妇女的这些变量进行比较，我们还评估了纳入时测量的变量对分娩时妊娠结局的预测价值。在多变量分析中，外周血浆白细胞介素 10 (IL-10) 和 γ 干扰素诱导蛋白 10 (IP-10) 水平与入组和分娩时的 PAM 相关，而较高的 IL-10 水平可区分入组时 qPCR 可检测的亚显微感染，但与分娩时无关。母亲分娩时贫血与纳入时测量的促炎（单核细胞频率增加）和抗炎（IL-10 水平增加和调节性 T 细胞活化增加）活性标志物相关。 IL-10 浓度升高与妊娠期间大多数恶性疟原虫感染有关，但仅靠这一标记物并不能识别所有亚显微感染。可靠地识别此类隐匿性感染需要更灵敏和更具体的方法。
The immunological consequences of pregnancy-associated malaria (PAM) due to Plasmodium falciparum have been extensively investigated in cross-sectional studies conducted at delivery, but there have been very few longitudinal studies of changes due to PAM during pregnancy. We conducted a prospective study in Benin to investigate the changes associated with PAM in groups of 131 and 111 women at inclusion in the second trimester and at delivery, respectively. Infected women were identified by standard microscopic examinations of blood smears and by quantitative PCR (qPCR) assays and were matched to uninfected control women by age, gestational age, and gravidity. We quantified plasma levels of a panel of soluble immunological mediators and other mediators, as well as the frequencies of peripheral blood mononuclear cell types. Comparisons of these variables in infected and uninfected women used multivariate analyses, and we also assessed the predictive value of variables measured at inclusion for pregnancy outcomes at delivery. In multivariate analyses, peripheral plasma interleukin 10 (IL-10) and gamma interferon-inducible protein 10 (IP-10) levels were associated with PAM at inclusion and at delivery, while higher IL-10 levels distinguished qPCR-detectable submicroscopic infections at inclusion but not at delivery. Maternal anemia at delivery was associated with markers of proinflammatory (increased frequency of monocytes) and anti-inflammatory (increased IL-10 levels and increased activation of regulatory T cells) activity measured at inclusion. Elevated concentrations of IL-10 are associated with the majority of P. falciparum infections during pregnancy, but this marker alone does not identify all submicroscopic infections. Reliably identifying such occult infections will require more sensitive and specific methods.