A novel histological grading scheme for placental malaria applied in areas of high and low malaria transmission.
A novel histological grading scheme for placental malaria applied in areas of high and low malaria transmission.
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DOI：
10.1086/656723
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发表时间：
2010-11-15
期刊：
影响因子：
--
通讯作者：
Duffy PE
中科院分区：
文献类型：
--
作者：
Muehlenbachs A;Fried M;McGready R;Harrington WE;Mutabingwa TK;Nosten F;Duffy PE
恶性疟原虫感染的红细胞在胎盘中隔离并引起对胎儿和母亲都有害的炎症反应。胎盘疟疾（PM）期间的组织学测量可能为干预性试验提供替代终点，但现有的组织学方案捕获有限的复杂性，并且在研究中心之间并不一致。使用坦桑尼亚（高传输区域）的冰冻切片组织学，我们建立了一种新的分级方案，以分别量化PM期间的炎症和色素沉积（n=102）。为了推广这种方法，福尔马林固定石蜡包埋的胎盘样本克伦妇女在泰国（低传输区），从那些有记录的产前寄生虫血症近期（n=18）。在坦桑尼亚队列中，炎症和色素沉积评分与出生体重独立相关，炎症评分与趋化因子水平相关。在来自泰国的较小队列中，炎症和色素评分均与出生体重相关，色素评分与产前诊所就诊次数呈相反趋势。这种半定量病理分级方案易于实施，但捕获的信息与亚洲和非洲的结果相关，因此应有助于不同流行地区临床试验结果的比较和标准化。
Plasmodium falciparum-infected erythrocytes sequester in the placenta and elicit an inflammatory response that is harmful to both fetus and mother. Histologic measurements during placental malaria (PM) might provide surrogate endpoints for interventional trials, but existing histologic schemes capture limited complexity and are not consistently used among study sites. Using frozen section histology in Tanzania (high transmission area), we establish a novel grading scheme to separately quantify inflammation and pigment deposition during PM (n=102). To generalize this method, formalin-fixed paraffin-embedded placental samples from Karen women in Thailand (low transmission area) were selected from among those with documented antenatal parasitemia near term (n=18). In the Tanzanian cohort, the inflammation and pigment deposition scores were independently associated with birth weight, and the inflammation score was associated with chemokine levels. In the smaller cohort from Thailand, both inflammation and pigment scores were associated with birth weight, and the pigment score had an inverse trend with the number of antenatal clinic visits. This semiquantitative pathological grading scheme is simple to implement yet captures information that is associated with outcomes in Asia and Africa, and therefore should facilitate the comparison and standardization of results among clinical trials across areas of differing endemicity.
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影响因子：
1.4
作者：
Plewes, K.;Lee, T.;McGready, R.
通讯作者：
McGready, R.
影响因子：
15.8
作者：
McGready, Rose;Tan, Saw Oo;Ashley, Elizabeth A.;Pimanpanarak, Mupawjay;Viladpai-Nguen, Jacher;Phaiphun, Lucy;Wuestefeld, Katja;Barends, Marion;Laochan, Natthapon;Keereecharoen, Lily;Lindegardh, Niklas;Singhasivanon, Pratap;White, Nicholas J.;Nosten, Francois
通讯作者：
Nosten, Francois
影响因子：
56.9
作者：
Fried, M;Duffy, PE
通讯作者：
Duffy, PE
影响因子：
6.4
作者：
BULMER, JN;RASHEED, FN;GREENWOOD, BM
通讯作者：
GREENWOOD, BM
影响因子：
3.3
作者：
Muehlenbachs, Atis;Mutabingwa, Theonest K.;Duffy, Patrick E.
通讯作者：
Duffy, Patrick E.