Molecular Principles of Intrauterine Growth Restriction in Plasmodium Falciparum Infection

Malaria in pregnancy still constitutes a particular medical challenge in tropical and subtropical regions. Of the five species that are pathogenic to humans, infection with leads to fulminant progression of the disease with massive impact on pregnancy. Severe anemia of the mother, miscarriage, still...

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Bibliographic Details
Published in:Frontiers in endocrinology (Lausanne) 2019-03, Vol.10, p.98
Main Authors: Seitz, Johanna, Morales-Prieto, Diana Maria, Favaro, Rodolfo R, Schneider, Henning, Markert, Udo Rudolf
Format: Article
Language:English
Subjects:
Endocrinology
intrauterine growth restriction
malaria
placenta
plasmodium
pregnancy
small for gestational age
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Summary:Malaria in pregnancy still constitutes a particular medical challenge in tropical and subtropical regions. Of the five species that are pathogenic to humans, infection with leads to fulminant progression of the disease with massive impact on pregnancy. Severe anemia of the mother, miscarriage, stillbirth, preterm delivery and intrauterine growth restriction (IUGR) with reduced birth weight are frequent complications that lead to more than 10,000 maternal and 200,000 perinatal deaths annually in sub-Saharan Africa alone. can adhere to the placenta via the expression of the surface antigen VAR2CSA, which leads to sequestration of infected erythrocytes in the intervillous space. This process induces a placental inflammation with involvement of immune cells and humoral factors. Especially, monocytes get activated and change the release of soluble mediators, including a variety of cytokines. This proinflammatory environment contributes to disorders of angiogenesis, blood flow, autophagy, and nutrient transport in the placenta and erythropoiesis. Collectively, they impair placental functions and, consequently, fetal growth. The discovery that women in endemic regions develop a certain immunity against VAR2CSA-expressing parasites with increasing number of pregnancies has redefined the understanding of malaria in pregnancy and offers strategies for the development of vaccines. The following review gives an overview of molecular processes in infection in pregnancy which may be involved in the development of IUGR.
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2019.00098