Maternal malaria induces a procoagulant and antifibrinolytic state that is embryotoxic but responsive to anticoagulant therapy.

PloS One
John W AveryJulie M Moore

Abstract

Low birth weight and fetal loss are commonly attributed to malaria in endemic areas, but the cellular and molecular mechanisms that underlie these poor birth outcomes are incompletely understood. Increasing evidence suggests that dysregulated hemostasis is important in malaria pathogenesis, but its role in placental malaria (PM), characterized by intervillous sequestration of Plasmodium falciparum, proinflammatory responses, and excessive fibrin deposition is not known. To address this question, markers of coagulation and fibrinolysis were assessed in placentae from malaria-exposed primigravid women. PM was associated with significantly elevated placental monocyte and proinflammatory marker levels, enhanced perivillous fibrin deposition, and increased markers of activated coagulation and suppressed fibrinolysis in placental plasma. Submicroscopic PM was not proinflammatory but tended to be procoagulant and antifibrinolytic. Birth weight trended downward in association with placental parasitemia and high fibrin score. To directly assess the importance of coagulation in malaria-induced compromise of pregnancy, Plasmodium chabaudi AS-infected pregnant C57BL/6 mice were treated with the anticoagulant, low molecular weight heparin. ...Continue Reading

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Citations

Feb 19, 2013·Cell Host & Microbe·Luciana Vieira de Moraes, Carlos Penha-Gonçalves
Mar 4, 2015·Biomarkers in Medicine·Esmée RuizendaalPetra F Mens
Jul 30, 2014·Frontiers in Pharmacology·Carlos Penha-GonçalvesLuciana V de Moraes
Apr 3, 2013·The American Journal of Tropical Medicine and Hygiene·Jaime Carmona-FonsecaAmanda Maestre
Jul 6, 2019·Frontiers in Microbiology·André BarateiroClaudio R F Marinho

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Methods Mentioned

BETA
light microscopy
ELISA
flow cytometry
PCR
dissection

Software Mentioned

GraphPad Prism
GNU Image Manipulation Program
SAS

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