Prospects and Pitfalls of Pregnancy-Associated Malaria Vaccination Based on the Natural Immune Response to Plasmodium falciparum VAR2CSA-Expressing Parasites.

Malaria Research and Treatment
Elizabeth G Kane, Andrew W Taylor-Robinson

Abstract

Pregnancy-associated malaria, a manifestation of severe malaria, is the cause of up to 200,000 infant deaths a year, through the effects of placental insufficiency leading to growth restriction and preterm delivery. Development of a vaccine is one strategy for control. Plasmodium falciparum-infected red blood cells accumulate in the placenta through specific binding of pregnancy-associated parasite variants that express the VAR2CSA antigen to chondroitin sulphate A on the surface of syncytiotrophoblast cells. Parasite accumulation, accompanied by an inflammatory infiltrate, disrupts the cytokine balance of pregnancy with the potential to cause placental damage and compromise foetal growth. Multigravid women develop immunity towards VAR2CSA-expressing parasites in a gravidity-dependent manner which prevents unfavourable pregnancy outcomes. Although current vaccine design, targeting VAR2CSA antigens, has succeeded in inducing antibodies artificially, this candidate may not provide protection during the first trimester and may only protect those women living in areas endemic for malaria. It is concluded that while insufficient information about placental-parasite interactions is presently available to produce an effective vaccine,...Continue Reading

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Citations

Jun 19, 2013·Immunological Reviews·Christina C ChangSharon R Lewin
Apr 29, 2014·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Bita BordbarAudrey Sabbagh
Jul 30, 2014·Frontiers in Pharmacology·Carlos Penha-GonçalvesLuciana V de Moraes
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Jul 16, 2016·The Korean Journal of Parasitology·Sri Lakshmi Hyndavi YeruvaJhansi Gajjala

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Methods Mentioned

BETA
biopsies
PCR

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