title: Biomarkers of Plasmodium falciparum infection during pregnancy in women living in northeastern Tanzania.
abstract: In pregnant women, Plasmodium falciparum infections are an important cause of maternal morbidity as well as fetal and neonatal mortality. Erythrocytes infected by these malaria-causing parasites accumulate through adhesive interactions in placental intervillous spaces, thus evading detection in peripheral blood smears. Sequestered infected erythrocytes induce inflammation, offering the possibility of detecting inflammatory mediators in peripheral blood that could act as biomarkers of placental infection. In a longitudinal, prospective study in Tanzania, we quantified a range of different cytokines, chemokines and angiogenic factors in peripheral plasma samples, taken on multiple sequential occasions during pregnancy up to and including delivery, from P. falciparum-infected women and matched uninfected controls. The results show that during healthy, uninfected pregnancies the levels of most of the panel of molecules we measured were largely unchanged except at delivery. In women with P. falciparum, however, both comparative and longitudinal assessments consistently showed that the levels of IL-10 and IP-10 increased significantly whilst that of RANTES decreased significantly, regardless of gestational age at the time the infection was detected. ROC curve analysis indicated that a combination of increased IL-10 and IP-10 levels and decreased RANTES levels might be predictive of P. falciparum infections. In conclusion, our data suggest that host biomarkers in peripheral blood may represent useful diagnostic markers of P. falciparum infection during pregnancy, but placental histology results would need to be included to verify these findings.
authors.affiliation: Department of Immunology, Wenner-Gren Institute, Stockholm University, Stockholm, Sweden. stephanie.bostrom@wgi.su.se
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Boström
authors.forename: Samad
authors.initials: S
authors.lastname: Ibitokou
authors.forename: Mayke
authors.initials: M
authors.lastname: Oesterholt
authors.forename: Christentze
authors.initials: C
authors.lastname: Schmiegelow
authors.forename: Jan-Olov
authors.initials: JO
authors.lastname: Persson
authors.forename: Daniel
authors.initials: D
authors.lastname: Minja
authors.forename: John
authors.initials: J
authors.lastname: Lusingu
authors.forename: Martha
authors.initials: M
authors.lastname: Lemnge
authors.forename: Nadine
authors.initials: N
authors.lastname: Fievet
authors.forename: Philippe
authors.initials: P
authors.lastname: Deloron
authors.forename: Adrian J F
authors.initials: AJ
authors.lastname: Luty
authors.forename: Marita
authors.initials: M
authors.lastname: Troye-Blomberg
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D018946:Chemokine CCL5 / Q000097:blood; D054357:Chemokine CXCL10 / Q000097:blood; D018925:Chemokines / Q000097:blood; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D008137:Longitudinal Studies; D016778:Malaria, Falciparum / Q000097:blood / Q000175:diagnosis* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000276:immunology*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000097:blood / Q000175:diagnosis* / Q000469:parasitology; D011446:Prospective Studies; D013636:Tanzania
chemical_list: D015415:Biomarkers; C114753:CXCL10 protein, human; D018946:Chemokine CCL5; D054357:Chemokine CXCL10; D018925:Chemokines; D016207:Cytokines; D016753:Interleukin-10