title: Protective Antibodies against Placental Malaria and Poor Outcomes during Pregnancy, Benin.
abstract: Placental malaria is caused by Plasmodium falciparum-infected erythrocytes that bind to placental tissue. Binding is mediated by VAR2CSA, a parasite antigen coded by the var gene, which interacts with chondroitin sulfate A (CSA). Consequences include maternal anemia and fetal growth retardation. Antibody-mediated immunity to placental malaria is acquired during successive pregnancies, but the target of VAR2CSA-specific protective antibodies is unclear. We assessed VAR2CSA-specific antibodies in pregnant women and analyzed their relationships with protection against placental infection, preterm birth, and low birthweight. Antibody responses to the N-terminal region of VAR2CSA during early pregnancy were associated with reduced risks for infections and low birthweight. Among women infected during pregnancy, an increase in CSA binding inhibition was associated with reduced risks for placental infection, preterm birth, and low birthweight. These data suggest that antibodies against VAR2CSA N-terminal region mediate immunity to placental malaria and associated outcomes. Our results validate current vaccine development efforts with VAR2CSA N-terminal constructs.
authors.forename: Nicaise Tuikue
authors.initials: NT
authors.lastname: Ndam
authors.forename: Lise
authors.initials: L
authors.lastname: Denoeud-Ndam
authors.forename: Justin
authors.initials: J
authors.lastname: Doritchamou
authors.forename: Firmine
authors.initials: F
authors.lastname: Viwami
authors.forename: Ali
authors.initials: A
authors.lastname: Salanti
authors.forename: Morten A
authors.initials: MA
authors.lastname: Nielsen
authors.forename: Nadine
authors.initials: N
authors.lastname: Fievet
authors.forename: Achille
authors.initials: A
authors.lastname: Massougbodji
authors.forename: Adrian J F
authors.initials: AJ
authors.lastname: Luty
authors.forename: Philippe
authors.initials: P
authors.lastname: Deloron
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology; D000953:Antigens, Protozoan / Q000276:immunology; D001541:Benin / Q000453:epidemiology; D004912:Erythrocytes / Q000276:immunology / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology / Q000276:immunology* / Q000469:parasitology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D063868:Patient Outcome Assessment; D010920:Placenta / Q000469:parasitology*; D010963:Plasmodium falciparum / Q000276:immunology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000276:immunology* / Q000469:parasitology; D011256:Pregnancy Outcome; D011485:Protein Binding; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D007074:Immunoglobulin G
keywords: Benin; Plasmodium falciparum; VAR2CSA; antibodies; erythrocytes; malaria; outcomes; parasites; placental malaria; pregnancy