Low antibody levels to pregnancy-specific malaria antigens and heightened cytokine responses associated with severe malaria in pregnancy

Abstract

Background. Pregnant women living in unstable malaria transmission settings may develop severe malaria (SM). The pathogenesis of SM in pregnancy is poorly understood.Methods. To determine whether SM in pregnancy is associated with lower malarial antibody responses and higher cytokine responses, plasma samples were collected from 121 Sudanese pregnant women of whom 39 were diagnosed with SM. Antibodies to pregnancy-specific and non-pregnancy-specific Plasmodium falciparum variant surface antigens (VSA) and concentrations of cytokines TNF, IFNγ;, IL-1β, IL-6, IL-8 and IL-10 were measured.Results. Pregnant women with SM demonstrated significantly lower antibody levels to pregnancy-specific VSA (P =. 020) and higher plasma IFNγ; (P =. 020), IL-10 (P =. 0002) and IL-6 levels (P