Malaria during pregnancy is a leading cause of maternal and infant morbidity, due to mother_Ls anemia, early birth and low birth weight. In Latin America, few studies address the subject of the immune response during gestational malaria, this is more notorious in Plasmodium vivax infection. The aim of the current study was to establish the effect of P. vivax infection in the balance of pro- versus anti- inflammatory cytokines and chemokines, and their relationship with some clinical and epidemiology outcomes. To this end, 43 pregnant women inhabitants in Uraba-South Cordoba. Out of these, 15 subjects were included at delivery (MGP+), 8 had history of gestational malaria (MGP-) and 20 had no exposition to infection throughout the pregnancy. Epidemiology and clinical data (age, gestational age, number of previous pregnancies, newborn's weight, mother's hemoglobin and parasitaemia) were recorded after reviewing the clinical records. At delivery, whole blood and plasma from the mother, placenta and cord, as well as placental tissue were collected. Diagnosis of infection was performed by thick smear and real time PCR. Pro-inflammatory ((TNFα, IFNγ, IL1β, IL17)/anti-inflammatory (IL4, IL6, IL10, TGF-β) cytokines and chemokines were measured by real time PCR and plasma level of them were assessed by multiplex ELISA. In order to characterize the changes on placental tissue (cell infiltrates, parasites, hemozoin, among other), histopathology analysis was performed and identification of the monocytes and NK cell infiltrates was carried out by immunohistochemistry. The clinical and epidemiology variables explored were similar in the three groups with exception of the gestational age. Placentas from the infected groups evidenced histopathology changes including chronic villitis, fibrin deposition, intervillous inflammation, and hemozoin deposition. Monocyte and NK cells infiltrates were observed within the intervillous space and in villi itself. Cytokine expression showed a bias towards a pro-inflammatory status in both groups. Antiinflammation cytokines remained unchanged. MCP1 was high in placentas of the MGP+ group and IL8 was high in the MGP- group. In conclusion, P. vivax induced modulation towards pro-inflammatory cytokines in placentas and produced histopathology changes that might affect the mother and fetus.
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