Variant surface antigen-specific IgG and protection against clinical consequences of pregnancy-associated Plasmodium falciparum malaria.

Staalsoe, T; Shulman, C; Bulmer, J; Kawuondo, K; Marsh, K; Hviid, L

Journal article

Variant surface antigen-specific IgG and protection against clinical consequences of pregnancy-associated Plasmodium falciparum malaria.

Abstract:: BACKGROUND: Pregnancy-associated malaria caused by Plasmodium falciparum adherence to chondroitin sulfate A in the placental intervillous space is a major cause of low birthweight and maternal anaemia in areas of endemic P falciparum transmission. Adhesion-blocking antibodies that specifically recognise parasite-encoded variant surface antigens (VSA) are associated with resistance to pregnancy-associated malaria. We looked for a possible relation between VSA-specific antibody concentrations, placental infection, and protection from low birthweight and maternal anaemia. METHODS: We used flow cytometry to measure VSA-specific IgG concentrations in plasma samples taken during child birth from 477 Kenyan women selected from a cohort of 910 women on the basis of HIV-1 status, gravidity, and placental histology. We measured VSA expressed by one placental P falciparum isolate and two isolates selected or not selected for chondroitin sulfate A adhesiveness in-vitro. FINDINGS: Concentrations of plasma IgG specific for VSA, expressed by chondroitin sulfate A-adhering parasites (VSA in pregnancy-associated malaria or vsa-pam), increased with gravidity and were associated with placental histological findings. Women with chronic pregnancy-associated malaria and low or absent VSA-PAM-specific IgG had lower haemoglobin values (reduced by 17 g/L; 95% CI 8.1-25.2) and delivered smaller babies (birthweight reduced by 0.26 kg; 0.10-0.55) than did corresponding women with high VSA-PAM-specific IgG. No such relation was shown for concentrations of IgG with specificity for non-pregnancy-associated malaria VSA. INTERPRETATION: VSA-PAM-specific IgG protects against low birthweight and maternal anaemia. Our data indicate an important mechanism of clinical protection against malaria and raise hope for the clinical effectiveness of a potential VSA-based vaccine against pregnancy-associated malaria.

Publication status:: Published

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APA Style

Staalsoe, T., Shulman, C., Bulmer, J., Kawuondo, K., Marsh, K., & Hviid, L. (2004). Variant surface antigen-specific IgG and protection against clinical consequences of pregnancy-associated Plasmodium falciparum malaria. Lancet, 363(9405), 283–289.

MLA Style

Staalsoe, T., et al. “Variant Surface Antigen-Specific IgG and Protection against Clinical Consequences of Pregnancy-Associated Plasmodium Falciparum Malaria.” Lancet, vol. 363, no. 9405, 2004, pp. 283–89.

Chicago Style

Staalsoe, T, C Shulman, J Bulmer, K Kawuondo, K Marsh, and L Hviid. 2004. “Variant Surface Antigen-Specific IgG and Protection against Clinical Consequences of Pregnancy-Associated Plasmodium Falciparum Malaria.” Lancet 363 (9405): 283–89.
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