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Infection and Immunity, October 1999, p. 5367-5371, Vol. 67, No. 10
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Development of Antibodies against Chondroitin Sulfate A-Adherent Plasmodium falciparum in Pregnant Women

Bertrand Maubert,1,2,3,* Nadine Fievet,2,3 Germaine Tami,2,3 Michel Cot,2,3 Christian Boudin,2,3 and Philippe Deloron1

Institut National de la Santé et de la Recherche Médicale U13 and Institut de Médecine et d'Epidémiologie Africaine, Hôpital Bichat-Claude Bernard, 75018 Paris, France1; Institut de Recherche pour le Développement, Paris, France2; and Organisation de Coordination pour la Lutte contre les Endémies en Afrique Centrale, PB288 Yaoundé, Cameroon3

Received 24 May 1999/Returned for modification 14 July 1999/Accepted 28 July 1999

In areas where Plasmodium falciparum is endemic, pregnant women are at increased risk for malaria, and this risk is greatest during the first pregnancy. The placenta sequesters parasites that are able to cytoadhere to chondroitin sulfate A (CSA), a molecule expressed by the placental syncytiotrophoblast, while parasites from a nonpregnant host do not bind to CSA. Cytoadherence is mediated by the expression of variants of the P. falciparum-erythrocyte membrane protein 1 family. Each member of this molecule family induces antibodies that specifically agglutinate infected erythrocytes and inhibit their cytoadherence ability. We investigated whether the higher susceptibility of primigravidae was related to the lack of immune response towards CSA-binding parasites. In a cross-sectional study, primigravidae delivering with a noninfected placenta were less likely to have antibodies agglutinating CSA-binding parasites than multigravidae (P < 0.01). In contrast, parasites from nonpregnant hosts were as likely to be recognized by the sera from women of various parities. In a longitudinal study, at 6 months of pregnancy, antibodies against CSA-binding parasites were present in 31.8% of primigravidae and in 76.9% of secundigravidae (P = 0.02). The antibodies against CSA-binding parasites inhibited the cytoadherence of a CSA-adherent parasite strain to the human placental trophoblast. Our data support the idea that the higher susceptibility of primiparae is related to a lack of a specific immune response to placental parasites.

* Corresponding author. Present address: Service de Parasitologie et Pathologie Exotique, Hôpital de la Croix-Rousse, 93, grande rue de la Croix-Rousse, 69317 Lyon Cedex 04, France. Phone: (033) 4 72 07 19 41. Fax: (033) 4 72 07 18 73. E-mail: bmaubert{at}rockefeller.univ-lyon1.fr.

Infection and Immunity, October 1999, p. 5367-5371, Vol. 67, No. 10
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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