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Infection and Immunity, December 2001, p. 7487-7492, Vol. 69, No. 12
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.12.7487-7492.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Gravidity-Dependent Production of Antibodies That Inhibit Binding of Plasmodium falciparum-Infected Erythrocytes to Placental Chondroitin Sulfate Proteoglycan during Pregnancy

Iona O'Neil-Dunne,1,2 Rajeshwara N. Achur,1 Sean T. Agbor-Enoh,1,2,3 Manojkumar Valiyaveettil,1 Ramachandra S. Naik,1 Christian F. Ockenhouse,4 Ainong Zhou,2 Rosette Megnekou,3 Rose Leke,3 Diane W. Taylor,2 and D. Channe Gowda1,*

Department of Biochemistry and Molecular Biology, Georgetown University Medical Center, Washington, D.C. 200071 and Department of Biology, Georgetown University, Washington, D.C. 200572; Faculty of Medicine and Biomedical Sciences and Biotechnology Center, University of Yaounde I. Yaounde, Cameroon3; and Division of Immunology, Walter Reed Army Institute of Research, Silver Spring, Maryland 209104

Received 14 June 2001/Returned for modification 27 August 2001/Accepted 24 September 2001

During pregnancy, Plasmodium falciparum-infected erythrocytes sequester in the placenta by adhering to chondroitin 4-sulfate, creating a risk factor for both the mother and the fetus. The primigravidae are at higher risk for placental malaria than the multigravidae. This difference in susceptibility has been attributed to the lack of antibodies that block the adhesion of infected erythrocytes to placental chondroitin 4-sulfate in primigravid women. However, recent results show that many primigravidae at term have antibody levels similar to those of multigravidae, and thus the significance of antiadhesion antibodies in providing protection against malaria during pregnancy remains unclear. In this study, we analyzed plasma samples from women of various gravidities at different gestational stages for antiadhesion antibodies. The majority of women, regardless of gravidity, had similar levels of antibodies at term. Most primigravidae had low levels of or no antiadhesion antibodies prior to ~20 weeks of pregnancy and then produced antibodies. Multigravidae also lacked antibodies until ~12 weeks of pregnancy, but thereafter they efficiently produced antibodies. In pregnant women who had placental infection at term, higher levels of antiadhesion antibodies correlated with lower levels of placental parasitemia. The difference in kinetics of antibody production between primigravidae and multigravidae correlated with the prevalence of malaria in these groups, suggesting that antibodies are produced during pregnancy in response to placental infection. The early onset of efficient antibody response in multigravidae and the delayed production to antibodies in primigravidae appear to account for the gravidity-dependent differential susceptibilities of pregnant women to placental malaria.

* Corresponding author. Mailing address: Department of Biochemistry and Molecular Biology, Georgetown University Medical Center, 3900 Reservoir Road, NW, Washington, DC 20007. Phone: (202) 687-3840. Fax: (202) 687-7186. E-mail: gowda{at}bc.georgetown.edu.

Infection and Immunity, December 2001, p. 7487-7492, Vol. 69, No. 12
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.12.7487-7492.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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