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Infection and Immunity, October 2002, p. 5412-5415, Vol. 70, No. 10
0019-9567/02/$04.00+0     DOI: 10.1128/IAI.70.10.5412-5415.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Selective Accumulation of Mature Asexual Stages of Plasmodium falciparum-Infected Erythrocytes in the Placenta

James G. Beeson,1* Nishal Amin,2 Maxwell Kanjala,2 and Stephen J. Rogerson1

Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Victoria 3050, Australia,1 Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi2

Received 20 May 2002/ Returned for modification 29 June 2002/ Accepted 18 July 2002

A feature of malaria in pregnancy is accumulation of P. falciparum-infected erythrocytes (IEs) in the placenta, which is associated with adverse outcomes for mothers and infants. Infection appears to involve parasite adhesion to molecules such as chondroitin sulfate A, hyaluronic acid, and immunoglobulins. In vitro, adhesion is predominantly a property of mature asexual forms of IEs; however, adhesion of immature or ring forms has recently been reported. We have assessed the parasitemia and developmental stages of IEs in the placenta by examination of placental blood and histological sections with comparison to parasites in the peripheral blood from the same individuals. Approximately 90% of IEs in the placenta were mature forms. Compared to peripheral blood, the placental parasitemia was 10-fold higher and the density of mature IEs was over 200-fold higher. By contrast, the average peripheral and placental ring-stage parasitemias were not significantly different. In 2 of 14 cases, the density of ring forms was higher in placental than in peripheral blood. These findings demonstrate prominent selective accumulation of mature asexual-stage IEs but infrequent accumulation of ring stages in the placental blood spaces, consistent with an important role for mature-stage IE adhesion.

* Corresponding author. Mailing address: Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Victoria 3050, Australia. Phone: 61-3-8344-6252. Fax: 61-3-9347-1863. E-mail: beeson{at}unimelb.edu.au.

Editor: W. A. Petri, Jr.

Infection and Immunity, October 2002, p. 5412-5415, Vol. 70, No. 10
0019-9567/02/$04.00+0     DOI: 10.1128/IAI.70.10.5412-5415.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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