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Am J Epidemiol 2003; 157:203-209.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Maternally Transmitted Antibodies to Pregnancy-Associated Variant Antigens on the Surface of Erythrocytes Infected with Plasmodium falciparum: Relation to Child Susceptibility to Malaria

Michel Cot1,, Jean Yves Le Hesran1,2, Trine Staalsoe3,4, Nadine Fievet1,2, Lars Hviid3,4 and Philippe Deloron1

1 Mother and Child Health in the Tropics, Research Institute for Development (IRD), Hôpital Tenon, Paris, France.
2 Organisation de Coordination pour la Lutte contre les Endémies en Afrique Centrale (OCEAC), Yaounde, Cameroon.
3 Centre for Medical Parasitology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
4 Institute for Medical Microbiology and Immunology, University of Copenhagen, Copenhagen, Denmark.

The consequences of pregnancy-associated malaria on a child’s health have been poorly investigated. Malarial infection of the placenta seems to result in a higher susceptibility of children to the parasite during their first year of life. In 1993–1995, the authors investigated the role of antibodies in variable surface antigens (VSA) specific to chondroitin sulfate A (CSA)-binding parasites to assess the parasitologic status of the child. Flow cytometry was used to measure levels of antibodies to VSA from CSA-selected and -unselected parasite lines in the cord blood of 79 newborns in Ebolowa, Cameroon. These newborns were subsequently followed up for 2 years to determine the date of first occurrence of blood parasites and mean parasite density during follow-up. Maternally transmitted antibodies to VSA expressed by CSA-binding parasites, but not antibodies to any other specificity, were negatively related to time of first appearance of Plasmodium falciparum in a child’s blood and were positively related to mean parasite density during the first 2 years of life. If maternal infection is thought to be the main mechanism influencing susceptibility of the newborn to malaria, antibodies to VSA may better denote maternal malaria infection during almost the entire pregnancy as opposed to placental blood smear reflecting infection during the last few months of pregnancy.

antibodies; antigens, surface; child; infant, newborn; malaria; Plasmodium falciparum; pregnancy

Abbreviations: Abbreviations: CSA, chondroitin sulfate A; PAM, pregnancy-associated malaria; VSA, variant surface antigen; VSACSA, variant surface antigen expressed by chondroitin sulfate A-adhering parasites.


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