Malaria-associated cytokine changes in the placenta of women with pre-term deliveries in Yaounde, Cameroon
Suguitan, A.L.; Cadigan, T.J.; Nguyen, T.A.; Zhou, A.; Leke, R.J.I.; Metenou, S.; Thuita, L.; Megnekou, R.; Fogako, J.; Leke, R.G.F.; Taylor, D.W.
American Journal of Tropical Medicine and Hygiene 69(6): 574-581
2003
ISSN/ISBN: 0002-9637 PMID: 14740871 Document Number: 565696
The prevalence of pre-term deliveries (PTDs) is increased in women who become infected with Plasmodium falciparum during pregnancy. Because prematurity is a risk factor for newborns, it is important to identify conditions that contribute to malaria-associated PTDs. Plasmodium falciparum-infected erythrocytes sequester in the placenta and attract activated mononuclear cells that secrete pro-inflammatory cytokines. Increased inflammatory cytokine levels in other microbial infections are associated with PTDs. To determine if such is the case in women with placental malaria, concentrations of interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4), and IL-10 were measured in placental plasma of 391 malaria-infected and -uninfected Cameroonian women with premature and full-term deliveries. Risk factors for malaria-associated PTDs included peripheral and placental parasitemias greater than 1%, maternal anemia, elevated IL-10 levels, and low TNF-alpha:IL-10 ratios due to over-expression of IL-10. Alterations in cytokine levels may contribute to PTDs through the induction of anemia and/or altering cellular immune responses required for eliminating placental parasites.