Evidence for the Involvement of VAR2CSA in Pregnancy-associated Malaria

By A. Salanti, Madeleine Dahlbäck, L. Turner, M. Nielsen, Lea K. Barfod, P. Magistrado, A. T. Jensen, T. Lavstsen, M. Ofori, K. Marsh and 2 more. Journal of Experimental Medicine, 2004

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In Plasmodium falciparum–endemic areas, pregnancy-associated malaria (PAM) is an important health problem. The condition is precipitated by accumulation of parasite-infected erythrocytes (IEs) in the placenta, and this process is mediated by parasite-encoded variant surface antigens (VSA) binding to chondroitin sulfate A (CSA). Parasites causing PAM express unique VSA types, VSAPAM, which can be serologically classified as sex specific and parity dependent. It is sex specific because men from malaria-endemic areas do not develop VSAPAM antibodies; it is parity dependent because women acquire anti-VSAPAM immunoglobulin (Ig) G as a function of parity. Previously, it was shown that transcription of var2csa is up-regulated in placental parasites and parasites selected for CSA binding. Here, we show the following: (a) that VAR2CSA is expressed on the surface of CSA-selected IEs; (b) that VAR2CSA is recognized by endemic plasma in a sex-specific and parity-dependent manner; (c) that high anti-VAR2CSA IgG levels can be found in pregnant women from both West and East Africa; and (d) that women with high plasma levels of anti-VAR2CSA IgG give birth to markedly heavier babies and have a much lower risk of delivering low birth weight children than women with low levels.

Subfields: Hematology, Immunology, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/05202fccd49b9c575a4cf6d96bae33be0bca0da4

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