HIV infection and placental malaria reduce maternal transfer of multiple antimalarial antibodies in Mozambican women - 02/04/21

Doi : 10.1016/j.jinf.2021.02.024

Selena Alonso ^a, Marta Vidal ^a,^{^{1
Contributed equally.}}, Gemma Ruiz-Olalla ^a,^{^{1
Contributed equally.}}, Raquel González ^a,^b, Chenjerai Jairoce ^b, M. Nelia Manaca ^b, Miquel Vázquez-Santiago ^a, Reyes Balcells ^a,^b, Anifa Vala ^b, María Rupérez ^a,^b,^d, Pau Cisteró ^a, Laura Fuente-Soro ^a,^b, Evelina Angov ^e, Ross L. Coppel ^f, Benoit Gamain ^g, David Cavanagh ^h, James G. Beeson ⁱ, Arsenio Nhacolo ^b, Esperança Sevene ^b,^c, John J. Aponte ^a,^b, Eusébio Macete ^b, Ruth Aguilar ^a, Alfredo Mayor ^a,^b, Clara Menéndez ^a,^b, Carlota Dobaño ^a,^b,^{⁎
Corresponding authors.}, ^{^{2
Contributed equally and share senior authorship.}} , Gemma Moncunill ^a,^b,^{⁎
Corresponding authors.}, ^{^{2
Contributed equally and share senior authorship.}}
^a ISGlobal, Hospital Clínic - Universitat de Barcelona, Carrer Rosselló 153, E-08036, Barcelona, Catalonia, Spain
^b Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Cambeve, Vila de Manhiça, CP 1929, Maputo, Mozambique
^c Department of Physiologic Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
^d Present address: London School of Hygiene and Tropical Medicine (LSHTM). Keppel Street, WC1E 7HT, London, UK
^e U.S. Military Malaria Vaccine Program, Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland, USA
^f Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Melbourne, VIC, Australia
^g Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge UMR_S1134, Laboratoire d'Excellence GR-Ex, Paris, France
^h Institute of Immunology & Infection Research and Centre for Immunity, Infection & Evolution, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, King's Buildings, Charlotte Auerbach Rd, Edinburgh, EH9 3FL, UK
ⁱ Burnet Institute, Melbourne, VIC, 3004, Australia

Highlights

•	Maternal antibody levels are the main determinant of cord antibody levels.
•	HIV infection reduced cord antimalarial IgG and IgG1 levels and placental transfer.
•	Placental malaria reduced cord levels and transfer of antimalarial IgG.

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Summary

Objectives

Maternal Plasmodium falciparum-specific antibodies may contribute to protect infants against severe malaria. Our main objective was to evaluate the impact of maternal HIV infection and placental malaria on the cord blood levels and efficiency of placental transfer of IgG and IgG subclasses.

Methods

In a cohort of 341 delivering HIV-negative and HIV-positive mothers from southern Mozambique, we measured total IgG and IgG subclasses in maternal and cord blood pairs by quantitative suspension array technology against eight P. falciparum antigens: Duffy-binding like domains 3-4 of VAR2CSA from the erythrocyte membrane protein 1, erythrocyte-binding antigen 140, exported protein 1 (EXP1), merozoite surface proteins 1, 2 and 5, and reticulocyte-binding-homologue-4.2 (Rh4.2). We performed univariable and multivariable regression models to assess the association of maternal HIV infection, placental malaria, maternal variables and pregnancy outcomes on cord antibody levels and antibody transplacental transfer.

Results

Maternal antibody levels were the main determinants of cord antibody levels. HIV infection and placental malaria reduced the transfer and cord levels of IgG and IgG1, and this was antigen-dependent. Low birth weight was associated with an increase of IgG2 in cord against EXP1 and Rh4.2.

Conclusions

We found lower maternally transferred antibodies in HIV-exposed infants and those born from mothers with placental malaria, which may underlie increased susceptibility to malaria in these children.

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Keywords : Maternal antibodies, Cord blood antibodies, Placental transfer, HIV, Placental malaria, IgG, IgG subclasses

Plan

Introduction

Materials and methods

Study design and sample collection

Antibody assays

Statistical analysis

Results

Description of participants

Profile of cord blood antibody levels and placental transfer to P. falciparum antigens

Altered maternal and cord blood anti-P. falciparum IgG levels by HIV and placental malaria

Factors associated with anti-P. falciparum IgG cord blood levels

Decreased placental transfer of anti-P. falciparum IgGs by HIV and placental malaria

Discussion

Authors’ contributions

Funding

Availability of data and materials

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Vol 82 - N° 4

P. 45-57 - avril 2021 Retour au numéro

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HIV infection and placental malaria reduce maternal transfer of multiple antimalarial antibodies in Mozambican women - 02/04/21

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