Plasmodium falciparum infection dysregulates placental autophagy.

Plasmodium (P.) falciparum malaria during pregnancy has been frequently associated with severe consequences such as maternal anemia, abortion, premature birth, and reduced birth weight. Placental damage promotes disruption of the local homeostasis; though, the mechanisms underlying these events are still to be elucidated. Autophagy is a fundamental homeostatic mechanism in the natural course of pregnancy by which cells self-recycle in order to survive in stressful environments. Placentas from non-infected and P. falciparum-infected women during pregnancy were selected from a previous prospective cohort study conducted in the Brazilian Amazon (Acre, Brazil). Newborns from infected women experienced reduced birth weight (P = 0.0098) and placental immunopathology markers such as monocyte infiltrate (P < 0.0001) and IL-10 production (P = 0.0122). The placentas were evaluated for autophagy-related molecules. As a result, we observed reduced mRNA levels of ULK1 (P = 0.0255), BECN1 (P = 0.0019), and MAP1LC3B (P = 0.0086) genes in placentas from P. falciparum-infected, which was more striking in those diagnosed with placental malaria. Despite the protein levels of these genes followed the same pattern, the observed reduction was not statistically significant in placentas from P. falciparum-infected women. Nevertheless, our data suggest that chronic placental immunopathology due to P. falciparum infection leads to autophagy dysregulation, which might impair local homeostasis during malaria in pregnancy that may result in poor pregnancy outcomes.

Fetal-Derived MyD88 Signaling Contributes to Poor Pregnancy Outcomes During Gestational Malaria.

Placental malaria (PM) remains a severe public health problem in areas of high malaria transmission. Despite the efforts to prevent infection poor outcomes in Plasmodium endemic areas, there is still a considerable number of preterm births and newborns with low birth weight resulting from PM. Although local inflammation triggered in response to malaria is considered crucial in inducing placental damage, little is known about the differential influence of maternal and fetal immune responses to the disease progression. Therefore, using a PM mouse model, we sought to determine the contribution of maternal and fetal innate immune responses to PM development. For this, we conducted a series of cross-breeding experiments between mice that had differential expression of the MyD88 adaptor protein to obtain mother and correspondent fetuses with distinct genetic backgrounds. By evaluating fetal weight and placental vascular spaces, we have shown that the expression of MyD88 in fetal tissue has a significant impact on PM outcomes. Our results highlighted the existence of a distinct contribution of maternal and fetal immune responses to PM onset. Thus, contributing to the understanding of how inflammatory processes lead to the dysregulation of placental homeostasis ultimately impairing fetal development.

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon.

Importance: Malaria during pregnancy is associated with adverse events for the fetus and newborn, but the association of malaria during pregnancy with the head circumference of the newborn is unclear. Objective: To investigate the association of malaria during pregnancy with fetal head growth. Design, Setting, and Participants: Two cohort studies were conducted at the general maternity hospital of Cruzeiro do Sul (Acre, Brazil) in the Amazonian region. One cohort study prospectively enrolled noninfected and malaria-infected pregnant women who were followed up until delivery, between January 2013 and April 2015. The other cohort study was assembled retrospectively using clinical and malaria data from all deliveries that occurred between January 2012 and December 2013. Data analyses were conducted from January to August 2017 and revised in November 2018. Clinical data from pregnant women and anthropometric measures of their newborns were evaluated. A total of 600 pregnant women were enrolled through volunteer sampling (prospective cohort study), and 4697 pregnant women were selected by population-based sampling (retrospective cohort study). After application of exclusion criteria, data from 251 (prospective cohort study) and 232 (retrospective cohort study) malaria-infected and 158 (prospective cohort study) and 3650 (retrospective cohort study) noninfected women were evaluated. Exposure: Malaria during pregnancy. Main Outcomes and Measures: The primary end point was the incidence of altered head circumference in newborns delivered from malaria-infected mothers compared with that from noninfected mothers. Secondary end points included measures of placental pathology relative to newborn head circumference. Results: In total, 4291 maternal-child pairs were analyzed. Among 409 newborns in the prospective cohort study, the mothers of 251 newborns had malaria during pregnancy, infected with Plasmodium vivax, Plasmodium falciparum, or both. Among 3882 newborns in the retrospective cohort study, 232 were born from mothers that had malaria during pregnancy. The prevalence of newborns with a small head (19 [30.7%] in the prospective cohort study and 30 [36.6%] in the retrospective cohort study) and the prevalence of microcephaly among newborns (5 [8.1%] in the prospective cohort study and 6 [7.3%] in the retrospective cohort study) were higher among newborns from women infected with P falciparum during pregnancy. Multivariate logistic regression analyses revealed that P falciparum infection during pregnancy represented a significant risk factor for the occurrence of small head circumference in newborns (prospective cohort study: odds ratio, 3.15; 95% CI, 1.52-6.53; P = .002; retrospective cohort study: odds ratio, 1.91; 95% CI, 1.21-3.04; P = .006). Placental pathologic findings corroborated this association, with more syncytial nuclear aggregates and inflammatory infiltrates occurring in placentas of newborns born with decreased head circumference. Conclusions and Relevance: This study indicates that falciparum malaria during pregnancy is associated with decreased head circumference in newborns, which is in turn associated with evidence of placental malaria.

Publisher Correction: TLR4-Mediated Placental Pathology and Pregnancy Outcome in Experimental Malaria.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

TLR4-Mediated Placental Pathology and Pregnancy Outcome in Experimental Malaria.

Malaria-associate pregnancy has a significant impact on infant morbidity and mortality. The detrimental effects of malaria infection during pregnancy have been shown to correlate with immune activation in the placental tissue. Herein we sought to evaluate the effect of Toll-like receptors (TLRs) activation on placental malaria (PM) development by using the Plasmodium berghei NK65GFP infection model. We observed that activation of the innate immune system by parasites leads to PM due to local inflammation. We identified TLR4 activation as the main pathway involved in the inflammatory process in the placental tissue since the absence of functional TLR4 in mice leads to a decrease in the pro-inflammatory responses, which resulted in an improved pregnancy outcome. Additionally, a similar result was obtained when infected pregnant mice were treated with IAXO-101, a TLR4/CD14 blocker. Together, this study illustrates the importance of TLR4 signalling for the generation of the severe inflammatory response involved in PM pathogenesis. Therefore, our results implicate that TLR4 blockage could be a potential candidate for therapeutic interventions to reduce malaria-induced pathology both in the mother and the fetus.

Polyclonal anti-intimin antibody: immunological characterization and its use in EPEC and EHEC diagnosis

EPEC e EHEC constituem um risco significativo para a saúde pública em diferentes partes do mundo. Ambas colonizam a mucosa intestinal e subvertem as funções celulares do epitélio intestinal ao produzirem uma lesão histopatológica característica, conhecida por lesão A/E (attaching-and-effacing), na qual a intimina é uma das proteínas envolvidas. A família das intiminas apresenta também uma região conservada, que compreende os aminoácidos de 388 a 667 (Int 388-667). O objetivo do presente trabalho foi a obtenção de um anticorpo policlonal contra a região conservada de intimina. A caracterização fenotípica das amostras de EPEC e EHEC utilizando este anticorpo permitiu observar-se a maneira variável que ele reconhece os diversos subtipos de intimina e sugere que ele seja uma ferramenta para detecção destes patógenos, sendo o ensaio de immuno-dot o método de captura de escolha.

Polyclonal anti-intimin antibody: immunological characterization and its use in EPEC and EHEC diagnosis

Intimins are outer membrane proteins expressed by enteric bacterial pathogens capable of inducing intestinal attachment-and-effacement lesion (A/E). Through immunoblotting, immunofluorescence, flow citometry and immunogold we observed that the obtained polyclonal antibody against conserved intimin region recognizes the different intimin subtypes and suggests that it can be used as a tool for EPEC and EHEC detection. Besides, immuno-dot assay seems to be a possible alternative as a capture method.

EPEC e EHEC constituem um risco significativo para a saúde pública em diferentes partes do mundo. Ambas colonizam a mucosa intestinal e subvertem as funções celulares do epitélio intestinal ao produzirem uma lesão histopatológica característica, conhecida por lesão A/E (attaching-and-effacing), na qual a intimina é uma das proteínas envolvidas. A família das intiminas apresenta também uma região conservada, que compreende os aminoácidos de 388 a 667 (Int 388-667). O objetivo do presente trabalho foi a obtenção de um anticorpo policlonal contra a região conservada de intimina. A caracterização fenotípica das amostras de EPEC e EHEC utilizando este anticorpo permitiu observar-se a maneira variável que ele reconhece os diversos subtipos de intimina e sugere que ele seja uma ferramenta para detecção destes patógenos, sendo o ensaio de immuno-dot o método de captura de escolha.

O papel do timo no desenvolvimento do sistema imune / The role of the thymus in the development of the immune system

Objetivo: discutir e atualizar informações relevantes sobre o papel do timo no desenvolvimento dos linfócitos T, na tolerância aos próprios antígenos, e na manutenção da homeostase do sistema imunológico. fonte dos dados: revisões, artigos e livros contendo informações relevantes e atuais. Síntese de dados: o timo é um órgão linfóide primário, essencial para o estabelecimento inicial de um repertório...

Objective: to discuss and update relevant information on the role of the thymus in the development of T lymphocytes, in the tolerance to the antigens and in the maintenance of the immunological system homeostasis. Data source: literature reviews, studies and books containing relevant and current information. Data synthesis: the thymus is a primary lymphoid organ, essential for the initial establishment of a functional T-cell reservoir in humans...