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Prospects and pitfalls of pregnancy associated malaria vaccination based on the natural immune response to Plasmodium falciparum VAR2CSA-expressing parasites.

journal contribution
posted on 06.12.2017, 00:00 by E Kane, Andrew Taylor-Robinson
Pregnancy-associated malaria, a manifestation of severe malaria, is the cause of up to 200,000 infant deaths a year, through the effects of placental insufficiency leading to growth restriction and preterm delivery. Development of a vaccine is one strategy for control. Plasmodium falciparum-infected red blood cells accumulate in the placenta through specific binding of pregnancy-associated parasite variants that express the VAR2CSA antigen to chondroitin sulphate A on the surface of syncytiotrophoblast cells. Parasite accumulation, accompanied by an inflammatory infiltrate, disrupts the cytokine balance of pregnancy with the potential to cause placental damage and compromise foetal growth. Multigravid women develop immunity towards VAR2CSA-expressing parasites in a gravidity-dependent manner which prevents unfavourable pregnancy outcomes. Although current vaccine design, targeting VAR2CSA antigens, has succeeded in inducing antibodies artificially, this candidate may not provide protection during the first trimester and may only protect those women living in areas endemic for malaria. It is concluded that while insufficientinformation about placental-parasite interactions is presently available to produce an effective vaccine, incremental progress isbeing made towards achieving this goal.

Funding

Category 1 - Australian Competitive Grants (this includes ARC, NHMRC)

History

Issue

2011

Start Page

1

End Page

21

Number of Pages

21

ISSN

2044-4362

Location

United States

Publisher

Hindawi Publishing Corporation

Language

en-aus

Peer Reviewed

Yes

Open Access

Yes

External Author Affiliations

University of Leeds

Era Eligible

Yes

Journal

Malaria Research and Treatment