Plasmodium falciparum malaria elicits inflammatory responses that dysregulate placental amino acid transport

Placental malaria (PM) can lead to poor neonatal outcomes, including low birthweight due to fetal growth restriction (FGR), especially when associated with local inflammation (intervillositis or IV). The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplace...

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Veröffentlicht in:PLoS pathogens 2013-02, Vol.9 (2), p.e1003153-e1003153
Hauptverfasser: Boeuf, Philippe, Aitken, Elizabeth H, Chandrasiri, Upeksha, Chua, Caroline Lin Lin, McInerney, Bernie, McQuade, Leon, Duffy, Michael, Molyneux, Malcolm, Brown, Graham, Glazier, Jocelyn, Rogerson, Stephen J
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creator Boeuf, Philippe
Aitken, Elizabeth H
Chandrasiri, Upeksha
Chua, Caroline Lin Lin
McInerney, Bernie
McQuade, Leon
Duffy, Michael
Molyneux, Malcolm
Brown, Graham
Glazier, Jocelyn
Rogerson, Stephen J
description Placental malaria (PM) can lead to poor neonatal outcomes, including low birthweight due to fetal growth restriction (FGR), especially when associated with local inflammation (intervillositis or IV). The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplacental amino acid transport, especially through the system A group of amino acid transporters, has been implicated. We hypothesized that PM-associated FGR could result from impairment of transplacental amino acid transport triggered by IV. In a cohort of Malawian women and their infants, the expression and activity of system A (measured by Na⁺-dependent ¹⁴C-MeAIB uptake) were reduced in PM, especially when associated with IV, compared to uninfected placentas. In an in vitro model of PM with IV, placental cells exposed to monocyte/infected erythrocytes conditioned medium showed decreased system A activity. Amino acid concentrations analyzed by reversed phase ultra performance liquid chromatography in paired maternal and cord plasmas revealed specific alterations of amino acid transport by PM, especially with IV. Overall, our data suggest that the fetoplacental unit responds to PM by altering its placental amino acid transport to maintain adequate fetal growth. However, IV more profoundly compromises placental amino acid transport function, leading to FGR. Our study offers the first pathogenetic explanation for FGR in PM.
doi_str_mv 10.1371/journal.ppat.1003153
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The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplacental amino acid transport, especially through the system A group of amino acid transporters, has been implicated. We hypothesized that PM-associated FGR could result from impairment of transplacental amino acid transport triggered by IV. In a cohort of Malawian women and their infants, the expression and activity of system A (measured by Na⁺-dependent ¹⁴C-MeAIB uptake) were reduced in PM, especially when associated with IV, compared to uninfected placentas. In an in vitro model of PM with IV, placental cells exposed to monocyte/infected erythrocytes conditioned medium showed decreased system A activity. Amino acid concentrations analyzed by reversed phase ultra performance liquid chromatography in paired maternal and cord plasmas revealed specific alterations of amino acid transport by PM, especially with IV. 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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Boeuf P, Aitken EH, Chandrasiri U, Chua CLL, McInerney B, et al. (2013) Plasmodium falciparum Malaria Elicits Inflammatory Responses that Dysregulate Placental Amino Acid Transport. 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The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplacental amino acid transport, especially through the system A group of amino acid transporters, has been implicated. We hypothesized that PM-associated FGR could result from impairment of transplacental amino acid transport triggered by IV. In a cohort of Malawian women and their infants, the expression and activity of system A (measured by Na⁺-dependent ¹⁴C-MeAIB uptake) were reduced in PM, especially when associated with IV, compared to uninfected placentas. In an in vitro model of PM with IV, placental cells exposed to monocyte/infected erythrocytes conditioned medium showed decreased system A activity. Amino acid concentrations analyzed by reversed phase ultra performance liquid chromatography in paired maternal and cord plasmas revealed specific alterations of amino acid transport by PM, especially with IV. Overall, our data suggest that the fetoplacental unit responds to PM by altering its placental amino acid transport to maintain adequate fetal growth. However, IV more profoundly compromises placental amino acid transport function, leading to FGR. Our study offers the first pathogenetic explanation for FGR in PM.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23408887</pmid><doi>10.1371/journal.ppat.1003153</doi><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Amino Acid Transport System A - genetics
Amino Acid Transport System A - metabolism
Amino acids
Amino Acids - analysis
Amino Acids - metabolism
Biological Transport
Biology
Blood & organ donations
Case-Control Studies
Cell Line, Tumor
Cohort Studies
Female
Fetal Growth Retardation - etiology
Fetal Growth Retardation - immunology
Fetal Growth Retardation - metabolism
Fetus
Growth
Health aspects
Host-parasite relationships
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Infections
Inflammation
Interleukin-1beta - blood
Interleukin-1beta - metabolism
Liquid chromatography
Malaria
Malaria, Falciparum - complications
Malaria, Falciparum - immunology
Malaria, Falciparum - metabolism
Malawi
Maternal-Fetal Exchange - immunology
Medical research
Medicine
Monocytes
Pathogenesis
Physiological aspects
Placenta - immunology
Placenta - metabolism
Placenta Diseases - immunology
Placenta Diseases - metabolism
Plasmodium falciparum
Plasmodium falciparum - immunology
Plasmodium falciparum - physiology
Pregnancy
Pregnancy Complications, Parasitic - immunology
Pregnancy Complications, Parasitic - metabolism
Statistical analysis
Vector-borne diseases
Womens health
Young Adult
title Plasmodium falciparum malaria elicits inflammatory responses that dysregulate placental amino acid transport
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