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MALARIA-ASSOCIATED CYTOKINE CHANGES IN THE PLACENTA OF WOMEN WITH PRE-TERM DELIVERIES IN YAOUNDE, CAMEROON

The prevalence of pre-term deliveries (PTDs) is increased in women who become infected with Plasmodium falciparum during pregnancy. Because prematurity is a risk factor for newborns, it is important to identify conditions that contribute to malaria-associated PTDs. Plasmodium falciparum–infected erythrocytes sequester in the placenta and attract activated mononuclear cells that secrete pro-inflammatory cytokines. Increased inflammatory cytokine levels in other microbial infections are associated with PTDs. To determine if such is the case in women with placental malaria, concentrations of interferon- (IFN-), tumor necrosis factor- (TNF-), interleukin-4 (IL-4), and IL-10 were measured in placental plasma of 391 malaria-infected and -uninfected Cameroonian women with premature and full-term deliveries. Risk factors for malaria-associated PTDs included peripheral and placental parasitemias greater than 1%, maternal anemia, elevated IL-10 levels, and low TNF-:IL-10 ratios due to over-expression of IL-10. Alterations in cytokine levels may contribute to PTDs through the induction of anemia and/or altering cellular immune responses required for eliminating placental parasites.

Received June 12, 2003. Accepted for publication September 18, 2003.

Acknowledgments: We express our gratitude to all the Cameroonian women who participated in this study. We are indebted for the immense help of the entire staff of the Biotechnology Center of the University of Yaounde, including the medical students who participated in the sample collection.

Financial support: This work was supported by the National Institute of Allergy and Infectious Diseases, National Institutes of Health (grant numbers UO1A153 and UO1AI-43888).

^* These authors contributed equally to this work.

Authors’ addresses: Amorsolo L. Suguitan, Jr., Simon Metenou, Lucy Thuita, and Diane Wallace Taylor, Room 406, Reiss Science Building, Department of Biology, Georgetown University, 37th and O Streets, NW, Washington, DC 20057. Timothy J. Cadigan, Department of Biology, University of Scranton, Scranton, PA 18510, Telephone: 570-941-4348. Thu A. Nguyen, Mayo Medical Center, Rochester, MN 55905, Telephone: 617-388-1938. Ainong Zhou, AZ Data Clinic, Inc., Rockville, MD, 20850, Telephone: 240-476-2148. Robert J. I. Leke, Rosette Megnekou, Josephine Fogako and Rose G. F. Leke, The Faculty of Medicine and Biomedical Sciences, Biotechnology Center, University of Yaounde I, Yaounde, Cameroon, Telephone: 237-223-7479.

Reprint requests: Diane Wallace Taylor, Room 406, Reiss Science Building, Department of Biology, Georgetown University, 37th and O Streets, NW, Washington, DC 20057, Telephone: 202-687-5972, Fax: 202-687-5662, E-mail: taylordw{at}georgetown.edu.

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