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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Maternal malaria induces a procoagulant and antifibrinolytic state that is embryotoxic but responsive to anticoagulant therapy
PLoS ONE, Volume 7, No. 2, Article e31090, Year 2012
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Description
Low birth weight and fetal loss are commonly attributed to malaria in endemic areas, but the cellular and molecular mechanisms that underlie these poor birth outcomes are incompletely understood. Increasing evidence suggests that dysregulated hemostasis is important in malaria pathogenesis, but its role in placental malaria (PM), characterized by intervillous sequestration of Plasmodium falciparum, proinflammatory responses, and excessive fibrin deposition is not known. To address this question, markers of coagulation and fibrinolysis were assessed in placentae from malaria-exposed primigravid women. PM was associated with significantly elevated placental monocyte and proinflammatory marker levels, enhanced perivillous fibrin deposition, and increased markers of activated coagulation and suppressed fibrinolysis in placental plasma. Submicroscopic PM was not proinflammatory but tended to be procoagulant and antifibrinolytic. Birth weight trended downward in association with placental parasitemia and high fibrin score. To directly assess the importance of coagulation in malaria-induced compromise of pregnancy, Plasmodium chabaudi AS-infected pregnant C57BL/6 mice were treated with the anticoagulant, low molecular weight heparin. Treatment rescued pregnancy at midgestation, with substantially decreased rates of active abortion and reduced placental and embryonic hemorrhage and necrosis relative to untreated animals. Together, the results suggest that dysregulated hemostasis may represent a novel therapeutic target in malaria-compromised pregnancies. © 2012 Avery et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3274552/bin/pone.0031090.s001.tif
Authors & Co-Authors
Avery, John W.
United States, Athens
University of Georgia
Smith, Geoffrey M.
United States, Athens
University of Georgia
Owino, Simon Odera
United States, Athens
University of Georgia
Kenya, Nairobi
Kenya Medical Research Institute
Sarr, Demba
United States, Athens
University of Georgia
Nagy, Tamas
United States, Athens
University of Georgia
Mwalimu, Stephen M.
United States, Athens
University of Georgia
Kenya, Nairobi
Kenya Medical Research Institute
Matthias, James
United States, Athens
University of Georgia
Kelly, Lauren F.
United States, Athens
University of Georgia
Poovassery, Jayakumar S.
United States, Athens
University of Georgia
Middii, Joab D.
United States, Athens
University of Georgia
Kenya, Nairobi
Kenya Medical Research Institute
Abramowsky, Carlos R.
United States, Atlanta
Emory University
Moore, Julie M.
United States, Athens
University of Georgia
Statistics
Citations: 39
Authors: 12
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0031090
e-ISSN:
19326203
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Participants Gender
Female