CD20, CD3, placental malaria infections and low birth weight in an area of unstable malaria transmission in Central Sudan

Samah E Batran,Elhassan M Elhassan,Ishag Adam,Ahmed A Mohmmed,Magdi M Salih

doi:10.1186/1746-1596-8-189

Samah E Batran, Elhassan M Elhassan + Show 3 more

Open Access

https://doi.org/10.1186/1746-1596-8-189

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Abstract

BackgroundMalaria during pregnancy is the main cause of low birth weight (LBW) in the tropics. There are few studies concerning B and T lymphocyte infiltrates in placental malaria infections or their potential association with LBW babies.MethodsA case–control study was conducted at the Medani Hospital, Central Sudan. Cases were women who had LBW deliveries (infants weighed < 2,500 g) and controls were parturient women with normal birth weight babies. Sociodemographic and medical characteristics were gathered from both groups of women using questionnaires. Cases and controls were investigated for malaria using microscopic blood film analysis, placental histology, and immunohistochemistry for detection of B (CD20) and T lymphocytes (CD3).ResultsThe two groups (97 in each arm) were well matched in their basic characteristics. There were no malaria-positive blood films in either the cases or the controls. Twenty-nine (30.0%) vs. 24 (24.7%), P = 0.519 of the cases vs. the controls had placental malaria infections on histological examination. Three (3.1%), two (2.1%) and 24 (24.7%) vs. two (2.1%), two (2.1%) and 20 (20.6%) of the placentae showed evidence of acute, chronic and past malarial infections on histopathological examination of the two groups (case–control), respectively, while 68 (70.1%) vs. 73 (75.3%) of them showed no signs of infection; P = 0.420. Women with placental malaria infections had significantly fewer CD20 cell infiltrates [6 (11.3% vs. 95 (67.4%), P < 0.001)] and higher numbers of CD3 cell infiltrates [50 (94.3%) vs. 42 (29.8%), P < 0.001] than those without placental malaria infection. Logistic regression analysis showed that neither placental malaria infections nor CD3 or CD20 were associated with LBW.ConclusionsSignificantly higher rates of CD3 T cells and lower rates of CD20 B cells were found in women with placental malaria infections compared with those without such infections. Neither placental malaria infection nor CD3 or CD20 are associated with LBW.Virtual slideshttp://www.diagnosticpathology.diagnomx.eu/vs/6879723961063755

Highlights

Malaria during pregnancy is the main cause of low birth weight (LBW) in the tropics
Malaria infections No P. falciparum-positive blood films were obtained for maternal peripheral blood, placenta or cord samples in either the cases or the controls
Neither placental P. falciparum infection nor CD3 or CD20 were associated with LBW or with anemia, Table 5

Summary

Introduction

Malaria during pregnancy is the main cause of low birth weight (LBW) in the tropics. There are few studies concerning B and T lymphocyte infiltrates in placental malaria infections or their potential association with LBW babies. Malaria during pregnancy can lead to maternal and perinatal adverse effects such as anemia [3] and low birth weight (LBW) delivery [4], the latter of which is the main risk for neonatal and infant morbidity and mortality [5,6]. Histological studies on placental malaria have shown that P. falciparum-infected placentae are characterized by an increase in inflammatory cells and that such cells are mainly monocytes and macrophages with a smaller population of granulocytes and lymphocytes [9]. Few studies have investigated immunological responses related to placental cell infiltrates [10]

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