Abstract
Complicated/severe cases of placental pathology due to Plasmodium falciparum and P. vivax, especially adverse pregnancy outcomes during P. vivax infection, have been increasing in recent years. However, the pathogenesis of placental pathology during severe malaria is poorly understood, while responses against IFN-γ are thought to be associated with adverse pregnancy outcomes. In the present study, we explored the role of IFN-γ receptor 1 (IFNGR1) signaling in placental pathology during severe malaria using luciferase-expressing rodent malaria parasites, P. berghei NK65 (PbNK65L). We detected luciferase activities in the lung, spleen, adipose tissue, and placenta in pregnant mice, suggesting that infected erythrocytes could accumulate in various organs during infection. Importantly, we found that fetal mortality in IFNGR1-deficient mice infected with PbNK65L parasites was much less than in infected wild type (WT) mice. Placental pathology was also improved in IFNGR1-deficient mice. In contrast, bioluminescence imaging showed that parasite accumulation in the placentas of IFNGR1-deficient pregnant mice was comparable to that in WT mice infected with PbNK65L. These findings suggest that IFNGR1 signaling plays a pivotal role in placental pathology and subsequent adverse pregnancy outcomes during severe malaria. Our findings may increase our understanding of how disease aggravation occurs during malaria during pregnancy.
Highlights
Malaria is a devastating parasitic disease in tropical and subtropical regions, with an estimated 214 million cases and 438,000 deaths per year [1]
These results suggest that pregnant mice show severe pathology compared with nonpregnant mice and adverse pregnancy outcomes during infection with malaria parasites
This study explored the role of IFNGR1 in the pathogenesis of placental pathology using a mouse model of malaria during pregnancy
Summary
Malaria is a devastating parasitic disease in tropical and subtropical regions, with an estimated 214 million cases and 438,000 deaths per year [1]. The populations at greatest risk of developing severe pathology are children under the age of 5 years and pregnant women in areas where Plasmodium falciparum is endemic. Placental malaria is characterized by the accumulation of infected erythrocytes and inflammatory cells in the placenta [2, 3]. Placental malaria has been reported to be correlated with adverse pregnancy outcomes such as fetal growth restriction, still birth, premature delivery and, possibly, preeclampsia [4, 5].
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