Main Article Content


Objective: The study concerned the effects of Plasmodium vivax infection on the balance of pro- versus anti-inflammatory cytokines and chemokines and their relationship with some clinical and epidemiology outcomes.

Methods: Thirty-five pregnant women were involved in this study.  Of these, 15 subjects were included at delivery (GMP+), and 20 had no exposition to infection throughout the pregnancy (GMP-C-). Epidemiological and clinical data were recorded after reviewing the clinical records. At delivery, whole blood from the mother as well as placental tissue was collected. Diagnosis of infection was performed by thick smear and real time PCR. Pro-inflammatory and anti-inflammatory cytokines and chemokines were measured by real time PCR.

Results: The clinical and epidemiological variables explored were similar in both groups, with the exception of gestational age. When comparing the GMP+ group with the GMP-C- group, it is clear that although the differences generally are not significant, pro-inflammatory cytokines are elevated in both maternal blood and placental; the anti-inflammatories are elevated in the mother and reduced in the placenta, and the chemokines are reduced in both, except for  MCP-1 which is elevated in both.

Conclusion: The results appear to be strongly affected by the small number of women with GM by P. vivax in childbirth. Additional studies are needed with more women from both this region and elsewhere.


Yasnot, M. F., Perkins, D. J., Corredor, M., Yanow, S., Carmona-Fonseca, J., & Maestre, A. E. (2013). The effects of Plasmodium vivax gestational malaria on the clinical and immune status of pregnant women in Northwestern Colombia. Colombia Medica, 44(3), 172–177.

Diagne N, Rogier C, Cisse B, Trape JF. Incidence of clinical malaria in pregnant women exposed to intense perennial transmission. Trans R Soc Trop Med Hyg. 1997; 91(2): 166-70.

Steketee RW, Nahlen BL, Parise ME, Menendez C. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg. 2001; 64: 28-35.

Rodriguez-Morales AJ, Sanchez E, Vargas M, Piccolo C, Colina R, Arria M, et al. Pregnancy outcomes associated with Plasmodium vivax malaria in northeastern Venezuela. Am J Trop Med Hyg. 2006; 74(5): 755-7.

Desai M, ter Kuile FO, Nosten F, McGready R, Asamoa K, Brabin B, et al. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis. 2007; 7(2): 93-104.

Carmona-Fonseca J, Maestre A. Incidencia de la Malaria Gestacional, Congénita y Placentaria en Urabá (Antioquia-Colombia), 2005-2007. Rev Colomb Obstetr Ginecol. 2009; 60: 12-26.

Lin HMT, Guilbert L, Tuntipopiat S, Wegmann TG. Synthesis of T helper 2 type cytokines at the maternal-fetal interface. J Immunol. 1993; 151: 4562-73.

Achidi EA, Apinjoh TO, Titanji VP. Malaria parasitemia and systemic cytokine bias in pregnancy. Int J Gynaecol Obstet. 2007; 97(1): 15-20.

Fried M, Nosten F, Brockman A, Brabin BJ, Duffy PE. Maternal antibodies block malaria. Nature. 1998; 395(6705): 851-2.

Rogerson SJ, Hviid L, Duffy PE, Leke RF, Taylor DW. Malaria in pregnancy: pathogenesis and immunity. Lancet Infect Dis. 2007; 7(2): 105-17.

Abrams ET, Brown H, Chensue SW, Turner GD, Tadesse E, Lema VM, et al. Host response to malaria during pregnancy: placental monocyte recruitment is associated with elevated beta chemokine expression. J Immunol. 2003; 170(5): 2759-64.

Ordi J, Menendez C, Ismail MR, Ventura PJ, Palacín A, Kahigwa E, et al. Placental malaria is associated with cell-mediated inflammatory responses with selective absence of natural killer cells. J Infect Dis. 2001; 183(7): 1100-7.

Enato EF, Mens PF, Okhamafe AO, Okpere EE, Pogoson E, Schallig HD. Plasmodium falciparum malaria in pregnancy: prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria. J Obstet Gynaecol. 2009; 29(4): 301-6.

Carmona FJ. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la falla terapéutica antimalárica. Parte 2. Iatreia. 2004; 17: 34-53.

Carmona-Fonseca J, Arango FE. Malaria mixta: prevalencia en Colombia y América Latina. Iatreia. 2012; 25: 334-46.

Lopez-Antuñano FJ, Schmunis G. Diagnóstico microscopico de los parásitos de la malaria en sangre. OPS-OMS 1988; Publicación Científica No 512. pp 39-50.

Campos IUM, Cuesta C, Franco-Gallego A, Carmona-Fonseca J, Maestre A. Diagnosis of gestational, congenital, and placental malaria in Colombia: comparison of the efficacy of microscopy, nested polymerase chain reaction, and histopathology. Am J Trop Med Hyg. 2011; 84(6): 929-35.

McGready R, Davison BB, Stepniewska K, Cho T, Shee H, Brockman A, et al. The effects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission. Am J Trop Med Hyg. 2004; 70: 398-407.

Rogerson SJ, Mwapasa V, Meshnick SR. Malaria in pregnancy: linking immunity and pathogenesis to prevention. Am J Trop Med Hyg. 2007;77:14-22.

Hartman TK, Rogerson SJ, Fischer PR. The impact of maternal malaria on newborns. Ann Trop Paediatr. 2010; 30(4): 271-82.

Rial M. CMA, Genovés J, Carreras R. Malaria y embarazo: fisiopatología y manejo. Ginecol Obstetr Clín. 2009; 3: 157-64.

Moormann AM, Sullivan AD, Rochford RA, Chensue SW, Bock PJ, Nyirenda T, et al. Malaria and pregnancy: placental cytokine expression and its relationship to intrauterine growth retardation. J Infect Dis. 1999; 180(6): 1987-93.

Rogerson SJ, Brown HC, Pollina E, Abrams ET, Tadesse E, Lema VM, et al. Placental tumor necrosis factor alpha but not gamma interferon is associated with placental malaria and low birth weight in Malawian women. Infect Immun. 2003; 71(1): 267-70.

Okoko BJ, Enwere G, Ota MO. The epidemiology and consequences of maternal malaria: a review of immunological basis. Acta Trop. 2003; 87(2): 193-205.

Chaisavaneeyakorn S, Moore JM, Mirel L, Othoro C, Otieno J, Chaiyaroj SC, et al. Levels of macrophage inflammatory protein 1 alpha (MIP-1 alpha) and MIP-1 beta in intervillous blood plasma samples from women with placental malaria and human immunodeficiency virus infection. Clin Diagn Lab Immunol. 2003; 10(4): 631-6.

Dong S, Kurtis JD, Pond-Tor S, Kabyemela E, Duffy PE, Fried M. CXC ligand 9 response to malaria during pregnancy is associated with low-birth-weight deliveries. Infect Immun. 2012; 80(9): 3034-8.

Conroy A, Serghides L, Finney C, Owino SO, Kumar S, Gowda DC, et al. C5a enhances dysregulated inflammatory and angiogenic responses to malaria in vitro: potential implications for placental malaria. PLoS One. 2009; 4(3): e4953.

Moore JM, Chaisavaneeyakorn S, Perkins DJ, Othoro C, Otieno J, Nahlen BL, et al. Hemozoin differentially regulates proinflammatory cytokine production in human immunodeficiency virus-seropositive and -seronegative women with placental malaria. Infect Immun. 2004; 72(12): 7022-9.


Download data is not yet available.
Received 2012-08-26
Accepted 2013-08-16
Published 2013-09-30