Impact of placental malaria and hypergammaglobulinemia on transplacental transfer of respiratory syncytial virus antibody in Papua New Guinea

Atwell, Jessica E., Thumar, Bhagvanji, Robinson, Leanne, Tobby, Roselyn, Yambo, Phantica, Ome-Kaius, Maria, Siba, Peter M., Unger, Holger W., Rogerson, Stephen, King, Christopher L., and Karron, Ruth A. (2016) Impact of placental malaria and hypergammaglobulinemia on transplacental transfer of respiratory syncytial virus antibody in Papua New Guinea. Journal of Infectious Diseases, 213 (3). pp. 423-431.

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Abstract

Background: Passively acquired respiratory syncytial virus (RSV) neutralizing antibody protects against RSV-associated lower respiratory infections, but placental malaria (PM) and maternal hypergammaglobulinemia might interfere with transplacental immunoglobulin transport.

Methods:We measured RSV plaque-reduction neutralization (PRN) antibody in 300 full-term maternal/cord serum pairs in 2 cohorts in malaria-endemic Papua New Guinea: Alexishafen (2005-2008) and the Fetal Immunity Study (FIS) (2011-2013). We defined impaired transport as a cord-to-maternal titer ratio < 1.0 and a protective RSV PRN titer (PRNT) 1:200.

Results:PM and hypergammaglobulinemia occurred in 60% and 54% of Alexishafen mothers versus 8% and 9% of FIS mothers, respectively. 34% of Alexishafen and 32% of FIS pairs demonstrated impaired transport. Multivariate modeling revealed significant associations between increasing maternal IgG (log(2)) and impaired transport (adjusted OR, Alexishafen: 2.68 [1.17-6.14], FIS: 6.94 [1.94-24.8]) but no association with PM. 34% of Alexishafen and 31% of FIS cord PRNTs were < 1:200.

Conclusions:Impaired RSV antibody transport was observed in approximately one-third of maternal/cord pairs. Hypergammaglobulinemia, but not PM, was associated with impaired transport, particularly among women with low RSV PRNT. Detection of RSV PRNT < 1:200 in one-third of cord sera confirms the need to increase levels of RSV neutralizing antibody in pregnant women through maternal immunization.

Item ID: 44056
Item Type: Article (Research - C1)
ISSN: 1537-6613
Keywords: hypergammaglobulinemia, maternal immunization, placental malaria, RSV, transplacental transfer of antibody
Funders: PATH Malaria Vaccine Initiative (PATH-MVI), National Institute of Allergy and Infectious Disease (NIAID)
Projects and Grants: NIH AI AI064687, DMID #11-0037
Date Deposited: 20 Apr 2016 07:34
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111401 Foetal Development and Medicine @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920114 Reproductive System and Disorders @ 50%
97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 50%
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