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We measured antibodies to chondroitin sulfate A (CSA)-binding and placental Plasmodium falciparum-infected red blood cells (PRBCs) among pregnant women with or without placental malaria. Immunoglobulin G to PRBC surface antigens was rare in uninfected primigravidae (3.7%), more prevalent in infected primigravidae (70%; P&lt;.001), and common in infected (77%) and uninfected (83%) multigravidae. Similar patterns were seen for agglutinating antibodies, and antibodies were similar among women with past or active placental infection. PRBC adhesion to CSA was inhibited 60% by serum from infected primigravidae but 24% by serum from uninfected primigravidae (P=.025), whereas infection did not alter adhesion inhibition by multigravidae (77% inhibition)[corrected]. There was substantial heterogeneity in antibody type and levels. Antibodies did not correlate with parasite density or pregnancy outcome. Comparisons between antibodies suggest that adhesion-inhibitory antibodies and those to PRBC variant antigens have distinct and overlapping epitopes, may be acquired independently, and have different roles in immunity.

the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases

Antibodies to Variant Surface Antigens of<i>Plasmodium falciparum</i>–Infected Erythrocytes and Adhesion Inhibitory Antibodies Are Associated with Placental Malaria and Have Overlapping and Distinct Targets

Antibodies to Variant Surface Antigens ofPlasmodium falciparum–Infected Erythrocytes and Adhesion Inhibitory Antibodies Are Associated with Placental Malaria and Have Overlapping and Distinct Targets