Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta

Introduction: Placental malaria (PM) is characterized by accumulation of inflammatory leukocytes in the placenta, leading to poor pregnancy outcomes. Understanding of the underlying mechanisms remains incomplete. Neutrophils respond to malaria parasites by phagocytosis, generation of oxidants, and e...

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Main Authors: Sarr, D., Oliveira, L.J., Russ, B.N., Owino, S.O., Middii, J.D., Mwalimu, Stephen, Ambasa, L., Almutairi, F., Vulule, J., Rada, B., Moore, J.M.
Format: Journal Article
Language:Inglés
Published: Frontiers Media 2021
Subjects:
Online Access:https://hdl.handle.net/10568/115863
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author Sarr, D.
Oliveira, L.J.
Russ, B.N.
Owino, S.O.
Middii, J.D.
Mwalimu, Stephen
Ambasa, L.
Almutairi, F.
Vulule, J.
Rada, B.
Moore, J.M.
author_browse Almutairi, F.
Ambasa, L.
Middii, J.D.
Moore, J.M.
Mwalimu, Stephen
Oliveira, L.J.
Owino, S.O.
Rada, B.
Russ, B.N.
Sarr, D.
Vulule, J.
author_facet Sarr, D.
Oliveira, L.J.
Russ, B.N.
Owino, S.O.
Middii, J.D.
Mwalimu, Stephen
Ambasa, L.
Almutairi, F.
Vulule, J.
Rada, B.
Moore, J.M.
author_sort Sarr, D.
collection Repository of Agricultural Research Outputs (CGSpace)
description Introduction: Placental malaria (PM) is characterized by accumulation of inflammatory leukocytes in the placenta, leading to poor pregnancy outcomes. Understanding of the underlying mechanisms remains incomplete. Neutrophils respond to malaria parasites by phagocytosis, generation of oxidants, and externalization of Neutrophil Extracellular Traps (NETs). NETs drive inflammation in malaria but evidence of NETosis in PM has not been reported. Neutrophil activity in the placenta has not been directly investigated in the context of PM and PM/HIV-co-infection. Methods: Using peripheral and placental plasma samples and placental tissue collected from Kenyan women at risk for malaria and HIV infections, we assessed granulocyte levels across all gravidities and markers of neutrophil activation, including NET formation, in primi- and secundigravid women, by ELISA, western blot, immunohistochemistry and immunofluorescence. Results: Reduced peripheral blood granulocyte numbers are observed with PM and PM/HIV co-infection in association with increasing parasite density and placental leukocyte hemozoin accumulation. In contrast, placental granulocyte levels are unchanged across infection groups, resulting in enhanced placental: peripheral count ratios with PM. Within individuals, PM- women have reduced granulocyte counts in placental relative to peripheral blood; in contrast, PM stabilizes these relative counts, with HIV coinfection tending to elevate placental counts relative to the periphery. In placental blood, indicators of neutrophil activation, myeloperoxidase (MPO) and proteinase 3 (PRTN3), are significantly elevated with PM and, more profoundly, with PM/HIV co-infection, in association with placental parasite density and hemozoin-bearing leukocyte accumulation. Another neutrophil marker, matrix metalloproteinase (MMP9), together with MPO and PRTN3, is elevated with self-reported fever. None of these factors, including the neutrophil chemoattractant, CXCL8, differs in relation to infant birth weight or gestational age. CXCL8 and MPO levels in the peripheral blood do not differ with infection status nor associate with birth outcomes. Indicators of NETosis in the placental plasma do not vary with infection, and while structures consistent with NETs are observed in placental tissue, the results do not support an association with PM. Conclusions: Granulocyte levels are differentially regulated in the peripheral and placental blood in the presence and absence of PM. PM, both with and without pre-existing HIV infection, enhances neutrophil activation in the placenta. The impact of local neutrophil activation on placental function and maternal and fetal health remains unclear. Additional investigations exploring how neutrophil activation and NETosis participate in the pathogenesis of malaria in pregnant women are needed.
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spelling CGSpace1158632025-08-15T13:21:53Z Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta Sarr, D. Oliveira, L.J. Russ, B.N. Owino, S.O. Middii, J.D. Mwalimu, Stephen Ambasa, L. Almutairi, F. Vulule, J. Rada, B. Moore, J.M. malaria health hiv infections placenta Introduction: Placental malaria (PM) is characterized by accumulation of inflammatory leukocytes in the placenta, leading to poor pregnancy outcomes. Understanding of the underlying mechanisms remains incomplete. Neutrophils respond to malaria parasites by phagocytosis, generation of oxidants, and externalization of Neutrophil Extracellular Traps (NETs). NETs drive inflammation in malaria but evidence of NETosis in PM has not been reported. Neutrophil activity in the placenta has not been directly investigated in the context of PM and PM/HIV-co-infection. Methods: Using peripheral and placental plasma samples and placental tissue collected from Kenyan women at risk for malaria and HIV infections, we assessed granulocyte levels across all gravidities and markers of neutrophil activation, including NET formation, in primi- and secundigravid women, by ELISA, western blot, immunohistochemistry and immunofluorescence. Results: Reduced peripheral blood granulocyte numbers are observed with PM and PM/HIV co-infection in association with increasing parasite density and placental leukocyte hemozoin accumulation. In contrast, placental granulocyte levels are unchanged across infection groups, resulting in enhanced placental: peripheral count ratios with PM. Within individuals, PM- women have reduced granulocyte counts in placental relative to peripheral blood; in contrast, PM stabilizes these relative counts, with HIV coinfection tending to elevate placental counts relative to the periphery. In placental blood, indicators of neutrophil activation, myeloperoxidase (MPO) and proteinase 3 (PRTN3), are significantly elevated with PM and, more profoundly, with PM/HIV co-infection, in association with placental parasite density and hemozoin-bearing leukocyte accumulation. Another neutrophil marker, matrix metalloproteinase (MMP9), together with MPO and PRTN3, is elevated with self-reported fever. None of these factors, including the neutrophil chemoattractant, CXCL8, differs in relation to infant birth weight or gestational age. CXCL8 and MPO levels in the peripheral blood do not differ with infection status nor associate with birth outcomes. Indicators of NETosis in the placental plasma do not vary with infection, and while structures consistent with NETs are observed in placental tissue, the results do not support an association with PM. Conclusions: Granulocyte levels are differentially regulated in the peripheral and placental blood in the presence and absence of PM. PM, both with and without pre-existing HIV infection, enhances neutrophil activation in the placenta. The impact of local neutrophil activation on placental function and maternal and fetal health remains unclear. Additional investigations exploring how neutrophil activation and NETosis participate in the pathogenesis of malaria in pregnant women are needed. 2021-10-19 2021-11-08T08:39:36Z 2021-11-08T08:39:36Z Journal Article https://hdl.handle.net/10568/115863 en Open Access Frontiers Media Sarr, D., Oliveira, L.J., Russ, B.N., Owino, S.O., Middii, J.D., Mwalimu, S., Ambasa, L., Almutairi, F., Vulule, J., Rada, B. and Moore, J.M. 2021. Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta. Frontiers in Immunology 12: 682668.
spellingShingle malaria
health
hiv infections
placenta
Sarr, D.
Oliveira, L.J.
Russ, B.N.
Owino, S.O.
Middii, J.D.
Mwalimu, Stephen
Ambasa, L.
Almutairi, F.
Vulule, J.
Rada, B.
Moore, J.M.
Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta
title Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta
title_full Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta
title_fullStr Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta
title_full_unstemmed Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta
title_short Myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria/HIV coinfection in the human placenta
title_sort myeloperoxidase and other markers of neutrophil activation associate with malaria and malaria hiv coinfection in the human placenta
topic malaria
health
hiv infections
placenta
url https://hdl.handle.net/10568/115863
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