Effect of maternal HIV and malaria on the transplacental transfer of antibodies against prevalent pathogens and vaccines in Mozambican women
[eng] Infectious diseases are one of the main causes of mortality in newborns born in Mozambique. Transplacental transfer of antibodies is essential for conferring protection during the first months of life against these diseases. In this doctoral thesis, we have assessed the impact of maternal HIV...
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| Formato: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Recursos: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/178908 |
| Acesso em linha: | https://hdl.handle.net/2445/178908 http://hdl.handle.net/10803/672103 |
| Access Level: | acceso abierto |
| Palavra-chave: | Immunologia Immunoglobulines Vacunes Malària VIH (Virus) Immunology Vaccines Malaria HIV (Viruses) |
| Resumo: | [eng] Infectious diseases are one of the main causes of mortality in newborns born in Mozambique. Transplacental transfer of antibodies is essential for conferring protection during the first months of life against these diseases. In this doctoral thesis, we have assessed the impact of maternal HIV infection and malaria during pregnancy on cord blood levels of antibodies and on the efficiency of placental transfer of IgG subclasses. The effect of other maternal factors and pregnancy outcomes has also been assessed. We have measured total IgG and IgG subclass levels in maternal and cord blood by quantitative suspension array technology against (i) pathogens of high burden and health impact in southern Mozambique, including Plasmodium falciparum, and (ii) antigens from vaccines used for maternal immunization and included in the Expanded Program of Immunization. Our results have shown that maternal antibody levels are the main determinants of cord antibody levels and the efficiency of IgG subclass transfer differs depending on the antigen and may vary with maternal antigen exposure. We have associated maternal HIV infection with a reduction in cord blood antibodies and with a decrease in placental transfer, mainly IgG1, against a wide range of pathogens and vaccine antigens. We have also associated malaria exposure with a reduction of cord antibody levels and with a decrease in placental transfer in an antigen-antibody dependent manner. Placental malaria has also been associated with a decrease in total IgG levels in the cord. Finally, we have assessed the effect of prematurity and low birth weight and we have found an association of prematurity with lower levels of total IgG against some antigens. We have not observed any negative effect of low birth weight, although we have found an increase in cord IgG2 levels against P. falciparum antigens that could be associated with a higher risk of severe malaria. In summary, in this thesis we have provided evidence that maternal HIV infection and malaria have negative implications in maternal and infant health, with special importance in sub-Saharan Africa where the prevalence and transmission of these pathogens are high. Our results point out that these infections should be further considered during vaccine development and evaluation, in particular with regards to maternal immunization strategies that are key in public health. |
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