Placental malaria is associated with attenuated CD4 T-cell responses to tuberculin PPD 12 months after BCG vaccination

Walther, B., Miles, D.J., Waight, P., Palmero, M.S., Ojuola, O., Touray, E.S., Whittle, H., van der Sande, M., Crozier, S. and Flanagan, K.L. (2012) Placental malaria is associated with attenuated CD4 T-cell responses to tuberculin PPD 12 months after BCG vaccination. BMC Infectious Diseases, 12, 6. (doi:10.1186/1471-2334-12-6). (PMID:22243970)

Abstract

Background
Placental malaria (PM) is associated with prenatal malaise, but many PM+ infants are born without symptoms. As malaria has powerful immunomodulatory effects, we tested the hypothesis that PM predicts reduced T-cell responses to vaccine challenge.

Methods
We recruited healthy PM+ and PM- infants at birth. At six and 12 months, we stimulated PBMCs with tuberculin purified protein derivative (PPD) and compared expression of CD154, IL-2 and IFN? by CD4 T-cells to a negative control using flow cytometry.

We measured the length, weight and head circumference at birth and 12 months.

Results
IL-2 and CD154 expression were low in both groups at both timepoints, without discernable differences. Expression of IFN? was similarly low at 6 months but by 12 months, the median response was higher in PM- than PM + infants (p = 0.026). The PM+ infants also had a lower weight (p = 0.032) and head circumference (p = 0.041) at 12 months, indicating lower growth rates.

At birth, the size and weight of the PM+ and PM- infants were equivalent. By 12 months, the PM+ infants had a lower weight and head circumference than the PM- infants.

Conclusions
Placental malaria was associated with reduced immune responses 12 months after immune challenge in infants apparently healthy at birth.

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