INFLAMMATORY REACTIONS IN PLACENTAL BLOOD OF PLASMODIUM-FALCIPARUM-INFECTED WOMEN AND HIGH-CONCENTRATIONS OF SOLUBLE E-SELECTIN AND A CIRCULATING PLASMODIUM-FALCIPARUM PROTEIN IN THE CORD SERA

To better understand reasons for increased susceptibility to malaria i n pregnancy; and the interrelationships between maternal malaria, loca l immune reactions and the development of the fetus, concentrations of soluble interleukin-10 (IL-10), cytokine receptors, adhesion molecule s, a Plasmodium falciparum protein, glutamate-rich protein (GLURP) and antibodies to P. falciparum rhoptry-associated protein-1 were measure d among 105 Gambian women and their neonates. Peripheral blood concent rations of IL-10, soluble cytokine receptors and soluble adhesion mole cules were found to be different from those concentrations measured in the placenta. Markers of inflammatory reactions: IL-10, sIL-2R, sIL-4 R, and soluble tumour necrosis factor receptor I (sTNF-RI) were found in high concentrations in the placenta, indicating that inflammatory r eactions take place in the placenta which has been regarded as an immu noprivileged site. Concentrations of soluble vascular cell adhesion mo lecule-1 (sVCAM-1) and soluble intracellular adhesion molecule-1 (sICA M-1), potential adhesion receptors for malaria parasites, were associa ted with an active P. falciparum infection in the placenta although th e associations did not reach significance. P. falciparum exoantigen, G LURP, was detected in cord blood indicating transplacental passage of malarial antigens. Concentrations of E-selectin were higher in cord bl ood samples compared with peripheral blood samples, This appeared to b e associated with development of cord endothelial cells and not with P . falciparum infection.