Cortisol, Prolactin, Cytokines and susceptibility of Pregnant Sudanese Women to Plasmodium falciparum Malaria
Cortisol, Prolactin, Cytokines and susceptibility of Pregnant Sudanese Women to Plasmodium falciparum Malaria
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Date
2015-04-12
Authors
Nada Kamal Abd Ellatif Bayoumi
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Publisher
University of Khartoum
Abstract
Introduction: Globally, 200 million pregnant women infected with malaria each year.
Pregnant women are more susceptible to malaria infection than nonpregnant ones. It has
been proposed that nonspecific immunosuppression may be caused by pregnancyassociated
hormones. Cortisol and prolactin are among the most important candidates
which affect maternal immunity to Plasmodium falciparum malaria. Understanding the
hormonal and cytokine interactions that underlie susceptibility to the disease should be
helpful in elucidating the pathogenesis of Plasmodium falciparum malaria during
pregnancy.
Objectives: The current study was conducted in Wad Medani and New Halfa, areas
characterized by unstable malarial transmission in central and eastern Sudan,
respectively. Its aims were to investigate the role of and interactions between cortisol,
prolactin, interferon-γ (IFN-γ), interleukin-4 (IL-4) and interleukin-10 (IL-10) in
pregnant women with Plasmodium falciparum malaria and to investigate the cytokine
profiles in peripheral, placental and cord blood in parturient women in these areas.
Methods: In Wad Medani, the 82 pregnant subjects who were enrolled either had
uncomplicated, Plasmodium falciparum malaria (the 45 cases) or were apparently
uninfected and healthy women (the 37 controls) who were well matched to the cases.
Five ml of venous blood were withdrawn in plain tube, centrifuged and kept at -20 until
processed in the laboratory for cortisol, prolactin and cytokine analysis. Total serum
cortisol concentrations were determined with the 125I-F RIA cortisol test kit, whereas125IPRL
IRMA prolactin test kit was used to determine serum prolactin concentrations.
Enzyme-linked immunosorbent assay was used to measure the concentrations of the three
cytokines, IFN-γ, IL-4 and IL-10. In New Halfa, 5 mL of maternal, placental and cord
blood was collected immediately after delivery, quickly withdrawn in plain tube and
centrifuged and kept at -20 until processed. Enzyme-linked immunosorbent assay was
used to measure the concentrations of the three cytokines, IFN-γ, IL-4 and IL-10, in the
sera from peripheral, placental and cord blood of 87 parturient women (53 were found to
have past placental malaria infections).
V
Results: Wad Medani, compared with the controls, the cases were found to have
significantly higher serum concentrations of total cortisol and IL-10 and significantly
lower levels of prolactin and IFN-γ (but similar concentrations of IL-4). The hormone
and cytokine concentrations measured in the infected primigravidae were similar to those
recorded in the infected multigravidae. Among the cases, there was a significant positive
correlation between serum cortisol and IL-10 (r=0.188; P=0.025) and significant negative
correlations between prolactin and both IL-4 (r=20.175; P=0.038) and IL-10 (r=20.186;
P=0.027) but no significant correlation between prolactin and cortisol. In New Halfa, The
concentrations of these cytokines were significantly higher in peripheral and placental
sera from uninfected women than in sera from infected women. IFN-γ concentrations
were higher in the cord sera from uninfected women in comparison to the infected ones
too. The levels of these cytokines were not significantly different between the
primigravidae and multigravidae. Cord sera in all the groups had the lower levels of these
cytokines. Strong positive correlations were observed between peripheral and placental
cytokines.
Conclusions: In conclusion, it appears that, irrespective of parity, cortisol, prolactin and
certain cytokines are key mediators in the host response to Plasmodium falciparum
infection during pregnancy in women living in central Sudan, where malarial
transmission is unstable. In eastern Sudan, the patterns of the immune responses that
occur in placental, peripheral and cord blood were influenced by the malaria infections,
irrespective to the parity. Additionally, immune response during Plasmodium falciparum
infection is not different in the peripheral and placental compartments.
Description
A Thesis Submitted infulfillment for the Requirements of the Degree of PhD. in
Medical Biochemistry
Keywords
Cortisol, Prolactin, Cytokines ,susceptibility,Pregnant,Plasmodium, falciparum, Malaria
Citation
Nada Kamal Abd Ellatif Bayoumi
, Cortisol, Prolactin, Cytokines and susceptibility of Pregnant Sudanese Women to Plasmodium falciparum Malaria. – Khartoum : University of Khartoum, 2009. - 138 P. : illus., 28 cm.
Ph.D.