Iron Homeostasis in Mother and Child during Placental Malaria Infection

Susanne Van Santen Department of General Internal Medicine, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

Search for other papers by Susanne Van Santen in
Current site
Google Scholar
PubMed
Close
,
Quirijn de Mast Department of General Internal Medicine, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

Search for other papers by Quirijn de Mast in
Current site
Google Scholar
PubMed
Close
,
Adrian J. F. Luty Department of General Internal Medicine, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

Search for other papers by Adrian J. F. Luty in
Current site
Google Scholar
PubMed
Close
,
Erwin T. Wiegerinck Department of General Internal Medicine, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

Search for other papers by Erwin T. Wiegerinck in
Current site
Google Scholar
PubMed
Close
,
Andre J. A. M. Van der Ven Department of General Internal Medicine, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

Search for other papers by Andre J. A. M. Van der Ven in
Current site
Google Scholar
PubMed
Close
, and
Dorine W. Swinkels Department of General Internal Medicine, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

Search for other papers by Dorine W. Swinkels in
Current site
Google Scholar
PubMed
Close
Restricted access

In malaria-endemic areas, iron deficiency and placental Plasmodium falciparum infection commonly coexist. In primigravidae and their newborns, hepcidin and other iron parameters were evaluated in groups and classified according to placental P. falciparum and maternal anemia status. Mothers had relatively high hepcidin levels considering their low iron status. In cord blood, levels of hepcidin, hemoglobin, and other iron parameters were also similar for groups. We conclude that maternal hepcidin is not significantly altered as a function of placental infection and/or anemia. Importantly, fetal hemoglobin and iron status were also unaffected, regardless of the presence of placental infection or maternal anemia.

Author Notes

*Address correspondence to Dorine W. Swinkels, Radboud University, Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: d.swinkels@labgk.umcn.nl

Authors' addresses: Susanne Van Santen, Quirijn de Mast, Adrian J. F. Luty, Erwin T. Wiegerinck, Andre J. A. M. Van der Ven, and Dorine W. Swinkels, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands, E-mails: s.vansanten@aig.umcn.nl, q.demast@aig.umcn.nl, adrianluty@ymail.com, e.wiegerinck@labg.umcn.nl, a.vanderven@aig.umcn.nl, and d.swinkels@labgk.umcn.nl.

Reprint requests: Dorine W. Swinkels, Department of Laboratory Medicine, Laboratory of Clinical Chemistry, 441, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands, E-mail: d.swinkels@labgk.umcn.nl.

  • 1.

    Desai M, Ter Kuile FO, Nosten F, McGready R, Asamoa K, Brabin B, Newman RD, 2007. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis 7: 93–104.

  • 2.

    Guyatt HL, Snow RW, 2004. Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa. Clin Microbiol Rev 17: 760–769.

  • 3.

    Rogerson SJ, Hviid L, Duffy PE, Leke RF, Taylor DW, 2007. Malaria in pregnancy: pathogenesis and immunity. Lancet Infect Dis 7: 105–117.

  • 4.

    Friedman JF, Kurtis JD, Kabyemela ER, Fried M, Duffy PE, 2009. The iron trap: iron, malaria and anemia at the mother-child interface. Microbes Infect 11: 460–466.

  • 5.

    World Health Organization, 2008. Worldwide Prevalence of Anemia 1993–2005. Available at: http://whqlibdoc/who/int/publications/2008. Accessed January 5, 2010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Sazawal S, Black RE, Ramsan M, Chwaya HM, Stoltzfus RJ, Dutta A, Dhingra U, Kabole I, Deb S, Othman MK, Kabole FM, 2006. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. Lancet 14: 133–143.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Prentice AM, Ghattas H, Doherty C, Cox SE, 2007. Iron metabolism and malaria. Food Nutr Bull 28: S524–S539.

  • 8.

    Nemeth E, Tuttle MS, Powelson J, Vaughn MB, Donovan A, Ward DM, Ganz T, Kaplan J, 2004. Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science 17: 2090–2093.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Nemeth E, Ganz T, 2009. The role of hepcidin in iron metabolism. Acta Haematol 122: 78–86.

  • 10.

    de Mast Q, Nadjm B, Reyburn H, Kemna EH, Amos B, Laarakkers CM, Silalye S, Verhoef H, Sauerwein RW, Swinkels DW, van der Ven AJAM, 2009. Assessment of urinary concentrations of hepcidin provides novel insight into disturbances in iron homeostasis during malarial infection. J Infect Dis 199: 253–262.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    de Mast Q, Syafruddin D, Keijmel S, Olde Riekerink T, Deky O, Asih PB, Swinkels DW, van der Ven AJ, 2010. Increased serum hepcidin and alterations in blood iron parameters associated with asymptomatic P. falciparum and P. vivax malaria. Haematologica 95: 1068–1074.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Kemna E, Pickkers P, Nemeth E, van der Hoeven H, Swinkels D, 2005. Time-course analysis of hepcidin, serum iron, and plasma cytokine levels in humans injected with LPS, 2005. Blood 106: 1864–1866.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Bastin J, Drakesmith H, Rees M, Sargent I, Townsend A, 2006. Localisation of proteins of iron metabolism in the human placenta and liver. Br J Haematol 134: 532–543.

  • 14.

    Gambling L, Czopek A, Andersen HS, Holtrop G, Srai SK, Krejpcio Z, McArdle HJ, 2009. Fetal iron status regulates maternal iron metabolism during pregnancy in the rat. Am J Physiol Regul Integr Comp Physiol 296: R1063–R1070.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    McArdle HJ, Andersen HS, Jones H, Gambling L, 2008. Copper and iron transport across the placenta: regulation and interactions. J Neuroendocrinol 20: 427–431.

  • 16.

    Martin ME, Nicolas G, Hetet G, Vaulont S, Grandchamp B, Beaumont C, 2004. Transferrin receptor 1 mRNA is downregulated in placenta of hepcidin transgenic embryos. FEBS Lett 574: 187–191.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Brustoski K, Moller U, Kramer M, Hartgers FC, Kremsner PG, Krzych U, Luty AJ, 2006. Reduced cord blood immune effector-cell responsiveness mediated by CD4+ cells induced in utero as a consequence of placental Plasmodium falciparum infection. J Infect Dis 193: 146–154.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    World Health Organization, 2010. Iron Deficiency Anemia: Assessment, Prevention and Control. A Guide for Programme Managers. Available at: http://www/who/int/nutrition/publications/en/ida_assessment_prevention_control.pdf. Accessed January 5, 2010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Swinkels DW, Girelli D, Laarakkers C, Kroot J, Campostrini N, Kemna EH, Tjalsma H, 2008. Advances in quantitative hepcidin measurements by time-of-flight mass spectrometry. PLoS One e2706.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Kroot JJ, Hendriks JC, Laarakkers CM, Klaver SM, Kemna EH, Tjalsma H, Swinkels DW, 2009. (Pre)analytical imprecision, between-subject variability, and daily variations in serum and urine hepcidin: implications for clinical studies. Anal Biochem 389: 124–129.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Beguin Y, 2003. Soluble transferrin receptor for the evaluation of erythropoiesis and iron status. Clin Chim Acta 329: 9–22.

  • 22.

    van den Broek NR, Letsky EA, 2000. Etiology of anemia in pregnancy in south Malawi. Am J Clin Nutr 72: 247S–256S.

  • 23.

    Kemna EH, Tjalsma H, Willems HL, Swinkels DW, 2008. Hepcidin: from discovery to differential diagnosis. Haematologica 93: 90–97.

  • 24.

    de Meeus JB, Pourrat O, Gombert J, Magnin G, 1998. C-reactive protein levels at the onset of labour and at day 3 post-partum in normal pregnancy. Clin Exp Obstet Gynecol 25: 9–11.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Howard CT, McKakpo US, Quakyi IA, Bosompem KM, Addison EA, Sun K, Sullivan D, Semba RD, 2007. Relationship of hepcidin with parasitemia and anemia among patients with uncomplicated Plasmodium falciparum malaria in Ghana. Am J Trop Med Hyg 77: 623–626.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Kabyemela ER, Muehlenbachs A, Fried M, Kurtis JD, Mutabingwa TK, Duffy PE, 2008. Maternal peripheral blood level of IL-10 as a marker for inflammatory placental malaria. Malar J 7: 26.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Keel SB, Abkowitz JL, 2009. The microcytic red cell and the anemia of inflammation. N Engl J Med 361: 1904–1906.

  • 28.

    Abrams ET, Kwiek JJ, Mwapasa V, Kamwendo DD, Tadesse E, Lema VM, Molyneux ME, Rogerson SJ, Meshnick SR, 2005. Malaria during pregnancy and foetal haematological status in Blantyre, Malawi. Malar J 4: 39.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Mokuolu OA, Falade CO, Orogade AA, Okafor HU, Adedoyin OT, Oguonu TA, Dada-Adegbola HO, Oguntayo OA, Ernest SK, Hamer DH, Callahan MV, 2009. Malaria at parturition in Nigeria: current status and delivery outcome. Infect Dis Obstet Gynecol 473971.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Muehlenbachs A, Fried M, Lachowitzer J, Mutabingwa TK, Duffy PE, 2007. Genome-wide expression analysis of placental malaria reveals features of lymphoid neogenesis during chronic infection. J Immunol 179: 557–565.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Abrams ET, Meshnick SR, 2009. Malaria during pregnancy in endemic areas: a lens for examining maternal-fetal conflict. Am J Hum Biol 21: 643–650.

Past two years Past Year Past 30 Days
Abstract Views 1750 1612 284
Full Text Views 314 19 1
PDF Downloads 114 21 3
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save