Publication: A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection
3
Accepted Date
2013-12-28
Issued Date
2014-01-04
Copyright Date
2014
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Chaikitgosiyakul S, Rijken MJ, Muehlenbachs A, Lee SJ, Chaisri U, Viriyavejakul P, et al. A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection. Malar J. 2014 Jan 4;13:4.
Suggested Citation
Sethawud Chaikitgosiyakul, เสฏฐวุฒิ ชัยกิตโกสิยกุล, Rijken, Marcus J., Muehlenbachs, Atis, Lee, Sue J., Urai Chaisri, อุไร ไชยศรี, Parnpen Viriyavejakul, พรรณเพ็ญ วิริยเวชกุล, Turner, Gareth D., Emsri Pongponratn, เอี่ยมศรี พงศ์พนรัตน์, Nosten, Francois, McGready, Rose A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection. Chaikitgosiyakul S, Rijken MJ, Muehlenbachs A, Lee SJ, Chaisri U, Viriyavejakul P, et al. A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection. Malar J. 2014 Jan 4;13:4.. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/662
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Title
A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection
Abstract
BACKGROUND: Malaria in pregnancy remains a major health problem. Placental
malaria infection may cause pathophysiological changes in pregnancy and result in
morphological changes to placental villi. Quantitative histomorphological image
analysis of placental biopsies was performed to compare placental villous
architecture between active or treated placental malaria cases and controls.
METHODS: A total of 67 placentas were studied from three clinical groups: control
patients who did not have malaria (n = 27), active (n = 14) and treated (n=26)
malaria cases, including both Plasmodium falciparum and Plasmodium vivax
infections. Image analysis of histological placental sections was performed using
ImageJ software to measure the number and size (area) of terminal villi,
perimeter measurement per villus and total perimeter per unit area, and number of
capillaries per villus (vascularity). Histological features of placental malaria
were scored and these results were correlated with malaria status and clinical
outcomes.
RESULTS: Villous size correlated with vascularity (p <0.0001) but was inversely
correlated with observed villi per unit area, (p = 0.0001). Significantly greater
villous area and vascularity was observed in UK controls. Indices of histological
malaria infection were significantly greater in active versus treated malaria
cases. Active placental malaria cases showed significantly smaller villous area
(p <0.0084), vascularity (p <0.0139) and perimeter (p <0.0006) than treated
malaria cases or controls, but significantly more villi per unit area (p
<0.0001). Villous size in treated malaria cases was significantly larger than
active placental malaria cases (p <0.001) and similar to controls. There was a
significant relationship between villous number and anaemia at the time of
infection (p <0.0034), but not placental weight, birth weight or gestational age
at delivery. No differences were found between histology or villous morphology
comparing infections with P. falciparum or P. vivax.
CONCLUSIONS: These results imply that villous size, perimeter and vascularity are
acutely decreased during active placental malaria, decreasing the surface area
available for gas exchange per villus. However the increased number of villi per
unit area offsets this change and persists after treatment. Histopathological and
villous architectural changes may be reversed by early detection and appropriate
anti-malarial treatment.