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Potential pharmacologic interventions targeting TLR signaling in placental malaria

Journal

TRENDS IN PARASITOLOGY
Volume 38, Issue 7, Pages 513-524

Publisher

CELL PRESS
DOI: 10.1016/j.pt.2022.04.002

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Funding

  1. European Union
  2. Novartis Global Health, Basel Switzerland [TMA2019CDF-2736]
  3. African Academy of Sciences
  4. Royal Society through the FLAIR [FLR\R1\201314]

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Complications from placental malaria affect pregnancy outcomes, but recent studies suggest that fetal innate immune responses may play a positive role in improving outcomes. Pharmacologic modulation shows promise for better placental malaria outcomes.
Complications from placental malaria cause poor pregnancy outcomes, including low birthweight, preterm delivery, and stillbirths. Many of these complications are driven by maternal innate proinflammatory responses to the sequestration of Plasmodium falciparum in the placenta. However, recent studies show that, in reaction to maternal innate immune responses that are detrimental to the fetus, the fetus mounts innate immune counter-responses that ameliorate pregnancy outcomes. Such fetal-maternal conflict in placental malaria has potential for pharmacologic modulation for better pregnancy outcomes. Here, we discuss placentalmalaria pathogenesis, its complications, and the role of innate immunity and fetal-maternal innate immune conflict in placental malaria. Finally, we discuss pharmacologic immunomodulatory strategies and agents with the potential to improve placental malaria outcomes.

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