The impact of lipid-based nutrient supplementation on anti-malarial antibodies in pregnant women in a randomized controlled trial.

Upeksha P Chandrasiri, Freya J I Fowkes, Jack S Richards, Christine Langer, Yue-Mei Fan, Steve M Taylor, James G Beeson, Kathryn G Dewey, Kenneth Maleta, Per Ashorn, Stephen J Rogerson

Journal: Malaria journal 2016;14():193

PMID: 25957793

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Abstract

BACKGROUND

Malaria and undernutrition frequently coexist, especially in pregnant women and young children. Nutrient supplementation of these vulnerable groups might reduce their susceptibility to malaria by improving immunity.

METHODS

Antibody immunity to antigens expressed by a placental-binding parasite isolate, a non-placental binding parasite isolate, merozoites and schizonts at enrolment (before 20 gestation weeks) and at 36 gestation weeks were measured in 1,009 Malawian pregnant women receiving a daily lipid-based nutrient supplement, multiple micronutrients or iron and folic acid, who were participants in a randomized clinical trial assessing the effects of nutrient supplementation on pregnancy outcomes and child development (registration ID: NCT01239693).

RESULTS

Antibodies to placental-binding isolates significantly increased while antibodies to most merozoite antigens declined over pregnancy. Overall, after adjustment for covariates, the type of supplementation did not influence antibody levels at 36 gestation weeks or the rate of change in antibody levels from enrolment to 36 weeks. A negative association between maternal body mass index and opsonizing antibodies to placental-binding antigens (coefficient (95% CI) -1.04 (-1.84, -0.24), was observed. Similarly, women with higher socioeconomic status had significantly lower IgG and opsonizing antibodies to placental-binding antigens. Neither of these associations was significantly influenced by the supplementation type.

CONCLUSIONS

In the current cohort nutrient supplementation did not affect anti-malarial antibody responses, but poor and undernourished mothers should be a priority group in future trials.

Address: Department of Medicine, Clinical Sciences Building, The University of Melbourne, Royal Parade, Parkville, VIC, 3052, Australia. [email protected].; Macfarlane Burnet Institute of Medical Research, 85 Commercial Road, Melbourne, Australia. [email protected].; Centre for Epidemiology and Biostatistics, Department of Epidemiology, The University of Melbourne, Melbourne, Australia. [email protected].; Preventive Medicine and Department of Infectious Diseases, Monash University, Melbourne, Australia. [email protected].; Department of Medicine, Clinical Sciences Building, The University of Melbourne, Royal Parade, Parkville, VIC, 3052, Australia. [email protected].; Macfarlane Burnet Institute of Medical Research, 85 Commercial Road, Melbourne, Australia. [email protected].; Macfarlane Burnet Institute of Medical Research, 85 Commercial Road, Melbourne, Australia. [email protected].; Department for International Health, University of Tampere School of Medicine, Tampere, Finland. [email protected].; Department of Paediatrics, Tampere University Hospital, Tampere, Finland. [email protected].; Duke University Medical Center, Durham, North Carolina, USA. [email protected].; Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA. [email protected].; Department of Medicine, Clinical Sciences Building, The University of Melbourne, Royal Parade, Parkville, VIC, 3052, Australia. [email protected].; Macfarlane Burnet Institute of Medical Research, 85 Commercial Road, Melbourne, Australia. [email protected].; Department of Nutrition, University of California Davis, Davis, California, USA. [email protected].; College of Medicine, University of Malawi, Blantyre, Malawi. [email protected].; Department for International Health, University of Tampere School of Medicine, Tampere, Finland. [email protected].; Department of Paediatrics, Tampere University Hospital, Tampere, Finland. [email protected].; Department of Medicine, Clinical Sciences Building, The University of Melbourne, Royal Parade, Parkville, VIC, 3052, Australia. [email protected].

DOI: 10.1186/s12936-015-0707-2

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MeSH Terms: Adaptive Immunity, Adolescent, Adult, Antibodies, Protozoan, Cohort Studies, Dietary Supplements, Female, Folic Acid, Humans, Iron, Lipid Metabolism, Malaria, Malawi, Merozoites, Micronutrients, Plasmodium, Pregnancy, Pregnancy Outcome, Schizonts, Young Adult