The Partners propose to conduct a cohort study in pregnant women and their newborns to quantify the effects of Pregnancy-Associated Malaria (PAM) and to identify a PAM vaccine candidate. Effects of PAM on the pregnant woman (placental infection and anaemia), the offspring (birth weight reduction), and the infant (increased morbidity and mortality) are well known. Studies underlined the role of P. falciparum variable surface antigens expressed on infected erythrocytes in binding to placenta. A specific immune response against this antigen reduces the effect of PAM during latter pregnancies, making possible to develop a new preventive strategy based on the enhancement of this specific response. This goal will be achieved through cohort studies in 2 endemic areas (West and East Africa), as the mechanisms and the resulting effects may vary with transmission. Biological samples will be collected during pregnancy and infancy to dissect the pathological and immune mechanisms involved, as well as to characterize phenotypically and genetically the infecting parasites, providing a structural basis for anti-PAM vaccine design. The immunopathological effects will be measured in the mothers, their newborns, and the infant, in relation with timing of infection. The ultimate goal is to identify the most immunogenic epitopes of VAR2CSA (the major variable surface antigens of P. falciparum parasites infecting the pregnant women) to be included in such a vaccine. It is anticipated that the product of this project will be directly usable to enter in the pipeline of vaccine development. The 7 Partners of the consortium (5 from 4 EU countries, and 2 from Benin and Tanzania) have a combined history of high class, internationally-recognized research in malaria. All EU teams have huge experience of collaboration with malaria endemic countries institutions and with studies related to malaria in pregnant women, that are also routinely conducted by the 2 African Partners.
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