Differential Activation of Fetal Hofbauer Cells in Primigravidas Is Associated with Decreased Birth Weight in Symptomatic Placental Malaria
Figure 3
Hemozoin localization within villous syncytiotrophoblasts and Hofbauer cells (HBCs) and associations with gravidity and birth weight. (a)-(b) Hemozoin (HZ) colocalized with KRT7+ syncytiotrophoblasts ((a) left with boxed area magnified [middle]) and CD68+ HBCs ((b) left with boxed area magnified [middle]) within the villi of P. falciparum-infected placentas. Polarized light enabled the visualization of HZ crystals ((a) and (b) right). Bar=40μm (left), 10μm (middle). (c) Primigravidas (PG, white, n=9) showed increased percentage of villi with HZ, numbers of HZ-positive STBs and HZ-positive HBCs, compared to multigravidas (MG, gray, n=8). Data is shown as median, interquartile range, and adjacent values. P-values were calculated using Wilcoxon rank sum test. (d) Linear regression showed that birth weight decreased as the percentage of villi containing HZ increased (regression coefficient b= -0.032 kg, p=0.035). Abbreviations: KRT7, cytokeratin 7; IVS, intervillous space; VC, villous core; HZ, hemozoin; PG, primigravida; MG, multigravida; STB, syncytiotrophoblast; HBC, Hofbauer cell; HPF, high-powered field.