Browsing by Author "Kobia, Francis M."

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    Infectious and environmental placental insults: from underlying biological pathways to diagnostics and treatments
    (Oxford Academic, 2023-09-23) Chenge, Samuel.; Ngure, Harrison.; Kanoi, Bernard N.; Sferruzzi-Perri, Amanda N.; Kobia, Francis M.
    Because the placenta is bathed in maternal blood, it is exposed to infectious agents and chemicals that may be present in the mother’s circulation. Such exposures, which do not necessarily equate with transmission to the fetus, may primarily cause placental injury, thereby impairing placental function. Recent research has improved our understanding of the mechanisms by which some infectious agents are transmitted to the fetus, as well as the mechanisms underlying their impact on fetal outcomes. However, less is known about the impact of placental infection on placental structure and function, or the mechanisms underlying infection-driven placental pathogenesis. Moreover, recent studies indicate that noninfectious environmental agents accumulate in the placenta, but their impacts on placental function and fetal outcomes are unknown. Critically, diagnosing placental insults during pregnancy is very difficult and currently, this is possible only through postpartum placental examination. Here, with emphasis on humans, we discuss what is known about the impact of infectious and chemical agents on placental physiology and function, particularly in the absence of maternal–fetal transmission, and highlight knowledge gaps with potential implications for diagnosis and intervention against placental pathologies.
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    Infectious and environmental placental insults: from underlying biological pathways to diagnostics and treatments
    (Pathogens and Disease, 2023-09-19) Chenge, Samuel; Ngure, Harrison; Kanoi, Bernard N.; Sferruzzi-Perr, Amanda N.; Kobia, Francis M.
    Because the placenta is bathed in maternal blood, it is exposed to infectious agents and chemicals that may be present in the mother’s circulation. Such exposures, which do not necessarily equate with transmission to the fetus, may primarily cause placental injury, thereby impairing placental function. Recent research has improved our understanding of the mechanisms by which some infectious agents are transmitted to the fetus, as well as the mechanisms underlying their impact on fetal outcomes. However, less is known about the impact of placental infection on placental structure and function, or the mechanisms underlying infection-driven placental pathogenesis. Moreover, recent studies indicate that noninfectious environmental agents accumulate in the placenta, but their impacts on placental function and fetal outcomes are unknown. Critically, diagnosing placental insults during pregnancy is very difficult and currently, this is possible only through postpartum placental examination. Here, with emphasis on humans, we discuss what is known about the impact of infectious and chemical agents on placental physiology and function, particularly in the absence of maternal–fetal transmission, and highlight knowledge gaps with potential implications for diagnosis and intervention against placental pathologies.
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    PublicationOpen Access
    Infectious and environmental placental insults: from underlying biological pathways to diagnostics and treatments
    (Pathogens and Disease, 2023-09-19) Chenge, Samuel; Ngure, Harrison; Kanoi, Bernard N.; Sferruzzi-Perri, Amanda N.; Kobia, Francis M.
    Because the placenta is bathed in maternal blood, it is exposed to infectious agents and chemicals that may be present in the mother’s circulation. Such exposures, which do not necessarily equate with transmission to the fetus, may primarily cause placental injury, thereby impairing placental function. Recent research has improved our understanding of the mechanisms by which some infectious agents are transmitted to the fetus, as well as the mechanisms underlying their impact on fetal outcomes. However, less is known about the impact of placental infection on placental structure and function, or the mechanisms underlying infection-driven placental pathogenesis. Moreover, recent studies indicate that noninfectious environmental agents accumulate in the placenta, but their impacts on placental function and fetal outcomes are unknown. Critically, diagnosing placental insults during pregnancy is very difficult and currently, this is possible only through postpartum placental examination. Here, with emphasis on humans, we discuss what is known about the impact of infectious and chemical agents on placental physiology and function, particularly in the absence of maternal–fetal transmission, and highlight knowledge gaps with potential implications for diagnosis and intervention against placental pathologies.
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    Potential pharmacologic interventions targeting TLR signaling in placental malaria
    (Cell press, 2022-05) Obimbo, Moses; Gitaka , Jesse; Smith, Roger; Kobia, Francis M.; Maiti, Kaushik
    In P. falciparum malaria endemic regions, expectant women are at high risk of placental malaria due to P. falciparum sequestration in the placenta, which adversely affects pregnancy outcomes. Placental malaria persists even when the peripheral parasite has been cleared from maternal circulation or is undetectable, and is detectable only by placental histological analysis. There are no interventions for clearing P. falciparum from the placenta or reversing associated placental injury. Poor placental malaria outcomes are attributed to maternal innate immune reactions to P. falciparum sequestration in the placenta. Studies show that fetal innate immune responses counter maternal responses, improving placental malaria outcomes. Evidence suggests that pharmacologically targeting fetal–maternal innate immune interactions during placental malaria may improve pregnancy 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 placental malaria 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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    Predictors of low birth weight in pregnant women with malaria: a prospective cohort facility-based 1 study in Webuye-Kenya
    (MEDRxiv, 2023-10-09) Gitaka, Jesse; Mukala, Joseph; Mogere, Dominic; Kirira, Peter; Kanoi, Bernard N; Akinyi, Violet; Kobia, Francis M.; Waweru, Harrison
    Malaria is caused by protozoa of the genus Plasmodium and remains a major public health burden in Sub-Saharan Africa. Its prevalence varies between 9 to 18% with harmful consequences to both the mother and her baby, including adverse pregnancy outcomes such low birth weight, high morbidity, and mortality. However, effective antenatal strategies for improving maternal and child health outcomes through the prevention, early detection, and treatment of malaria in pregnancy, are still lacking in resource-constrained settings. Here, we sought to determine the predictors of low birth weight in pregnant women with malaria in a cohort study in Webuye hospital. Prior to the enrollment of 140 participants, permission was sought from relevant institutions and consent from the participants. Malaria test was conducted either with microscopy or rapid test, and then the cohort splits into malaria positive and negative followed up from the first antenatal visit (March 2022) and delivery (December 2022). Before data collection, training, pre-testing and quality control were duly observed. Data were fed into SPSS 27 version, Chi-square and Fischer’s Exact were used for bi-variate analysis at a p-value less or equal 0.05 (95%). Our results revealed that birth cohort with malaria did not result in significant low birth weight with a relative risk of 0.999, confidence level of 0.926-1.077. The prevalence of low birth weight was 4.6% with 6 cases of which 3 (4.5%) in the negative cohort and 3 (4.7%) in the positive cohort. Anemic pregnant women were 41 (31.5%), HIV were 5 (3,8%), pre-eclampsia was 5 (3.8%), gestational diabetes was 2 (1.5%). Confounding factors, such as anemia, HIV, preeclampsia, and gestational diabetes did not influence low birthweight (p-value >0.923). Otherwise, most of the participants were aged 18–25 years, were primigravida, were married, had secondary school level education, earned between 20-30 thousand shillings, were resident in rural areas, and were in their second trimester. Marital status, gestational age and area of residence were associated with malaria with a p-value less than 0.001 and 0.028 respectively.