{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:49Z","timestamp":1788355249243,"version":"build-2803163510"},"reference-count":56,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Infection with\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    or\n                    <jats:italic>Plasmodium vivax<\/jats:italic>\n                    during pregnancy can result in adverse outcomes for both mother and child. Submicroscopic infections are common in malaria-endemic areas but often remain chronic, asymptomatic, and untreated. Chronic infections persistently stimulate the immune system, altering expression of immune mediators and promoting expansion of regulatory T cells. These immune changes could compromise responses to routine vaccinations. This study evaluated the immunomodulatory effects of submicroscopic infection by\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    and\n                    <jats:italic>P. vivax<\/jats:italic>\n                    during pregnancy and their associations with immune responses to the tetanus toxoid (TT) vaccine. A descriptive, prospective, and longitudinal design was applied to three groups: 1) women infected with malaria during pregnancy but negative at delivery (\n                    <jats:italic>n<\/jats:italic>\n                    = 50), 2) women with submicroscopic infection at delivery (\n                    <jats:italic>n<\/jats:italic>\n                    = 48), and 3) uninfected women (\n                    <jats:italic>n<\/jats:italic>\n                    = 75). Samples were collected between 2008 and 2018 in two regions of Colombia. Women with submicroscopic plasmodial infections and a history of pregnancy-associated malaria were diagnosed by quantitative polymerase chain reaction (qPCR) and thick blood smears. Cytokine expression was quantified by real-time qPCR, and anti-TT IgG levels were measured by ELISA in peripheral blood. Pregnant women with submicroscopic\n                    <jats:italic>Plasmodium<\/jats:italic>\n                    infection exhibited higher expression of IL-10, FoxP3, CTLA4, and TNFRII, indicative of immune regulation. Anti-TT IgG levels were significantly reduced in infected women compared with uninfected women. These findings suggest that submicroscopic\n                    <jats:italic>Plasmodium<\/jats:italic>\n                    infection during pregnancy promotes a regulatory immune profile characterized by expression of immune molecules typical of exhausted T cells and alters immune response to the TT vaccine.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0775","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:07:57Z","timestamp":1783616877000},"page":"528-536","source":"Crossref","is-referenced-by-count":0,"title":["Dysregulation of Immune Regulatory Mediators and Reduced Antitetanus Toxoid Antibodies Are Associated with Submicroscopic Plasmodium Infection in Pregnancy in Colombia"],"prefix":"10.4269","volume":"115","author":[{"given":"Catalina","family":"\u00c1lvarez\u2010Larrotta","sequence":"first","affiliation":[{"name":"Grupo Salud y Comunidad-Cesar Uribe Piedrah\u00edta, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga M.","family":"Agudelo","sequence":"additional","affiliation":[{"name":"Grupo Salud y Comunidad-Cesar Uribe Piedrah\u00edta, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Carmona\u2010Fonseca","sequence":"additional","affiliation":[{"name":"Grupo Salud y Comunidad-Cesar Uribe Piedrah\u00edta, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie K.","family":"Yanow","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Alberta, Edmonton, Canada;"},{"name":"School of Public Health, University of Alberta, Edmonton, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana M.","family":"Arango","sequence":"additional","affiliation":[{"name":"Grupo Salud y Comunidad-Cesar Uribe Piedrah\u00edta, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia;"},{"name":"GEINCRO, Facultad de Ciencias de la Salud, Fundaci\u00f3n Universitaria San Mart\u00edn, Sabaneta, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"2","key":"b1","series-title":"Lancet Infect Dis","first-page":"93","article-title":"Epidemiology and burden of malaria in pregnancy","volume":"7","author":"Desai","year":"2007"},{"issue":"3","key":"b2","series-title":"Rev Bras Epidemiol","first-page":"373","article-title":"Efecto de la infecci\u00f3n submicrosc\u00f3pica o policlonal de Plasmodium falciparum sobre la madre y el producto de la gestaci\u00f3n. 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