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Malaria during pregnancy has been associated with significant risks to both the mother and the fetus, leading to complications such as anemia, low birth weight, and increased infant mortality. The trophoblast cells, a key component of the placenta, are crucial for nutrient and oxygen exchange between mother and fetus. The differentiation of cytotrophoblasts (CTBs) into syncytiotrophoblasts (STBs) is critical for proper pregnancy development. These cells form the bi-stratified epithelium surrounding the placental villi. While previous studies have described an inflammatory activation of STB cells exposed to Plasmodium falciparum-infected erythrocytes (P. falciparum-IE) or components such as hemozoin (HZ), little is known about the direct effect this parasite may have on the epithelial turnover and function of trophoblast cells. This study aims to contribute to understanding mechanisms leading to placental damage during placental malaria using a BeWo cell line as a differentiation model. It was found that P. falciparum-IE interferes with the fusion of BeWo cells, affecting the differentiation process of trophoblast. A reduction in syncytialization could be associated with the adverse effects of infection in fetal health, altering the remodeling of the trophoblast epithelial barrier and reducing their capacity to exchange substances. However, further studies are necessary to assess alterations in the functionality of this epithelium. [ABSTRACT FROM AUTHOR]

Hemozoin (HZ) is a waste product of hemoglobin digestion by Plasmodium and has been implicated in several pathological processes, including inflammation, oxidative stress, endothelial dysfunction, and immune dysregulation. Studying the effects of HZ on the human placenta is essential to understanding the impact of malaria infection during pregnancy. The present study explored the impact of HZ produced by Plasmodium and β-hematin, referred to here as natural HZ (nHZ) and synthetic HZ (sHZ), respectively, on human placental explants exposed in vitro ., Methodology: nHZ was derived from Plasmodium falciparum cultures and isolated using magnetic MACS® Separation Columns (Miltenyi Biotec, Auburn, CA) [1]. sHZ was synthesized from hemin closure in an aqueous solution. Both nHZ and sHZ were characterized by infrared spectroscopy and scanning electron microscopy. Human placental explants (HPE) were exposed to 5 and 10 μg/mL of nHZ and sHZ for 24 h, and tissue integrity was studied using histological and immunohistochemical techniques., Results: The studies have demonstrated that the exposition of both the nHZ and sHZ to placental tissue are comparable and cause effects in increased STB detachment, dysregulation of collagen distribution in the villous stroma, and increase in the frequency of cell apoptosis. This contributes to the understanding of the pathophysiology of malaria in pregnancy using synthetic products such as β-hematin., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Authors.)