School of Public Health
Bangladesh - Arsenic and immune response to influenza vaccination in pregnant women and newborns
It is estimated that 200 million people worldwide are exposed to toxic levels of arsenic, 45 million of those people in Bangladesh alone. Arsenic is a known carcinogen, and also associated with cardiovascular disease, respiratory disease, diabetes, and skin lesions. It is also now understood that arsenic is immunotoxic, and may increase susceptibility to infectious disease, including in newborns exposed prenatally, and effect antibody response to vaccines. There is a fundamental gap in understanding whether arsenic alters maternal immune responses to vaccination and whether exposure to arsenic during pregnancy impairs the transfer of maternal vaccine-induced antibody to the newborn. Furthermore, factors known to affect arsenic metabolism and toxicity, particularly micronutrients needed for one-carbon metabolism, have not been evaluated in studies of arsenic immunotoxicity and vaccine-induced protection in mothers and their newborns. Continued existence of this gap represents an important problem because, until it is filled, optimal points for intervention to prevent arsenic-related immunotoxicity and morbidity during pregnancy and early life will not be known. Our objective is to investigate how maternal arsenic exposure and one-carbon metabolism micronutrient deficiencies alter maternal and newborn influenza antibody titer and avidity, respiratory morbidity, and measures of systemic immune function following vaccination of pregnant women with an inactivated influenza vaccine (IIV).
The Pregnancy Arsenic Immune Response (PAIR) study is a 5 year NIEHS-funded study, that will enroll, vaccinate, and follow a birth-cohort of 500 pregnant women and newborns. This study is in collaboration with the JiVitA Project in Gaibandha, Bangladesh, one of the largest population health and nutrition intervention research projects in South Asia, and the Institute of Epidemiology, Disease Control and Research in Dhaka, Bangladesh. The purpose of conducting this research is to develop interventions to address environmental arsenic exposure and micronutrient deficiencies and their health consequences in mothers, infants, and children.
Global Health PI/Mentor: Christopher Heaney