Fecal microbiota transplantation alleviates adverse pregnancy outcomes and intestinal injury in experimental malaria

Malaria in pregnancy remains a major global health concern, contributing significantly to maternal and offspring morbidity and mortality. While gut microbiota dysregulation has been implicated in pregnancy complications and malaria pathogenesis, its functional role and the underlying mechanisms within the gut-placenta axis during placental malaria remain poorly understood. In pregnant mice, Plasmodium berghei ANKA infection disrupted the gut-placenta axis, leading to intestinal inflammation, placental injury and reduced fetal weight. Microbiome analysis revealed gut dysbiosis characterized by reduced abundance of Ligilactobacillus and increased abundance of Desulfovibrio. The metabolomic profiling identified disruption in amino acid and fatty acid metabolism, including changes in metabolites such as indole-3-propionic acid and taurine. These microbial and metabolic alterations may contribute to impaired intestinal barrier integrity and dysregulated inflammatory responses. Importantly, fecal microbiota transplantation (FMT) restored gut microbial balance, alleviated colonic and placental inflammation, and improved offspring growth. These findings provide novel mechanistic insights into the gut-placenta axis in malaria during pregnancy. Future studies should validate these findings in clinical settings and explore alternative microbiota-targeted interventions.