Journal
TRENDS IN PARASITOLOGY
Volume 29, Issue 12, Pages 585-592Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.pt.2013.10.004
Keywords
severe malaria; sequestration; inflammation; endothelial activation; biomass
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Funding
- MRC [G0701427, MC_U190081986] Funding Source: UKRI
- Medical Research Council [G0701427, MC_U190081986] Funding Source: researchfish
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Severe malaria defines individuals at increased risk of death from their infection. Proposed pathogenic mechanisms include parasite sequestration, inflammation, and endothelial dysfunction. Severe malaria is not a single entity, manifesting with distinct syndromes such as severe anemia, severe respiratory distress or coma, each characterized by differences in epidemiology, underlying biology, and risk of death. The relative contribution of the various pathogenic mechanisms may differ between syndromes, and this is supported by accumulating evidence, which challenges sequestration as the initiating event. Here we propose that high parasite biomass is the common initiating feature, but subtle variations in the interaction between the host and parasite exist, and understanding these differences may be crucial to improve outcomes in patients with severe malaria.
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