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Parasites from patients with cerebral malaria stick preferentially in their brains



A team of LSTMs with their collaborators in Malawi and Denmark provided, for the first time, evidence linking the ability of red blood cells infected by malaria parasite to bind to cells that line blood vessels in the brain, with the clinical syndrome of cerebral malaria.

Brain malaria is a life-threatening complication of the parasite Plasmodium falciparum. This complication is characterized by the fact that red blood cells infected with parasites accumulate in the brain and occur in 1-2% of the more than 200 million reported cases of malaria.

First author on paper, recently published in the journal EMBO Molecular Medicine Dr. Janet Storm, explained: "We know very little about why this serious complication occurs in some children but not in others. However, it is understood that infected red blood cells have a protein called P. falciparum erythrocyte the membrane protein 1

(PfEMP1) on its surface binds to host cells that coat blood vessels in many organs, including the brain. "

A property of the PfEMP1 protein is its variability, which results in changes in the ability of infected red blood cells to bind to host cells in the brain. This has been suggested as the reason we only see brain malaria in some infected individuals, and if the infected red blood cells do not bind in the brain, brain malaria can not occur.

In their MLW lab in Malawi, the team used a flow-based adhesion analysis to study the binding of red blood cells infected by children with cerebral or uncomplicated malaria to cells derived from human cerebral blood vessels. The team also used molecular techniques to study the PfEMP1 expressed by infected red blood cells.

The results showed that the binding of red blood cells infected by patients with brain malaria to cells derived from the brain was higher than that observed by patients without malaria complications. This suggests that in most cases P. falciparum avoids striking the brain and that cerebral malaria occurs only when the red blood cells express a subgroup of PfEMP1 proteins with particular adhesion phenotypes that allow an effective bond to the blood vessels brain. Knowing that brain binding is a key feature of brain malaria, researchers can focus their attention on the development of new interventions for serious disease based on the interaction between infected red blood cells and host cells that line blood vessels. in the brain.

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