Cytoadherence, pathogenesis and the infected red cell surface in Plasmodium falciparum

The particular virulence of Plasmodium falciparum compared with the other m alaria species which naturally infect humans is thought to be due to the wa y in which the parasite modifies the surface of the infected red cell. Appr oximately 16 hours into the asexual cycle, parasite encoded proteins appear on the red cell surface which mediate adherence to a variety of host tissu es. Binding of infected red cells to vascular endothelium, a process which occurs in all infections, is thought to be an important factor in the patho genesis of severe disease where concentration of organisms in particular or gans such as the brain occurs. Binding to uninfected red cells to form eryt hrocyte rosettes, a property of some isolates, is linked to disease severit y. Here we summarise the data on the molecular basis of these interactions on both the host and parasite surfaces and review the evidence for the invo lvement of particular receptors in specific disease syndromes. Finally we d iscuss the relevance of these data to the development of new treatments for malaria. (C) 1999 Australian Society for Parasitology Inc. Published by El sevier Science Ltd. All rights reserved.