Unravelling mysteries at the perivascular space: a new rationale for cerebral malaria pathogenesis

Trends Parasitol. 2024 Jan;40(1):28-44. doi: 10.1016/j.pt.2023.11.005. Epub 2023 Dec 8.

Abstract

Cerebral malaria (CM) is a severe neurological complication caused by Plasmodium falciparum parasites; it is characterized by the sequestration of infected red blood cells within the cerebral microvasculature. New findings, combined with a better understanding of the central nervous system (CNS) barriers, have provided greater insight into the players and events involved in CM, including site-specific T cell responses in the human brain. Here, we review the updated roles of innate and adaptive immune responses in CM, with a focus on the role of the perivascular macrophage-endothelium unit in antigen presentation, in the vascular and perivascular compartments. We suggest that these events may be pivotal in the development of CM.

Keywords: antigen presentation; blood–brain barrier disruption; cerebral malaria; pathogenesis; perivascular macrophages.

Publication types

  • Review

MeSH terms

  • Brain
  • Erythrocytes / parasitology
  • Host-Parasite Interactions
  • Humans
  • Malaria, Cerebral*
  • Plasmodium falciparum / physiology