Malaria remains the most important vector-borne infectious disease, causing massive mortality and suffering in humans. Its importance for human health has been recognized recently by the award of the 2015 Nobel Prize in medicine to the malaria researcher Youyou Tu.
Malaria is caused by Plasmodium parasites that propagate inside first the liver cells and then the red blood cells of their mammalian host. Pathogenicity results exclusively from the asexual blood stage of the parasites, which is characterized by the remarkable colonization and remodelling of erythrocytes. The infected erythrocytes sequester in capillary endothelia, causing localized inflammation and organ damage. The growth and replication of the parasite within the red blood cell involves the uptake and metabolism of nutrients, the expulsion of metabolic wastes, and the regulation of intracellular ion concentrations. The evolutionary pressure on human populations by malaria has led to the selection of host adaptations that provide at least partial protection against the disease. For example, the most common inherited genetic disorders, mutations in red blood cells such as sickle cell anaemia or thalassemia, affect one in six people and most are believed to have been selected on the basis of the survival advantage they confer in malaria endemic environments.
Understanding the mechanisms of host-parasite interplay that have led to the enormous survival success of these parasites will elucidate important biological principles of a parasitic life style and provide essential leads in ongoing efforts to control, and ultimately eradicate, the disease.
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