The Human Spleen in Malaria: Filter or Shelter?
Plasmodium
artemisinin
gametocytes
hyper-reactive malarial splenomegaly
malaria
spleen
Journal
Trends in parasitology
ISSN: 1471-5007
Titre abrégé: Trends Parasitol
Pays: England
ID NLM: 100966034
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
02
11
2019
revised:
10
02
2020
accepted:
04
03
2020
entrez:
17
4
2020
pubmed:
17
4
2020
medline:
2
12
2020
Statut:
ppublish
Résumé
The human spleen is an immune sentinel and controls red blood cell (RBC) quality. By mechanically retaining subsets of infected RBCs, the spleen may reduce the pace at which the parasite biomass increases before the adaptive immune response operates. Conversely, the spleen may contribute to malaria pathogenesis, particularly anemia that is associated with splenomegaly. Large spleens may also shelter parasites in chronic carriers. Upon treatment with artemisinins, the spleen clears circulating parasites by pitting and releases 'once-infected' RBCs in circulation. This triggers postartesunate delayed hemolysis and explains the long post-treatment positivity of histidine-rich protein 2 (HRP2)-based dipsticks. Importantly, splenic retention of RBCs also applies to gametocytes, the clearance of which may be enhanced by stiffening them with drugs, a potential way to block malaria transmission.
Identifiants
pubmed: 32298631
pii: S1471-4922(20)30060-X
doi: 10.1016/j.pt.2020.03.001
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
435-446Informations de copyright
Copyright © 2020. Published by Elsevier Ltd.