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Background  Cytoadherence of  Plasmodium falciparum- infected erythrocytes (IEs) in deep microvasculature endothelia plays a major role in the pathogenesis of cerebral malaria (CM). This biological process is thought to be mediated by  P. falciparum  erythrocyte membrane protein-1 (PfEMP-1) and human receptors such as CD36 and ICAM-1. The relationship between the expression of PfEMP-1 variants and cytoadherence phenotype in the pathology of malaria is not well established.    Methods  Cytoadherence phenotypes of IEs to CD36, ICAM-1, CSPG and the transcription patterns of A, B, var2csa , var3, var  gene groups and domain cassettes DC8 and DC13 were assessed in parasites from children with CM and uncomplicated malaria (UM) to determine if cytoadherence is related to a specific transcription profile of  pfemp -1 variants.    Results  Parasites from CM patients bind significantly more to CD36 than those from UM patients, but no difference was observed in their binding ability to ICAM-1 and CSPG. CM isolates highly transcribed groups A, B, var2csa , var3 , DC8 and DC13 compared to UM parasites. The high transcription levels of  var  genes belonging to group B positively correlated with increased binding level to CD36.    Conclusion  CM isolates bind significantly more to CD36 than to ICAM-1, which was correlated with high transcription level of group B  var  genes, supporting their implication in malaria pathogenesis.

malaria journal

Cytoadherence phenotype of Plasmodium falciparum- infected erythrocytes is associated with specific pfemp-1 expression in parasites from children with cerebral malaria