Reorganization of host red blood cells by the malaria parasite Plasmodium falciparum enables their sequestration via attachment to the microvasculature. This artificially increases the dwelling time of the infected red blood cells within inner organs such as the brain, which can lead to cerebral malaria. Cerebral malaria is the deadliest complication patients infected with P. falciparum can experience and still remains a major public health concern despite effective antimalarial therapies. Here, the current understanding of the effect of P. falciparum cytoadherence and their secreted proteins on structural features of the human blood-brain barrier and their involvement in the pathogenesis of cerebral malaria are highlighted. Advanced 2D and 3D in vitro models are further assessed to study this devastating interaction between parasite and host. A better understanding of the molecular mechanisms leading to neuronal and cognitive deficits in cerebral malaria will be pivotal in devising new strategies to treat and prevent blood-brain barrier dysfunction and subsequent neurological damage in patients with cerebral malaria.
Keywords: 2D/3D in vitro models; 3D bioprinting; Plasmodium falciparum; Plasmodium falciparum erythrocyte membrane protein 1; blood-brain barrier; blood-brain barrier-on-a-chip; cytoadherence; endothelial cells; infectious diseases; malaria; neuron; sequestration.
© 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.