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Cerebral malaria – clinical manifestations and pathogenesis

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Abstract

One of the most common central nervous system diseases in tropical countries is cerebral malaria (CM). Malaria is a common protozoan infection that is responsible for enormous worldwide mortality and economic burden on the society. Episodes of Plasmodium falciparum (Pf) caused CM may be lethal, while survivors are likely to suffer from persistent debilitating neurological deficits, especially common in children. In this review article, we have summarized the various symptoms and manifestations of CM in children and adults, and entailed the molecular basis of the disease. We have also emphasized how pathogenesis of the disease is effected by the parasite and host responses including blood brain barrier (BBB) disruption, endothelial cell activation and apoptosis, nitric oxide bioavailability, platelet activation and apoptosis, and neuroinflammation. Based on a few recent studies carried out in experimental mouse malaria models, we propose a basis for the neurological deficits and sequelae observed in human cerebral malaria, and summarize how existing drugs may improve prognosis in affected individuals.

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Acknowledgments

Laboratories of Rachna Hora and Prakash Chandra Mishra are funded by Department of Biotechnology (DBT), Govt. of India, University Grants Commission (UGC, Govt. of India) and Department of Science and technology (DST, Govt. of India). Payal Kapoor is a DST INSPIRE (Department of Science and Technology - Innovation in Science Pursuit for Inspired Research) senior research fellow. Kirandeep Kaur Thind was initially funded by DBT and later supported by junior research fellowship from CSIR (Council of Scientific and Industrial Research), Govt. of India.

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  1. Department of Molecular Biology and Biochemistry, Guru Nanak Dev University, Amritsar, 143005, India

    Rachna Hora, Payal Kapoor & Kirandeep Kaur Thind

  2. Department of Biotechnology, Guru Nanak Dev University, Amritsar, 143005, India

    Prakash Chandra Mishra

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  1. Rachna Hora
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  2. Payal Kapoor
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  3. Kirandeep Kaur Thind
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  4. Prakash Chandra Mishra
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Correspondence to Rachna Hora.

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Hora, R., Kapoor, P., Thind, K.K. et al. Cerebral malaria – clinical manifestations and pathogenesis. Metab Brain Dis 31, 225–237 (2016). https://doi.org/10.1007/s11011-015-9787-5

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