Abstract:
Malaria is a leading cause of morbidity and mortality in the world. In general, malaria is easily treated
but in a subset of cases it develops to severe disease. Severe malaria has a high rate of mortality even
with the best available care. This creates the need for intensive research to fully characterise the
pathogenesis of the disease in order to create future novel therapies. One of the hallmarks of malaria
infections is its ability to adhere to specific sites in the body leading to severe disease syndromes such
as cerebral malaria and pregnancy associated malaria. In this review, the platelet-mediated clumping
adhesion phenotypes of malaria-infected erythrocytes were discussed in the context of infected
erythrocyte adhesion phenotypes such as cytoadhesion and rosetting. Platelet-mediated clumping
refers to a phenomenon of P. falciparum-infected erythrocytes whereby they agglutinate to form large
aggregates held together by activated platelets. This unique phenotype is important because it has
been associated with severe malaria in both children and adults in diverse geographical and
transmission settings. The precise mechanisms by which platelet-mediated clumping occurs are yet to
be precisely described. The platelet receptors implicated in this phenotype include CD36, P-Selectin
and gC1qR. The parasite derived ligands that mediate this phenotype are yet to be described.
