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Trends Parasitol. 2009 Jul;25(7):314-8. doi: 10.1016/j.pt.2009.04.003. Epub 2009 Jun 21.

Is human malarial coma caused, or merely deepened, by sequestration?

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  • 1School of Biochemistry and Molecular Biology, Australian National University, Canberra, ACT 0200, Australia. ian.clark@anu.edu.au

Abstract

Much research into falciparum malaria coma assumes the primary event to be vascular obstruction by parasitized red blood cells. Recent evidence that vivax malaria, caused by a parasite traditionally thought not to block blood flow, seems to alter brain function to the same degree as falciparum malaria has seriously questioned this. These data are a timely call to reassess whether vascular obstruction should still be considered the primary cause of the coma of falciparum disease. They add to a growing literature that suggests that enhancement of brain-origin cytokines, such as tumour necrosis factor, by non-brain systemic inflammation and an appreciation of the degree to which neuronal homeostasis depends on them provide a more fruitful research direction.

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