Plasmodium falciparum erythrocyte membrane protein 1

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Plasmodium falciparum erythrocyte membrane protein 1[edit | edit source]

Erythrocyte knobs

Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) is a key protein expressed on the surface of erythrocytes infected by the Plasmodium falciparum parasite, the causative agent of the most severe form of malaria. This protein plays a crucial role in the pathogenesis of malaria by mediating the adhesion of infected erythrocytes to the endothelial cells of blood vessels, thereby avoiding clearance by the spleen.

Structure[edit | edit source]

Diagrammatic structure of PfEMP1

PfEMP1 is a large, complex protein that is encoded by the highly variable var gene family. Each parasite genome contains approximately 60 different var genes, but only one is expressed at a time, allowing the parasite to evade the host's immune system through antigenic variation. The protein consists of several domains, including Duffy binding-like (DBL) domains and cysteine-rich interdomain regions (CIDR), which are responsible for binding to various host receptors.

Function[edit | edit source]

PfEMP1 on knob

The primary function of PfEMP1 is to mediate cytoadherence, the process by which infected erythrocytes adhere to the endothelial cells lining blood vessels. This adhesion is facilitated by the interaction of PfEMP1 with host receptors such as CD36, ICAM-1, and EPCR. This process is critical for the parasite's survival as it prevents the infected erythrocytes from being filtered out by the spleen.

Cytoadherence and Pathogenesis[edit | edit source]

PfEMP1 cytoadhesion

Cytoadherence is a major factor in the pathogenesis of severe malaria. The sequestration of infected erythrocytes in the microvasculature can lead to obstruction of blood flow and contribute to complications such as cerebral malaria, placental malaria, and severe anemia. The ability of PfEMP1 to bind to different receptors allows the parasite to adhere to various tissues, leading to diverse clinical manifestations.

Antigenic Variation[edit | edit source]

PfEMP1 is a major target of the host immune response. To evade immune detection, Plasmodium falciparum frequently switches the expression of different var genes, a process known as antigenic variation. This allows the parasite to persist in the host by presenting a constantly changing antigenic surface.

Research and Implications[edit | edit source]

Understanding the structure and function of PfEMP1 is crucial for developing interventions against malaria. Efforts are underway to develop vaccines targeting PfEMP1 and to design therapies that can block its interaction with host receptors, thereby preventing cytoadherence and reducing the severity of malaria.

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Contributors: Prab R. Tumpati, MD