Chemokines and Malaria Infection

Malaria is a devastating disease of the tropics, with an estimated 3.2 billion people exposed to the threat of malaria. There are 1-3 million deaths annually, mostly of children in sub-Saharan Africa. Deaths due to malaria often arise from complications of Plasmodium falciparum infection, particularly cerebral malaria, but difficulties during pregnancy also contribute to the high incidence of morbidity and mortality. Cytokines are known to play a major role in the pathogenesis of severe malaria, which is generally considered to be an immunopathological process. Chemokines are a family of chemotactic cytokines, with diverse roles that include cellular trafficking and neuronal signaling. Studies on chemokines in malaria infection indicate that they may be important mediators of the immune response to malaria. There is also evidence to suggest that chemokines are involved in the recruitment of leukocytes to the placenta during pregnancyassociated malaria, and also to the brain during cerebral malaria. Chemokines and infiltrating leukocytes can contribute to the severe manifestations of malaria through the actions of cytokines and other inflammatory mediators, for example, low birth weight in placental malaria, and neurological symptoms in cerebral malaria.