Sample Term Paper
The parasites employ two methods to avoid detection by the body’s immune system. When a sporozoite infects a hepatocyte, it hides in the cell membrane of the hepatocyte. This shields it from the surveillance of the white blood cells. Once the red blood cells are infected though, they cannot escape detection as they circulate. The parasite counters this by sticking to the sides of blood vessels with the help of certain sticky proteins. This protein is known as PfEMP1, for Plasmodium falciparum erythrocyte membrane protein 1, and while it is visible to the immune system, there are so many variations of this protein that it is difficult for the immune system to narrow down on one particular variation and target it. The parasite can easily change the variation of PfEM1 used and so avoid detection.
The sticking of the red blood cells to the walls of the blood vessels as well as their rupturing (known as hemolysis) leads to further complications. Since the rupturing results in loss of hemoglobin from the blood, the oxygen carrying capacity of the blood is reduced. Also, the narrowing of the blood vessels due to accumulation of stuck red blood cells leads to reduced blood supply to the organs. This can result in mental deformities in growing/unborn children and even coma and death. Non-immune pregnant women are at high risk of malaria. The illness can result in high rates of miscarriage and cause over 10% of maternal deaths (soaring to a 50% death rate in cases of severe disease) annually.
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