DYNAMIC DETERMINANTS OF THE CYTOADHERENCE OF PLASMODIUM FALCIPARUM–INFECTED ERYTHROCYTES

thologists also observed that the process was not uniform among the vital organs, noting particularly the “accumulation in the cerebral vessels of red blood corpuscles loaded with amoebae.” The result of this pathologic process was described as “mechanical alterations in the circulation”; or, in other words, a traffic jam. With the development of methods for ex vivo culture of Plasmodium falciparum, malariologists have studied this process of cytoadherence of parasitized erythrocytes to endothelial cells (or the purified immobilized cell surface “receptors”) in the laboratory and have progressively tried to recreate the same conditions that occur in vivo. This is not easy, as blood is a thick and complex soup of deformable cells suspended in a variable consomme of plasma proteins, electrolytes, and a variety of small organic molecules. Its effective viscosity changes nonlinearly under the different shear rates encountered in the circulation (non-Newtonian behavior). Malaria is associated with fever, progressive anemia, thrombocytopenia, an increase in acute phase proteins, reduction in serum albumin, and, in severe infections, re