Parasite adhesion and immune evasion in placental malaria

Parasite sequestration in the placenta is a key feature of infection by Plasmodium falciparum during pregnancy and is associated with severe adverse outcomes for both mother and baby. Here, James Beeson and colleagues draw together the findings of recent studies on parasite mechanisms that mediate this process. They review evidence for novel parasite va ria nts that appear able to evade pre-existing immunity, for the adhesion of Fl falciparum-infected erythrocytes to placental glycosaminoglycans land the molecular basis of these parasite properties) and for the expression of var genes encoding the variant antigen and adhesive ligand P. falciparum-erythrocyte membrane protein 1 (PfEMP1).