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Fig. 1 | Malaria Journal

Fig. 1

From: Pathophysiology and neurologic sequelae of cerebral malaria

Fig. 1

Graphical abstract of cerebral malaria pathogenesis. Cerebral malaria pathology manifests itself differently in white matter and gray matter of the brain. Whereas haemorragic punctae are abundant in white matter, they are not obvious in gray matter. The cerebral vasculature in these brain areas is different, which may lead to differential attachment of PRBC—as guided by var gene expression—of PfEMP1 and resulting activation of alternate signalling pathways in the brain endothelial vasculature in these regions. The release of chemokines and cytokines from the inflamed BBB endothelium towards the brain, in conjunction with the opening of the blood brain barrier that allows ingress of both neurotoxic plasma substances and soluble Plasmodium factors into the brain, leads to astroglial activation. This, together with an influx of immune cells, causes neurological damage that is responsible for the post CM neurologic sequelae

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