Like the skin, the spleen constantly shields us from microbes but harbours some. Focus on malaria | Voices in Infection Biology

Abstract:

From a few weeks after birth until death, the human spleen constantly filters the blood, with stringent check of red blood cells shape and content. Like many physiological protective processes, this one is more easily observed in disease than in health. Asplenia portends indeed a risk of severe infectious and non-infectious complications. Excessive retention of abnormal red blood cells in sickle cell disease, hereditary spherocytosis, and malaria induces splenomegaly and precipitates anemia. After summarizing the main consequences of splenic removal of vacuoles and malaria parasites from red blood cells (pitting), and how the mechanical retention of red blood cells by the spleen (infected or not) contributes to the initial severe or uncomplicated evolution of infection in non-immune subjects, the accumulation of red blood cells in chronic and acute infections by several Plasmodium species will be analyzed, as well as how this naturally protective mechanism may be influenced by genetics of the host, and enhanced by new antimalarial drugs.