1. Genes expressed in red cells could shape a malaria attack
Lucio Luzzatto 
The Lancet Haematology 
Volume 5, Issue 8, Pages e322-e323 (August 2018)
DOI: /S (18)
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions

2. Figure
Role of environment and genes in P falciparum malaria, a simplified diagram
Life-threatening Plasmodium falciparum malaria comes from the environment, but host genes play a part. The environment is paramount, because anopheles mosquitoes inoculate a number of sporozoites having a specific genotype and a circumsporozoite protein that targets hepatocytes: these environmental factors will in large part determine the size of the parasite biomass (blue arrows). However, genes expressed in red cells can influence the intraerythrocytic (asexual) schizogonic cycle and, therefore, might also influence the size of the biomass (black arrows), which is vital to the transition from uncomplicated malaria to severe malaria. Genes can also influence which severe malaria syndrome develops in a specific individual. To date, no more than 7% of variance in developing severe malaria is accounted for by genes: but here we have arbitrarily allowed 15%, because many genes having a small effect might not yet have been identified. The main factor (85%), however, is still the environment, which includes current exposure (eg, place of abode, lifestyle, use of mosquito nets, antimalarial prophylaxis, etc), and previous exposure and consequent development of immunity.
The Lancet Haematology 2018 5, e322-e323DOI: ( /S (18) )
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions