Malaria remains a major health problem with 0.58 million of deaths in 2013. Malaria pathogenesis involves complex molecular interactions between parasite and host that lead to a wide variety of clinical symptoms. Among people living in endemic regions, only a fraction of infected people develops severe disease such as cerebral malaria, severe anemia and respiratory distress. This inter-individual variability may be explained by the parasite genetic diversity and the host genetic susceptibility. Children are susceptible to malaria disease and death until they develop an adaptive immunity after multiple exposures to parasite during their childhood. Several host genetic factors that may alter this immune response have already been identified. However, the molecular aspects are not fully understood and a major challenge is to identify these factors to progress in the understanding of the pathophysiological mechanisms and to propose new therapeutic strategies.
Keywords: Adaptive immunity, Antigenic variation, Cerebral malaria, Genetic susceptibility, Innate immunity, Metabolic acidosis, Microvascular obstruction, Sequestration, Severe anemia, Severe disease, Uncomplicated malaria.