Plasmodium is a genus of unicellular that are obligate parasites of and . The life cycles of Plasmodium species involve development in a Hematophagy insect host which then injects parasites into a vertebrate host during a blood meal. Parasites grow within a vertebrate body tissue (often the liver) before entering the bloodstream to infect red blood cells. The ensuing destruction of host red blood cells can result in malaria. During this infection, some parasites are picked up by a blood-feeding insect ( in majority cases), continuing the life cycle.
Plasmodium is a member of the phylum Apicomplexa, a large group of parasitic eukaryotes. Within Apicomplexa, Plasmodium is in the order Haemosporida and family Plasmodiidae. Over 200 species of Plasmodium have been described, many of which have been subdivided into 14 subgenera based on parasite morphology and host range. Evolutionary relationships among different Plasmodium species do not always follow taxonomic boundaries; some species that are morphologically similar or infect the same host turn out to be distantly related.
Species of Plasmodium are distributed globally wherever suitable hosts are found. Insect hosts are most frequently of the genera Culex and Anopheles. Vertebrate hosts include reptiles, birds, and mammals. Plasmodium parasites were first identified in the late 19th century by Charles Laveran. Over the course of the 20th century, many other species were discovered in various hosts and classified, including five species that regularly infect humans: Plasmodium vivax, P. falciparum, P. malariae, Plasmodium ovale, and P. knowlesi. P. falciparum is by far the most lethal in humans, resulting in hundreds of thousands of deaths per year. A number of drugs have been developed to treat Plasmodium infection; however, the parasites have evolved resistance to each drug developed.
Although the parasite can also infect people via blood transfusion, this is very rare, and Plasmodium cannot be spread from person to person. Some of subspecies of Plasmodium are obligate intracellular parasites.
Like other apicomplexans, Plasmodium species have several cellular structures at the apical end of the parasite that serve as specialized organelles for secreting effectors into the host. The most prominent are the bulbous rhoptry which contain parasite proteins involved in invading the host cell and modifying the host once inside. Adjacent to the rhoptries are smaller structures termed that contain parasite proteins required for motility as well as recognizing and attaching to host cells. Spread throughout the parasite are secretory vesicles called dense granules that contain parasite proteins involved in modifying the membrane that separates the parasite from the host, termed the parasitophorous vacuole.
Species of Plasmodium also contain two large membrane-bound organelles of Symbiogenesis, the mitochondria and the apicoplast, both of which play key roles in the parasite's metabolism. Unlike mammalian cells which contain many mitochondria, Plasmodium cells contain a single large mitochondrion that coordinates its division with that of the Plasmodium cell. Like in other eukaryotes, the Plasmodium mitochondrion is capable of generating energy in the form of ATP via the citric acid cycle; however, this function is only required for parasite survival in the insect host, and is not needed for growth in red blood cells. A second organelle, the apicoplast, is derived from a secondary endosymbiosis event, in this case the acquisition of a red alga by the Plasmodium ancestor. The apicoplast is involved in the synthesis of various metabolic precursors, including , , iron-sulphur clusters, and components of the heme biosynthesis pathway.
Even when humans have such subclinical plasmodial infections, there can nevertheless be very large numbers of multiplying parasites concealed in, particularly, the spleen and bone marrow. Certainly, this applies in the case of P. vivax. These hidden parasites (in addition to hypnozoites) are thought to be the origin of instances of recurrent P. vivax malaria.
Within the red blood cells, the merozoites grow first to a ring-shaped form and then to a larger form called a trophozoite. Trophozoites then mature to which divide several times to produce new merozoites. The infected red blood cell eventually bursts, allowing the new merozoites to travel within the bloodstream to infect new red blood cells. Most merozoites continue this replicative cycle, however some merozoites upon infecting red blood cells differentiate into male or female sexual forms called gametocytes. These gametocytes circulate in the blood until they are taken up when a mosquito feeds on the infected vertebrate host, taking up blood which includes the gametocytes.
In the mosquito, the gametocytes move along with the hematophagy to the mosquito's midgut. Here the develop into male and female which fertilization each other, forming a zygote. Zygotes then develop into a motile form called an ookinete, which penetrates the wall of the midgut. Upon traversing the midgut wall, the ookinete embeds into the gut's exterior membrane and develops into an oocyst. Oocysts divide many times to produce large numbers of small elongated . These sporozoites migrate to the salivary glands of the mosquito where they can be injected into the blood of the next host the mosquito bites, repeating the cycle.
The genus Plasmodium consists of over 200 species, generally described on the basis of their appearance in blood smears of infected vertebrates.
Species infecting and apes with the exceptions of P. falciparum and P. reichenowi (which together make up the subgenus Laverania) are classified in the subgenus Plasmodium. Parasites infecting other including some primates ( and others) are classified in the subgenus Vinckeia. The five subgenera Bennettinia, Giovannolaia, Haemamoeba, Huffia, and Novyella contain the known avian malarial species. The remaining subgenera: Asiamoeba, Carinamoeba, Lacertamoeba, Ophidiella, Paraplasmodium, and Sauramoeba contain the diverse groups of parasites found to infect reptiles.
Estimates for when different Plasmodium lineages diverged have differed broadly. Estimates for the diversification of the order Haemosporida range from around 16.2 million to 100 million years ago. There has been particular interest in dating the divergence of the human parasite P. falciparum from other Plasmodium lineages due to its medical importance. For this, estimated dates range from 110,000 to 2.5 million years ago.
Humans are primarily infected by five species of Plasmodium, with the overwhelming majority of severe disease and death caused by Plasmodium falciparum. Some species that infect humans can also infect other primates, and zoonoses of certain species (e.g. P. knowlesi) from other primates to humans are common. Non-human primates also contain a variety of Plasmodium species that do not generally infect humans. Some of these can cause severe disease in primates, while others can remain in the host for prolonged periods without causing disease. Many other mammals also carry Vinckeia, such as a variety of rodents, ungulates, and . Again, some species of Plasmodium can cause severe disease in some of these hosts, while many appear not to.
Over 150 species of Plasmodium infect a broad variety of birds. In general each species of Plasmodium infects one to a few species of birds. Plasmodium parasites that infect birds tend to persist in a given host for years or for the life time of the host, although in some cases Plasmodium infections can result in severe illness and rapid death. Unlike with Plasmodium species infecting mammals, those infecting birds are distributed across the globe.
Species from several subgenera of Plasmodium infect diverse reptiles. Plasmodium parasites have been described in most lizard families and, like avian parasites, are spread worldwide. Again, parasites can result either in severe disease or be apparently asymptomatic depending on the parasite and the host.
A number of drugs have been developed over the years to control Plasmodium infection in vertebrate hosts, particularly in humans. Quinine was used as a frontline antimalarial from the 17th century until widespread resistance emerged in the early 20th century. Resistance to quinine spurred the development of a broad array of antimalarial medications through the 20th century including chloroquine, proguanil, atovaquone, sulfadoxine/pyrimethamine, mefloquine, and artemisinin. In all cases, parasites resistant to a given drug have emerged within a few decades of the drugs deployment. To combat this, antimalarial drugs are frequently used in combination, with artemisinin combination therapies currently the gold standard for treatment. In general, antimalarial drugs target the life stages of Plasmodium parasites that reside within vertebrate red blood cells, as these are the stages that tend to cause disease. However, drugs targeting other stages of the parasite life cycle are under development in order to prevent infection in travelers and to prevent transmission of sexual stages to insect hosts.
In 1966, Cyril Garnham proposed separating Plasmodium into nine subgenera based on host specificity and parasite morphology. This included four subgenera that had previously been proposed for bird-infecting Plasmodium species by A. Corradetti in 1963. This scheme was expanded upon by Sam R. Telford in 1988 when he reclassified Plasmodium parasites that infect reptiles, adding five subgenera. In 1997, G. Valkiunas reclassified the bird-infecting Plasmodium species adding a fifth subgenus: Bennettinia.
Life cycle
Evolution and taxonomy
Taxonomy
Phylogeny
Distribution
Vertebrates
Insects
History
See also
Notes
Further reading
Identification
Biology
History
External links
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