Recent research led by Carmen Fernández-Becerra and Hernando A del Portillo from ISGlobal and the Germans Trias i Pujol Research Institute has highlighted the crucial role of the spleen and extracellular vesicles in cryptic malaria infections caused by Plasmodium vivax.

Malaria remains a significant global health issue, with P. vivax causing nearly 77 million cases in 2022. 

This parasite can either cause acute infections with symptoms or remain in a latent state, making detection and eradication challenging, especially as up to 90% of chronic infections are asymptomatic.

The research team focused on the spleen, which harbors over 95% of the parasite's biomass. 

The spleen filters old and defective red blood cells and serves as a hiding place for malaria-infected cells. 

The study revealed that extracellular vesicles, secreted by infected cells, help these cells adhere to spleen cells, facilitating the parasite's survival.

Collaborating with various institutes, the researchers used advanced genetic techniques to show that a specific P. vivax gene, dependent on the spleen, enhances parasite adherence to spleen cells in the presence of extracellular vesicles.

They demonstrated that these vesicles signal spleen cells to express proteins aiding the parasite's adherence.

This study, published in Frontiers in Cellular and Infection Microbiology, opens new avenues for understanding how P. vivax hides in the spleen, offering potential targets for combating chronic asymptomatic malaria infections and advancing global eradication efforts.