Intercellular communication between malaria-infected erythrocytes in the accelerated multidrug resistance phenotype of the Plasmodium falciparum parasite

The so-called ARMD (‘accelerated resistance to multidrug’) phenotype of the human malaria parasite Plasmodium falciparum that is prevalent in South East Asia is believed to confer a special hypermutator characteristic upon parasite strains in which it is expressed. Examination of the ARMD phenotype suggests that alternative mechanisms may be responsible for this ability that is unique among strains of P. falciparum parasite worldwide, but over which there is concern that further dissemination may lead to widespread loss of sensitivity to current chemotherapeutic regimens. Therefore, other recently discovered mechanisms that demonstrate potential in contributing to this noted drug resistance phenomenon merit further investigation. One important example, the cell-to-cell communication pathway in P. falciparum-infected erythrocytes, is being examined as a potential target for intervention and forms the subject of this article.