Rosetting refers to the adherence of uninfected erythrocytes to erythrocytes containing mature forms of some, but not all, isolates of P. falciparum. The phenomenon is observed when suspensions of parasitised cells are viewed under the microscope, and for some isolates depends on the blood group of the cells used for culture (Figure 3.5). The relevance of the in vitro findings is debated, as in some (Carlson et al., 1990), but

Fig. 3.4 Adherence of trophozoite- and schizont-infected RBCs to vascular endothelium. (A) Section of brain from a patient with cerebral malaria. (B) In vitro cytoadherence of RBCs to Chinese hamster ovary cells. B reprinted from Rogerson and Brown (1997), with permission from Elsevier Science

not all, studies (e.g. al-Yaman et al, 1995), the phenomenon has been associated with cerebral malaria. Other studies show an association with severe malaria with anaemia (Newbold et al., 1997). At least for some parasites, rosetting is mediated by PfEMPl (Rowe et al., 1995).

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