Figure 4.

Pathophysiology of BBB leakage in CM. Increase systemic immune response against the malaria parasite causes increase circulating levels of pro‐inflammatory cytokines and chemokines. This inflammatory environment induces increase expression of adhesion molecules and secretion pro‐coagulation factors. These signals contribute to the recruitment of leukocytes. Increased cytoadherence of parasitized RBC to ECs via adhesion molecules (P‐ and E‐selectin, ICAM‐1, and VCAM‐1) compromises microvascular blood‐flow. Increase aggregation due to the secretion of pro‐coagulation factors (Tissue Factor, PAF, and vWF) promote intravascular coagulation. These mechanisms generate morphological alterations to activated ECs and contribute to BBB. dysfunction.