Abstract
Ever since Haldane proposed in 1949 that thalassaemia might protect individuals against the scourge of malaria [ 1], the challenge has been to provide supporting evidence—be it at the cellular, clinical, or epidemiological level. The general topic of human red cell polymorphisms and malarial protection has attracted enormous interest, largely because this subject provides the most compelling example of natural selection and, hence, “survival of the fittest” in humans. Sickle cell trait remains the paradigm of a red cell polymorphism that protects against malaria. Several lines of evidence, including plausible cellular mechanisms, confirm that this haemoglobinopathy provides up to 90% protection against death due to malaria [ 2]. However, there are many gaps in our knowledge of whether other common red cell variants, notably thalassaemia, might protect against malaria and of the mechanism of such protection.
Highlights
Why has investigation of the interaction between thalassaemias and malaria remained inconclusive despite our best efforts? For β-thalassaemia, it is only in a limited part of West Africa that it continues to co-exist with malaria
Malarial parasites can certainly invade and multiply within α+thalassaemic cells [4]. They appear to cytoadhere well to endothelial cells as do parasitized normal red cells [5]
How does thalassaemia protect against malaria? Carlson and colleagues proposed that thalassaemic cells have a reduced ability to form rosettes, which causes harm perhaps by aiding and abetting the obstruction of capillary blood flow and leading to sequestration of schizont-infected red cells in vital organs [6]
Summary
Ever since Haldane proposed in 1949 that thalassaemia might protect individuals against the scourge of malaria [1], the challenge has been to provide supporting evidence—be it at the cellular, clinical, or epidemiological level. The general topic of human red cell polymorphisms and malarial protection has attracted enormous interest, largely because this subject provides the most compelling example of natural selection and, “survival of the fittest” in humans. Sickle cell trait remains the paradigm of a red cell polymorphism that protects against malaria. Several lines of evidence, including plausible cellular mechanisms, confirm that this haemoglobinopathy provides up to 90% protection against death due to malaria [2]. There are many gaps in our knowledge of whether other common red cell variants, notably thalassaemia, might protect against malaria and of the mechanism of such protection
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
