Abstract

The absence of the Duffy protein at the surface of erythrocytes was considered for decades to confer full protection against Plasmodium vivax as this blood group is the receptor for the key parasite ligand P. vivax Duffy binding protein (PvDBP). However, it is now clear that the parasite is able to break through this protection and induce clinical malaria in Duffy-negative people, although the underlying mechanisms are still not understood. Here, we briefly review the evidence of Duffy-negative infections by P. vivax and summarize the current hypothesis at the basis of this invasion process. We discuss those in the perspective of malaria-elimination challenges, notably in African countries.

Highlights

  • The absence of the Duffy protein at the surface of erythrocytes was considered for decades to confer full protection against Plasmodium vivax as this blood group is the receptor for the key parasite ligand P. vivax Duffy binding protein (PvDBP)

  • It was considered for decades to be almost absent from sub-Saharan African countries because the majority of people in these areas lack a red blood cell receptor, the Duffy protein, which is the critical gateway for the parasite’s entry into erythrocytes

  • This dogma has been challenged by an increasing number of observations of P. vivax clinical infections into Duffy-negative people in many African countries as well as in South America where a significant number of people of African descent are Duffy-negative

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Summary

OPEN ACCESS

The absence of the Duffy protein at the surface of erythrocytes was considered for decades to confer full protection against Plasmodium vivax as this blood group is the receptor for the key parasite ligand P. vivax Duffy binding protein (PvDBP). It is clear that the parasite is able to break through this protection and induce clinical malaria in Duffy-negative people, the underlying mechanisms are still not understood. We briefly review the evidence of Duffy-negative infections by P. vivax and summarize the current hypothesis at the basis of this invasion process. We discuss those in the perspective of malaria-elimination challenges, notably in African countries

Author summary
Introduction
Findings
Future directions and conclusive remarks

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