Cytoadherence and rosetting of parasitised red blood cells in cerebral microvasculature, the central event in the pathogenesis of cerebral malaria due to Plasmodium falciparum, is mediated by parasite-derived proteins called knobs that bind to which endothelial receptor?
- A Glycophorin A
- B Duffy antigen
- C ICAM-1 ✓
- D Band 3 protein
Correct answer: C. ICAM-1
Explanation
Knob-associated histidine-rich protein (KAHRP) expressed on the infected erythrocyte surface mediates binding to intercellular adhesion molecule 1 (ICAM-1) on cerebral endothelium, causing sequestration, microvascular obstruction and hypoxia. Duffy antigen is the receptor for P. vivax invasion, glycophorins are erythrocyte receptors, and band 3 changes occur later in ring-infected erythrocyte surface antigen expression, none of which drive cerebral sequestration.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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