"Inside the blood cells" of the malaria patient, "the parasites replicate and also begin to expose adhesive proteins on the cell surface that change the physical nature of the cells in the bloodstream" (American). Medical experiments "show that infected red blood cells are stiffer and stickier than normal ones." In "later stages of the disease" the cells can be "up to 10 times stiffer" than healthy red blood cells. These infected cells may also anchor onto "endothelial cells lining the vasculature, affecting the normal blood flow. This explains some of the common symptoms of malaria, such as anemia and joint pain" (American).
The parasites avoid a whirlpool of blood cell death in the spleen by anchoring in the safe harbors of the blood vessels. "Sticking to the walls of blood vessels is a survival mechanism for the parasite. In order to develop completely, it needs several days inside a red blood cell. Even though parasitized cells are nearly invisible for the immune system, they may be destroyed in the spleen while circulating freely in the bloodstream" (American).
Brown University professor George Karniadakis and student Dmitry Fedosov study "how malaria infections affect the physical properties of red blood cells, and alter normal blood flow circulation. In particular, they examine an increase in blood flow resistance, and dynamics of infected cells in the bloodstream." The properties that they measure are "used in modeling the flow of red blood cells in people infected with malaria" (American).
Fedosov says, "Our model predicts the dynamics of malaria-infected RBCs in the bloodstream, which anticipates the possible course of the disease." Each infected human contains a slightly different map and provides a unique environment that the parasites must navigate. The researchers recently discovered "that temperature fluctuations of infected red blood cell membranes measured in experiments are not directly correlated with the reported cell properties, hence, suggesting significant influence of metabolic processes" (American).
Hypothesizing on the metabolic processes that affect the patients' body temperatures, the researchers "measured an increase in resistance to blood flow in the capillaries and small arterioles during the course of malaria and found that parasitized red blood cells have a "flipping" motion at the vessel wall that appears to be due to stiffness of the infected cells. The developed models will aid to make realistic predictions of the possible course of the disease, and enhance current malaria treatments" (American).
Play the parasite game (NobelPrize.org site), and see if you can navigate your way to the liver.
Sources:
American Institute of Physics. "Measuring and Modeling Blood Flow in Malaria." ScienceDaily 22 November 2009. 27 November 2009