Immunopathological Mechanisms of Brain Damage in Cerebral Malaria: A Literature Review on Immunological Pathways and Neuroinflammatory Biomarkers

Abstract

Cerebral malaria, a complication of Plasmodium falciparum infection, affects the central nervous system and has the potential to cause brain damage. Reviewing its immunopathological mechanisms is crucial for developing more effective diagnostic and therapeutic strategies. This study aims to investigate the immunopathological mechanisms of brain damage in cerebral malaria by synthesizing recent literature through a narrative literature review approach. A total of 29 articles from the Scopus database were screened, with 23 meeting the inclusion and exclusion criteria. Thematic analysis identified five key sub-themes: (1) immune system activation and endothelial dysfunction; (2) the role of neutrophils and macrophages in neurological pathogenesis; (3) implicated molecular pathways and gene expression; (4) neuropathological findings in experimental models; and (5) clinical implications and therapeutic advancements. The findings indicate that immune overactivation, the release of pro-inflammatory cytokines, and dysregulated gene expression are core mechanisms underlying blood-brain barrier (BBB) disturbances and neural tissue damage. A profound understanding of these mechanisms is essential for designing more effective therapeutic interventions to mitigate the long-term neurological sequelae of cerebral malaria.