Maurer's clefts,the enigma of Plasmodium falciparum

Plasmodium falciparum, the causative agent of malaria, completely remodels the infected human erythrocyte to acquire nutrients and to evade the immune system. For this process, the parasite exports more than 10% of all its proteins into the host cell cytosol, including the major virulence factor PfEMP1 (P. falciparum erythrocyte surface protein 1). This unusual protein trafficking system involves long-known parasite-derived membranous structures in the host cell cytosol, called Maurer’s clefts. However, the genesis, role, and function of Maurer’s clefts remain elusive. Similarly unclear is how proteins are sorted and how they are transported to and from these structures. Recent years have seen a large increase of knowledge but, as yet, no functional model has been established. In this perspective we review the most important findings and conclude with potential possibilities to shed light into the enigma of Maurer’s clefts. Understanding the mechanism and function of these structures, as well as their involvement in protein export in P. falciparum, might lead to innovative control strategies and might give us a handle with which to help to eliminate this deadly parasite.Since Charles Louis Alphonse Laveran discovered the malaria parasite in 1881 (1) in Algeria, while examining the blood of a patient who had died from marsh fever, research has been conducted on these deadly parasites. Laveran received the Nobel Prize in medicine for his discovery in 1907, which causally explained that malaria symptoms are caused by protozoan parasites, eventually described as Plasmodium species of the phylum Apicomplexa. Among the five species infecting humans, Plasmodium falciparum causes the most lethal forms of the disease, but zoonotic Plasmodium knowlesi infections can also be lethal.