PMID: 2491691Jan 1, 1989Paper

The hypnozoite and malarial relapse

Progress in Clinical Parasitology
W A Krotoski

Abstract

As described above, perhaps the most compelling arguments against the cyclic schizogony (Shortt-Garnham) hypothesis of malarial relapse have been (1) its inability to explain the disparate relapse patterns of P. vivax strains as they occur in nature, and (2) the dearth of concrete evidence for its support. The hypnozoite theory, in contrast, both provides an explanation for the variety of observed relapse patterns, and has direct morphologic and time-related, quantitative evidence for its support. Moreover, it provides a potential, unifying framework for the development of relapsing malaria from the time of introduction of sporozoites onward, taking as controlling factors, both the survival of the parasite and ecological interactions within its natural environment. It also suggests the possibility of an improved taxonomic classification, one based on whether or not the hypnozoite stage exists in a given species. Finally, Figure 6 presents a composite of relapse data pertinent to a number of strain groups of P. vivax, in comparison with a generalized, nonrelapsing species, schematically depicted within the framework of the hypnozoite theory. Thus, no hypnozoites are shown to result from sporozoites of the nonrelapsing species at...Continue Reading

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