Immune Escape Mechanisms are Plasmodium's Secret Weapons Foiling the Success of Potent and Persistently Efficacious Malaria Vaccines

- Co-evolution between Plasmodium and mammalian hosts result in the ability of the parasite to escape immune responses
- Parasite immune escape mechanisms target both arms of the immune system - innate and adaptive effectors
- Escape mechanisms range from infecting cells that are exempt from immunosurveillance to production of immunomodulatory molecules
- Considering the plethora of decoy- and escape mechanism is crucial for successful vaccine development

Despite decades of active research, an efficacious vaccine mediating long-term protection is still not available. This review highlights various mechanisms and the different facets by which the parasites outsmart the immune system. An understanding of how the parasites escape immune recognition and interfere with the induction of a protective immune response that provides sterilizing immunity will be crucial to vaccine design.