Plasmodium parasites contain various virulence factors that modulate the host immune response. Malarial pigment, or hemozoin (Hz), is an undegradable crystalline product of the hemoglobin degradation pathway in the parasite and possesses immunomodulatory properties. An association has been found between Hz accumulation and severe malaria, suggesting that the effects of Hz on the host immune response may contribute to the development of malarial complications. Although the immunomodulatory roles of Hz have been widely investigated, many conflicting data exist, likely due to the variability between experimental set-ups and technical limitations of Hz generation and isolation methods. Here, we critically assess the potential immunomodulatory effects of Hz, its role in malarial complications, and its potential effects after parasite clearance.

疟原虫寄生虫包含多种可调节宿主免疫反应的毒力因子。疟疾色素或血红蛋白（Hz）是寄生虫中血红蛋白降解途径的不可降解结晶产物，具有免疫调节特性。已发现Hz积累与严重疟疾之间存在关联，这表明Hz对宿主免疫反应的影响可能有助于疟疾并发症的发展。尽管已广泛研究了Hz的免疫调节作用，但由于实验设置之间的差异以及Hz生成和分离方法的技术局限性，存在许多相互矛盾的数据。在这里，我们严格评估Hz的潜在免疫调节作用，其在疟疾并发症中的作用以及寄生虫清除后的潜在作用。