The major growth in point-of-care malaria diagnosis over the past decade has been based on immunochromatographic malaria rapid diagnostic tests (mRDTs), which generally detect Plasmodium falciparum via its abundant histidine-rich protein 2 (HRP2). Here, we review the discovery and biology of HRP2, as well as the strengths and weaknesses of HRP2-based diagnosis compared with alternative antigens. We highlight recent studies describing HRP2 deletion in Latin America, Eritrea, and possibly other regions, and the methodological challenges of confirming deletion of the pfhrp2 gene. We also discuss the mechanism of persistent HRP2 positivity after effective antimalarial treatment, along with other emerging HRP2-based applications, including detection of submicroscopic malaria and diagnosis of severe malaria.

中文翻译：

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HRP2：改变疟疾诊断，但有警告。

过去十年来，即时诊室疟疾诊断的主要增长是基于免疫色谱疟疾快速诊断测试（mRDT），该测试通常通过其丰富的富含组氨酸的蛋白质2（HRP2）检测出恶性疟原虫。在这里，我们回顾与替代抗原相比，HRP2的发现和生物学，以及基于HRP2的诊断的优缺点。我们重点介绍了最近的研究，这些研究描述了拉丁美洲，厄立特里亚以及其他地区的HRP2缺失，以及确认pfhrp2基因缺失的方法学挑战。我们还讨论了有效的抗疟疾治疗后HRP2阳性持续的机制，以及其他基于HRP2的新兴应用，包括亚显微疟疾的检测和严重疟疾的诊断。