The influence of the microbiota on homeostasis of the metaorganism has recently taken center stage. Notably, its contribution to malaria infections has only now started to emerge.
Recent studies have shown that infection by Plasmodium, the causative agent of malaria, induces alterations in the composition of the gut microbiota. Moreover, studies in both humans and mice indicate that certain gut bacterial communities correlate with risk of malaria infection. However, the putative mechanism(s) underlying this phenomenon is still not understood.
While state-of-the-art research focuses on unraveling host–pathogen interactions, we envision a new concept, where a three-way axis, host–pathogen–microbiota, becomes central to understanding malaria and other infectious diseases.
Plasmodium, the causative agent of malaria, is responsible for more than 200 million new infections and 400 000 deaths yearly. While in recent years the influence of the microbiota in homeostasis and a wide variety of disorders has taken center stage, its contribution during malaria infections has only now started to emerge. The few published studies suggest two distinct but complementary directions. Plasmodium infections can cause significant alterations in host (at least gut) microbiota, and host gut microbiota can influence the clinical outcome of malaria infections. In this opinion article, we highlight the most fundamental unanswered questions in the field that will, hopefully, point future research directions towards unveiling key mechanistic insights of the Plasmodium–host–microbiota axis.
