Asexual cycle of Plasmodium vivax in human

Infection:
A healthy person acquires infection when a female anopheles mosquito, containing infective stage of
parasite (sporozoites) in its salivary gland bites him/her for sucking blood. The mosquito punctures the
host,s skin by its proboscis and first introduce some saliva into blood stream. Along with saliva, thousands
of sporozoites are also inoculated. Purpose of pouring saliva is to check clotting of blood as it contains an
anti-coagulant.
Liver schizogony:
Once within the human blood, sporozoites circulates for half an hour and then gets into liver to invade
hepatic cells. Here they multiply asexually by schizogony. Liver schizogony has two phases:
 Pre-erythrocytic phase
 Exo-erythrocytic phase
Pre-erythrocytic phase
After penetrating a hepatic cell, each sporozoite becomes a cryptozoite. It grows for number of days and
become spherical and non-pigmented schizont. It divides by schizogony (multiple fission) and forms
large number of uni-nucleated cells, cryptomerozoites. Their number varies from one thousands to several
thousands. They are liberated when liver cell bursts. This is the end of pre-erythrocytic phase.
Exo-erythrocytic phase
Cryptomerozoites enters fresh liver cells to become meta-cryptozoites. They undergo schizogony similar
to previous one producing enormous number of meta-cryptomerozoites. This may be repeated several
times and each time new liver cells are infected. All these succeeding schizogonic division are reffered to
as exo-erythrocytic schizogony.
It has been reported that meta-cryptomerozoites produced are of two types. Smaller and more in number
are micro-metacryptomerozoites which enters Red blood corpuscles (RBC) to start erythrocytic cycle.
Larger and less in number are macro-metacryptomerozoites which again invades fresh liver cell to
continue exo-erythrocytic schizogony. Both type of schizogony continue side by side.
Erythrocytic schizogony:
Micro-metacryptomerozoites, after escaping into blood stream invades the erythrocytes or RBCs. This
starts the erythrocytic schizogony which includes following stages:
 Trophozoite stage
 Signet-ring stage
 Amoeboid stage
 Schizont
 Rosette stage
Trophozoite stage
As micro-metacryptomerozoite enters RBCs, it gets transformed into oval or rounded structure. It has
vacuole with haemozoin, prominent nucleus, endoplasmic reticulum, pallade ,s granules, dense body,
mitochondria, ribosome, pinocytosis vesicles etc. it is the feeding stage. It feeds on cytoplasm of RBCs.
Signet-ring stage
As the trophozoite grows in size, a central vacuole is developed so that the nucleus is pushed to one side
into peripheral cytoplasm. This stage is clinically reffered to as signet ring stage, as it resembles the signet
ring with the peripherally located nucleus looking like the gem of ring.
Amoeboid stage
Signet-ring stage of Plasmodium vivax further feeds on cytoplasm, central vacuole disappear and
cytoplasmic development takes place to form pseudopodial processes. Pseudopodia thus, developed
probably helps to feed on cytoplasm of RBC. Heamoglobin is ingested by organism but globin part of it is
only digested, hematin part remains undigested and forms toxic substance, Haemozoin. At this time,
small red eosinophilic granules appears in the cytoplasm of host corpuscles, which are known as
schuffner,s granules.
Schizont
The amoeboid trophozoite, after active feeding grows in size and become schizont. Soon, its nucleus gets
divide by multiple fission and surrounds by small mass of cytoplasma.
Rosette stage
Schizont gives rise to large number of merozoites after multiple fission, which are arranged in the
periphery of RBC to form like the petals arrangement in rose flower so called Rosette stage. The
haemozoin granules are gathered at the center. With the rupture of RBC, merozoites are liberated into the
blood stream.
Release of merozoites
When the merozoites gets matured they are released by brusting of RBC in blood. Merozoites thus,
released in blood repeats the next erythrocytic cycle or some of which invades the liver cell starting liver
schizogony. Haemozoin, found at the center of Rosette stage are also released into blood stream. One
complete erythrocytic cycle takes 48hrs in Plasmodium vivax.
Post-erythrocytic cycle
Sometimes, some merozoites produced in erythrocytic schizogony reaches liver cells and undergo
schizogonic development in liver cells. This is reffered to as post-erythrocytic schizogony.
Formation of Gametocytes
After the number of erythrocytic schizogony, merozoites released gets exhausted and do-not proceed
ahead with erythrocytic cycle. They enters the RBCs, increase in size to become rounded gametocytes.
These shows the sexual dimorphism being of two type. The male or micro-gametocytes are smaller and
contains a large diffused nucleus whereas, female or mega-gametocytes are large with small compact
peripheral nucleus. The gametocytes do-not divides but remains as intracellular parasite within their host
blood corpuscles, waiting for ingestion by vector in which they continue their further development
(sexual cycle).

Fig:- Asexual cycle of Plasmodium vivax in human

 Pre-patent and incubation periods
The duration between initial infection and first appearance of parasites in blood is termed as pre-patent
period. It varies from species to species, being of about 8 days in Plasmodium vivax.
The duration between infection and appearance of first malarial symptoms in termed as incubation
period which is of about 10-17 days (average 14 days) in Plasmodium vivax.