Why do Kupffer cells not attack malarial sporozoites?

Question

During malaria, why don't Kupffer cells (hepatic macrophages) attack the _Plasmodium_ sporozoites and stop schizogony, thus saving us from the disease?

Answer 1

The malaria sporozoites use the Kupffer cells to gain entry into the liver, this mechanism is known as the Gateway Theory. This is not uncommon. There are many examples of pathogens (especially bacteria) that gain entry into macrophages and use the cells as protection from the immune system and a means to infect other tissues. It is still unclear how the sporozoites gain entry into the Kupffer cells but the surface molecule CD68 has been implicated. When interacting with the Kupffer cells, the sporozoites suppress phagocytic pathways and can induce apoptosis in the macrophages.