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Gene polymorphism studies suggest that TLR4 and TLR2 contribute to severe malaria, but the roles of these signaling molecules in malaria pathogenesis remain incompletely understood. We hypothesize that danger-associated molecular patterns produced in response to malaria activate TLR2 and TLR4 signaling and contribute to liver and lung pathologies. By using a mouse model of Plasmodium berghei NK65 infection, we show that the combined TLR2 and TLR4 signaling contributes to malaria liver and lung pathologies and mortality. Macrophages, neutrophils, natural killer cells, and T cells infiltrate to the livers and lungs of infected wild-type mice more than TLR2,4\u2212\/\u2212 mice. Additionally, endothelial barrier disruption, tissue necrosis, and hemorrhage were higher in the livers and lungs of infected wild-type mice than in those of TLR2,4\u2212\/\u2212 mice. Consistent with these results, the levels of chemokine production, chemokine receptor expression, and liver and lung pathologic markers were higher in infected wild-type mice than in TLR2,4\u2212\/\u2212 mice. In addition, the levels of HMGB1, a potent TLR2- and TLR4-activating danger-associated molecular pattern, were higher in livers and lungs of wild-type mice than TLR2,4\u2212\/\u2212 mice. Treatment with glycyrrhizin, an immunomodulatory agent known to inhibit HMGB1 activity, markedly reduced mortality in wild-type mice. These results suggest that TLR2 and TLR4 activation by HMGB1 and possibly other endogenously produced danger-associated molecular patterns contribute to malaria liver and lung injury via signaling mechanisms distinct from those involved in cerebral malaria pathogenesis.<\/jats:p>","DOI":"10.1093\/jleuko\/qiad021","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T01:29:36Z","timestamp":1679534976000},"page":"471-488","source":"Crossref","is-referenced-by-count":5,"title":["Different TLR signaling pathways drive pathology in experimental cerebral malaria vs. malaria-driven liver and lung pathology"],"prefix":"10.1093","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6892-378X","authenticated-orcid":false,"given":"Xianzhu","family":"Wu","sequence":"first","affiliation":[{"name":"Departments of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, 500 University Drive , Hershey, PA 17033 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4665-6243","authenticated-orcid":false,"given":"Kiran K","family":"Dayanand","sequence":"additional","affiliation":[{"name":"Departments of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, 500 University Drive , Hershey, PA 17033 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-6780","authenticated-orcid":false,"given":"Ramesh","family":"Thylur Puttalingaiah","sequence":"additional","affiliation":[{"name":"Departments of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, 500 University Drive , Hershey, PA 17033 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4484-1552","authenticated-orcid":false,"given":"Kishore","family":"Punnath","sequence":"additional","affiliation":[{"name":"Departments of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, 500 University Drive , Hershey, PA 17033 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7411-6987","authenticated-orcid":false,"given":"Christopher C","family":"Norbury","sequence":"additional","affiliation":[{"name":"Departments of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Milton S. 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