Beyond the bite: how mosquito salivary proteins modulate midgut biology and malaria parasite transmission

Mosquito blood feeding is complicated by the host's hemostatic and immune responses, which remain active after ingestion, affecting blood ingestion and digestion and threatening the midgut epithelium integrity. At the bite site, mosquitoes bypass the host's hemostatic and immune defenses by injecting saliva containing bioactive molecules, such as anticoagulants and immunomodulators, which facilitate efficient blood extraction. Ingested saliva can also modulate similar responses in the blood bolus. Here, we examine current evidence on how mosquito saliva proteins modulate blood responses in the midgut and enhance Plasmodium transmission. Saliva proteins are potential transmission-blocking targets for new intervention strategies to combat mosquito-borne diseases.