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Plasmodium falciparum is a major cause of severe malaria. This protozoan infects human red blood cells and secretes large quantities of histidine-rich protein 2 (PfHRP2) into the bloodstream, making it a well-known diagnostic marker. Here, however, we identified PfHRP2 as a pathogenic factor produced by P. falciparum. PfHRP2 showed cell penetration and cytotoxicity against various human cells. PfHRP2 also exhibited significant cytotoxicity at concentrations found in P. falciparum-infected patients' blood (90-100 nM). We also showed that PfHRP2 binds to Ca2+ ions, localizes to intracellular lysosomes, increases lysosomal Ca2+ levels, and inhibits the basal level of autophagy by preventing autolysosome formation. Furthermore, the Ca2+-dependent cytotoxicity of PfHRP2 was suppressed by the metal ion chelator ethylenediaminetetraacetic acid. In summary, our findings suggest PfHRP2 as a crucial pathogenic factor produced by P. falciparum and its mode of action. Overall, this study provides preliminary insights into P. falciparum malaria pathogenesis., (© The Author(s) 2025. Published by Oxford University Press on behalf of Japan Society for Bioscience, Biotechnology, and Agrochemistry.)

Many institutions perform thoracoscopic surgery for pediatric extrapulmonary sequestration (EPS). This approach achieves good cosmetic outcomes due to the small skin incision in comparison to open surgery. However, an extension or additional incision is sometimes necessary to extract resected specimens from the thoracic cavity, which reduces the advantages of this procedure. We herein report 5 cases of two-site thoracoscopic surgery (TTS) using an extraction wound with left-sided EPS. In this procedure, a camera port was inserted inside the skin incision at the sixth intercostal space of the middle axillary line using optical methods, and the operator's left-hand port was inserted inside the same skin incision. The EPS was resected and extracted through a skin incision without extension or additional incision. A surgeon-in-training performed the procedure in 4 of the 5 cases. The postoperative course was uneventful in all cases. The patients showed quick recovery and good cosmetic outcomes. TTS is a cosmetically favorable approach for EPS., (© 2025 The Author(s). Asian Journal of Endoscopic Surgery published by Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)