Conditional genome engineering in the human malaria pathogen Plasmodium falciparum remains highly challenging. Here we describe a strategy for facile and rapid functional analysis of genes using an approach based on the Cre/lox system and tailored for organisms with short and few introns. Our method allows the conditional, site-specific removal of genomic sequences of essential and non-essential genes by placing loxP sites into a short synthetic intron to produce a module (loxPint) can be placed anywhere in open reading frames without compromising protein expression. When duplicated, the loxPint module serves as an intragenic recombineering point that can be used for the fusion of gene elements to reporters or the conditional introduction of point mutations. We demonstrate the robustness and versatility of the system by targeting the P. falciparum merozoite surface protein 1 gene (msp1), which has previously proven refractory to genetic interrogation, and the parasite exported kinase FIKK10.1.

Summary The most severe form of human malaria is caused by Plasmodium falciparum . Its virulence is closely linked to the increase in rigidity of infected erythrocytes and their adhesion to endothelial receptors, obstructing blood flow to vital organs. Unlike other human-infecting Plasmodium species, P. falciparum exports a family of 18 ‘FIKK’ serine/threonine kinases into the host cell, suggesting that phosphorylation may modulate erythrocyte modifications. We reveal substantial species-specific phosphorylation of erythrocyte proteins by P. falciparum , but not by Plasmodium knowlesi , which does not export FIKK kinases. By conditionally deleting all FIKK kinases combined with large-scale quantitative phosphoproteomics we identify unique phosphorylation fingerprints for each kinase, including phosphosites on parasite virulence factors and host erythrocyte proteins. Despite their non-overlapping target sites, a network analysis reveals that some FIKKs may act in the same pathways. Only deletion of the non-exported kinase FIKK8 resulted in reduced parasite growth, suggesting the exported FIKKs may instead support functions important for survival within the host. We show that one kinase, FIKK4.1, mediates both rigidification of the erythrocyte cytoskeleton and trafficking of the adhesin and key virulence factor PfEMP1 to the host cell surface. This establishes the FIKK family as important drivers of parasite evolution and malaria pathology.

Plasmodium falciparum has a complex life cycle that involves interaction with multiple tissues inside the human and mosquito hosts. Identification of essential genes at all different stages of the P. falciparum life cycle is urgently required for clinical development of tools for malaria control and eradication. However, the study of P. falciparum is limited by the inability to genetically modify the parasite throughout its life cycle with the currently available genetic tools. Here, we describe the detailed characterization of a new marker-free P. falciparum parasite line that expresses rapamycin-inducible Cre recombinase across the full life cycle. Using this parasite line, we were able to conditionally delete the essential invasion ligand AMA1 in three different developmental stages for the first time. We further confirm efficient gene deletion by targeting the nonessential kinase FIKK7.1. IMPORTANCE One of the major limitations in studying P. falciparum is that so far only asexual stages are amenable to rapid conditional genetic modification. The most promising drug targets and vaccine candidates, however, have been refractory to genetic modification because they are essential during the blood stage or for transmission in the mosquito vector. This leaves a major gap in our understanding of parasite proteins in most life cycle stages and hinders genetic validation of drug and vaccine targets. Here, we describe a method that supports conditional gene deletion across the P. falciparum life cycle for the first time. We demonstrate its potential by deleting essential and nonessential genes at different parasite stages, which opens up completely new avenues for the study of malaria and drug development. It may also allow the realization of novel vaccination strategies using attenuated parasites.

Tithonia diversifolia, Cyclea barbata, Tinospora crispa, Arcangelisia flava, Pycnarrhena cauliflora are plants used in Indonesia for the traditional treatment of malaria. In the search for new antiparasitic drugs, the parts traditionally used of these 5 plants were extracted with various solvents and evaluated in vitro against Plasmodium falciparum but also against Babesia divergens and Leishmania infantum. Seven crude plant extracts out of 25 tested displayed high antimalarial activities with IC50 < 5 µg/ml and in the case of some of them an interesting selectivity regarding their cytotoxicity against mammalian cells. A. flava appeared to be the most promising antiplasmodial plant with the highest antiplasmodial activity (IC50 values less than 3 µg/ml) and the weakest cytotoxicity. By contrast, only P. cauliflora radix, through its dichloromethane and methanol extracts also demonstrated a high activity against L. infantum, with IC50 values around 3 µg/ml; their high selectivity index, especially on VERO cells, hypothesises a specific parasiticidal action. Moreover, for all the extracts showing antiplasmodial activity, a positive correlation was demonstrated with antibabesial activity, suggesting that these antiplasmodial extracts could be a potential source of antibabesial compounds. These preliminary results confirm the antiplasmodial interest of some of these plants used in traditional medicine but also their effects on leishmaniasis and babesiosis. Ongoing phytochemical investigations should allow identification of the chemical series responsible for these activities.