Chloroquine (CQ) accumulates in the acidic food vacuole of intraerythrocytic malaria parasites (Plasmodium falciparum) by virtue of its weak base properties. In the present work, the extent of CQ accumulation was determined by the transvacuolar pH gradient: modification of the lattereither by changing the external pH or by adding the acidotropic agent NH4Cl-led to a corresponding change in CQ distribution between cells and medium. Changes in pH gradient provoked a change in the susceptibility of parasites to CQ: at external pH values of 8.0, 7.4, and 6.8, the IC50 values for CQ were 0.48 x 10-7 M, 1.8 x 10-7 M, and 3.3 x 10-7 M, respectively. Marked resistance to CQ (IC50 = 9.8 x 10-7 M) was conferred upon cells by exposing them simultaneously to CQ and 10 mM NH4Cl, at pH 7.4. The final concentration of CQ attained within the acidic compartment of the parasite was correlated with inhibition of parasite growth. At therapeutic drug levels, CQ accumulation caused minor changes in the food vacuole pH, whereas at higher CQ concentrations substantial alkalinization was observed. The antimalarial activity of CQ is suggested to be exerted by the interference of the high concentrations of the accumulated drug with vital functions of the food vacuole.The development of resistance of malarial parasites to the drug chloroquine (CQ), for many years the most popular and efficient antimalarial drug, has been of growing concern (1). However, the factors responsible for drug resistance have not been identified nor has the mode of CQ action been fully elucidated. The antimalarial effect of the drug has been attributed to the ability of CQ-sensitive parasites to accumulate relatively high levels of the drug (2, 3). It has been proposed that CQ accumulation results from its binding to a putative intraparasitic receptor, ferriprotoporphyrin IX (FeP), with consequent formation of a membrane lytic agent (4). Alternatively, in analogy with the lysosomotropic effects of weak bases on animal cells (5), it was postulated that CQ accumulates to high levels in the acidic food vacuoles of malaria parasites, causing their alkalinization and interfering with vital cellular processes (6).This latter hypothesis rests on the idea that the food vacuole of an intraerythrocytic malaria parasite is an acidic compartment (7,8) whose pH is maintained by metabolic input (9) and in which CQ accumulates by virtue of its weak base properties, following transmembrane proton gradients. This has recently been demonstrated by fluorescence measurements of intravacuolar pH and determination of CQ distribution as a function of established pH gradients and their dissipation by various agents (10). However, at therapeutic levels, the effect of CQ on intravacuolar pH, as determined by CQ and methylamine distribution, was minor, thus casting doubt on the validity of vacuolar alkalinization per se as a major factor in CQ-mediated inhibition of parasite development.The mode of action of CQ and the mechanism of drug resistance in human malaria have been assessed...