We recently reported that Plasmodium falciparum-infected erythrocytes (IRBCs) can adhere to hyaluronic acid (HA), which appears to be a receptor, in addition to chondroitin sulfate A (CSA), for parasite sequestration in the placenta. Further investigations of the nature and specificity of this interaction indicate that HA oligosaccharide fragments competitively inhibit parasite adhesion to immobilized purified HA in a sizedependent manner, with dodecasaccharides being the minimum size for maximum inhibition. Rigorously purified and structurally defined HA dodecasaccharides, free of contamination by CSA or other glycosaminoglycans, effectively inhibited IRBC adhesion to HA but not CSA, providing compelling evidence of a specific interaction between IRBCs and HA.A characteristic of infection with the malaria parasite Plasmodium falciparum is the ability of parasite-infected erythrocytes (IRBCs) to adhere to host endothelial cells and accumulate in various organs. During pregnancy, the accumulation of IRBCs in the placenta is a key feature of infection and is associated with adverse outcomes and excess perinatal and maternal mortality (6,18). Studies in Africa suggest that sequestration of IRBCs in the placenta is mediated in part by adhesion of parasites to the glycosaminoglycan (GAG) chondroitin sulfate A (CSA) present on syncytiotrophoblasts lining the placental blood spaces (2, 11).We have recently reported that hyaluronic acid (HA) can also support the adhesion of IRBCs in vitro and appears to be an additional receptor for parasite sequestration in the placenta (4). HA is nonsulfated and is the simplest member of the GAG family composed of repeating disaccharide units, -4GlcA1-3GlcNAc1-, in a linear chain that varies in size from 2,000 to 25,000 disaccharide units. It has been identified on syncytiotrophoblasts (17, 28), and we found that most parasite isolates from infected placentas bound to immobilized HA, whereas isolates from the peripheral blood bound to a lesser extent (4). HA is also present on the surfaces of microvascular endothelial cells (19), raising the possibility that it acts as a receptor for parasite sequestration in other organs.To further investigate the nature and specificity of the interaction of HA with IRBCs, we generated oligosaccharide fragments, including high-performance liquid chromatography (HPLC)-purified and structurally defined dodecasaccharides, and examined their abilities to competitively inhibit parasite adhesion to immobilized HA. Some HA preparations can be contaminated with other GAGs, such as CSs, and it was therefore important to exclude the possibility that the adhesion observed could be explained by such contaminants.
MATERIALS AND METHODSPartial depolymerization of HA. HA (from bovine vitreous humor; Sigma) (HA-BVH) was partially depolymerized by controlled digestion with either testicular hyaluronidase (EC 3.2.1.35; from bovine testes; Sigma) or hyaluronate lyase (EC 4.2.2.1; from Streptomyces hyalurolyticus; Sigma). Testicular hyaluronidase digestion was carried...