Malaria infection is initiated when the insect vector injectsPlasmodium sporozoites into a susceptible vertebrate host. Sporozoites rapidly leave the circulatory system to invade hepatocytes, where further development generates the parasite form that invades and multiplies within erythrocytes. Previous experiments have shown that the thrombospondin-related adhesive protein (TRAP) plays an important role in sporozoite infectivity for hepatocytes. TRAP, a typical type-1 transmembrane protein, has a long extracellular region, which contains two adhesive domains, an A-domain and a thrombospondin repeat. We have generated recombinant proteins of the TRAP adhesive domains. These TRAP fragments show direct interaction with hepatocytes and inhibit sporozoite invasion in vitro. When the recombinant TRAP A-domain was used for immunoprecipitation against hepatocyte membrane fractions, it bound to ␣2-Heremans-Schmid glycoprotein/ fetuin-A, a hepatocyte-specific protein associated with the extracellular matrix. When the soluble sporozoite protein fraction was immunoprecipitated on a fetuin-A-adsorbed protein A column, TRAP bound this ligand. Importantly, anti-fetuin-A antibodies inhibited invasion of hepatocytes by sporozoites. Further, onset of malaria infection was delayed in fetuin-A-deficient mice compared to that in wild-type C57BL/6 mice when they were challenged with Plasmodium berghei sporozoites. These data demonstrate that the extracellular region of TRAP interacts with fetuin-A on hepatocyte membranes and that this interaction enhances the parasite's ability to invade hepatocytes.Malaria is a deadly parasitic disease which affects nearly 40% of the world's population. In any given year 300 to 500 million clinical cases occur, with more than a million deaths. Malaria is caused by species of the protozoan parasite Plasmodium. The infection is initiated when a female Anopheles mosquito injects Plasmodium sporozoites into a susceptible vertebrate host. The sporozoites migrate to the liver, where they undergo many rounds of schizogony in the hepatocytes. The resulting merozoites then invade and multiply within erythrocytes, causing the clinical symptoms of malaria.Understanding the pathogenesis of malaria requires a keen understanding of the molecular mechanisms used by Plasmodium to recognize and invade host cells. Invasion is mediated by interactions between specific parasite molecules and complementary ligands on the host cells. Plasmodium has three invasive stages: (i) sporozoites (sporogonic cycle), which invade the salivary glands of the mosquito; (ii) salivary gland sporozoites (exoerythrocytic cycle), which invade hepatocytes in the vertebrate; and (iii) merozoites (erythrocytic cycle), which invade erythrocytes. The invasion of hepatocytes by sporozoites has been known to require two parasite proteins: circumsporozoite protein (CS) and thrombospondin-related adhesive protein (TRAP) (6,28,30,33,34,44). These proteins are conserved in all Plasmodium species examined to date (26,40) and are present on the parasit...