Red blood cells (RBCs) parasitized byPlasmodium falciparum are rigid and poorly deformable and show abnormal circulatory behavior. During parasite development, knob-associated histidinerich protein (KAHRP) and P falciparum erythrocyte membrane protein 3 (PfEMP3) are exported from the parasite and interact with the RBC membrane skeleton. Using micropipette aspiration, the membrane shear elastic modulus of RBCs infected with transgenic parasites (with kahrp or pfemp3 genes deleted) was measured to determine the contribution of these proteins to the increased rigidity of parasitized RBCs (PRBCs). In the absence of either protein, the level of membrane rigidification was significantly less than that caused by the normal parental parasite clone. KAHRP had a significantly greater effect on rigidification than PfEMP3, contributing approximately 51% of the overall increase that occurs in PRBCs compared to 15% for PfEMP3. This study provides the first quantitative information on the contribution of specific parasite proteins to altered mechanical properties of PRBCs.
IntroductionMalaria caused by Plasmodium falciparum remains the most serious and widespread parasitic disease of humans. Clinical symptoms of malaria occur during the asexual stage of the parasite's life cycle, when it multiplies within red blood cells (RBCs). The extreme virulence of P falciparum and the occurrence of severe, often fatal clinical complications is related to the ability of RBCs parasitized by mature forms of the parasite to accumulate in the microvasculature of a variety of organs. 1 This abnormal circulatory behavior for RBCs appears to be directly related to parasite-induced alteration of its mechanical and adhesive properties.During the last 2 decades, the altered adhesive properties of parasitized RBCs (PRBCs) have been studied intensively (see 2,3 for recent reviews). In contrast, alterations of their mechanical properties, and the molecular mechanisms underpinning these changes, have been relatively ignored. Previous studies have clearly demonstrated that the deformability of intact PRBCs is profoundly reduced. [4][5][6] The overall increase in red cell rigidity is due, in part, to the presence of the large, nondeformable intracellular parasite and to a number of stage-specific parasite-encoded proteins that associate with the RBC membrane skeleton. 3,5,6 Paulitschke and Nash 6 used micropipette aspiration to measure the rigidity of RBCs parasitized by a number of unrelated parasite lines of knobby and knobless phenotypes. In general, the membranes of knobby PRBCs were more rigid than those lacking knobs; however, there was considerable variation in rigidity, particularly between knobby lines, with some knobby PRBCs only slightly more rigid than others infected with knobless parasite lines. Unfortunately, in their study, there was no characterization of the parasite genotype or immunohistochemical analysis of the PRBCs to determine precisely which parasite proteins were or were not expressed in different parasite lines. As such, thoug...