25The pore forming Plasmodium perforin like proteins (PPLP), expressed in all stages of 26 the parasite life cycle are central drivers for host interactions critical for completion of 27 parasite life cycle and high transmission rates. The high sequence similarity in the central 28 membrane attack complex/ perforin (MACPF) domain and consequent functional overlaps 29 defines them as an attractive target for the development of multi-stage antimalarials. Herein 30 we evaluated the mechanism of pan active function of central, highly conserved region of 31 PPLPs, MACPF domain (PMD) and inhibitory potential of specifically designed anti-PMD 32 chemo. The E. coli expressed rPMD interacts with erythrocyte membrane and form pores of 33 ~10.5 nm height and ~24.3 nm diameter leading to haemoglobin release and dextran uptake.
34The treatment with PMD induced erythrocytes senescence at 48 hours which can account for 35 the physiological effect of disseminated PLPs in loss of circulating erythrocytes inducing 36 anemia during malaria infection. The anti-PMD inhibitors effectively blocked 37 intraerythrocytic growth by suppressing invasion and egress of merozoites and protecting 38 against erythrocyte senescence. Moreover, these inhibitors also blocked the hepatic stage and 39 transmission stage parasite development suggesting multi-stage and transmission-blocking 40 potential of these inhibitors. Additionally, the erythrocyte senescence protective potential of 41 PMD inhibitors can be used to occlude PPLPs mediated severe malarial anemia. Further these 42 inhibitors can be developed with a potential to protect against severity of the disease. 43 44 45 Author Summary 46Malaria continues to be a major global health threat despite of several exciting improvements 47 in the treatment and prevention of the disease. One of the major concerns in the development 48 of therapy is the emergence of the drug resistance. But for the efficient treatment regime, 49 targeting multiple stages including host and vector would serve as an ideal therapy. Perforin 50 like proteins (PLPs) are eukaryotic pore forming proteins that are highly conserved in the 51 apicomplexan parasites. These play crucial roles in entry and exit of parasites from the host 52 cells and establish infection at multiple stages of Plasmodium spp. life cycle. Understanding 53 the mechanism of pore formation by smaller, functional, pan-active scaffold of PLPs can 54 serve as a target for development of cross stage protection. Here, using various biochemical, 55 biophysical and pharmacological evidences, we validate the activity and characterize the pore 56 formation of PLPs on erythrocytes. Further, our specifically designed inhibitors could restrict 57 this pore formation and impede the exit/entry of the parasites. Moreover, these inhibitors 58 could also exert multiple stage inhibition and rescue the uninfected erythrocytes from death.
59Together, this study highlights the mechanism of pore formation by PPLPs and evaluates 60 their potential for the development of...