9 Plasmodium protozoan parasites undergo rounds of asexual replication inside human 10 erythrocytes, progressing from ring stage, to trophozoites and schizonts, before egress and 11 reinvasion. Given the discovery of ring-specific artemisinin tolerance and quiescence in 12Plasmodium falciparum, there is great urgency to better understand ring stage biology. However, 13the lack of an effective enrichment method has left rings and related parasite stages 14 understudied compared to their late stage counterparts, which can be easily isolated due to their 15 paramagnetic properties. Here, a method for separating all Plasmodium infected erythrocytes 16 from uninfected erythrocytes is presented. This approach takes advantage of streptolysin-O 17(SLO) to preferentially lyse uninfected erythrocytes as previously shown by Jackson, et al.
18Following lytic treatment, Percoll gradient centrifugation removes lysed cells, leaving an intact 19 cell population enriched in infected erythrocytes. This SLO-Percoll (SLOPE) method is effective 20 on stages from the entire erythrocytic cycle, including previously inaccessible forms such as 21circulating rings from malaria-infected patients and artemisinin-induced quiescent parasites. 22Furthermore, the utility of SLOPE is extended to multiple media formulations used for the 23 propagation of two human Plasmodium species. The alteration of external cholesterol levels 24modulates SLOPE effectiveness, demonstrating the role of erythrocyte membrane cholesterol 25 in lytic discrimination. Importantly, enrichment does not impact parasite viability, which 26 establishes the non-toxic nature of SLOPE. Targeted metabolomics of SLOPE-enriched ring 27 stage samples confirms the impact on treated samples; parasite-derived metabolites are 28 increased and contaminating host material is reduced compared to non-enriched samples.
30Importance 31Malaria is caused by infection with protozoan Plasmodium parasites and is responsible for over 32 400,000 deaths annually. The availability of effective antimalarial drugs is critical to the reduction 33 of malaria-related mortality, yet widespread resistance highlights the need for the continued 34 study of Plasmodium biology. The SLOPE method is an accessible, scalable, rapid (30-40min), 35and non-toxic enrichment method that is broadly effective on many erythrocytic stages. This 36 method is ideal for use upstream of a variety of sensitive analyses, which will increase 37 experimental quality in virtually all areas of asexual Plasmodium parasite research. Further, 38because the consumption of cholesterol is a common characteristic of other intracellular 39 parasites (both bacteria and other protozoa), SLOPE holds potential for extension to other 40 relevant pathogens. 41 45 falciparum being responsible for the large majority of malaria morbidity and mortality (1). While 46 the global malaria burden has decreased over the past decade, the emergence and spread of 47 antimalarial resistant Plasmodium threatens to undo this progress and emphasizes the dire nee...