The Journal of Experimental Medicine
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Published online 26 June 2000.
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© The Rockefeller University Press, 0022-1007/2000/7/1/ $5.00
The Journal of Experimental Medicine, Volume 192, Number 1, July 3, 2000 1-10


Original Article

The Semiconserved Head Structure of Plasmodium falciparum Erythrocyte Membrane Protein 1 Mediates Binding to Multiple Independent Host Receptors

Qijun Chena, Andreas Heddinia, Antonio Barragana, Victor Fernandeza, S. Frieda A. Pearceb, and Mats Wahlgrena
a Microbiology and Tumor Biology Center, Karolinska Institutet, The Swedish Institute for Infectious Disease Control, S-171 77 Stockholm, Sweden
b Department of Medicine, Division of Hematology-Oncology, Cornell University, Medical College, New York, New York 10021

Correspondence to: Mats Wahlgren, Microbiology and Tumor Biology Center, Karolinska Institutet, The Swedish Institute for Infectious Disease Control, Box 280, S-171 77 Stockholm, Sweden. Tel:46-8-4572510 Fax:46-8-310525 E-mail:mats.wahlgren{at}smi.ki.se.

Erythrocytes infected with mature forms of Plasmodium falciparum do not circulate but are withdrawn from the peripheral circulation; they are bound to the endothelial lining and to uninfected erythrocytes in the microvasculature. Blockage of the blood flow, hampered oxygen delivery, and severe malaria may follow if binding is excessive. The NH2-terminal head structure (Duffy binding–like domain 1 [DBL1{alpha}]–cysteine-rich interdomain region [CIDR1{alpha}]) of a single species of P. falciparum erythrocyte membrane protein 1 (PfEMP1) is here shown to mediate adherence to multiple host receptors including platelet-endothelial cell adhesion molecule 1 (PECAM-1)/CD31, the blood group A antigen, normal nonimmune immunoglobulin M, three virulence-associated receptor proteins, a heparan sulfate–like glucosaminoglycan, and CD36. DBL2{delta} was found to mediate additional binding to PECAM-1/CD31. The exceptional binding activity of the PfEMP1 head structure and its relatively conserved nature argues that it holds an important role in erythrocyte sequestration and therefore in the virulence of the malaria parasite.

Key Words: malaria, sequestration, cytoadherence, rosetting, ligand


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