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Prepublished online as a Blood First Edition Paper on August 15, 2002; DOI 10.1182/blood-2002-06-1725.
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Blood, 1 January 2003, Vol. 101, No. 1, pp. 331-337
RED CELLS
Recombinant PfEMP1 peptide inhibits and reverses cytoadherence of
clinical Plasmodium falciparum isolates in
vivo
Bryan G. Yipp,
Dror I. Baruch,
Ciaran Brady,
Allan G. Murray,
Sornchai Looareesuwan,
Paul Kubes, and
May Ho
From the Immunology Research Group, University of
Calgary, Calgary, AB, Canada; Laboratory for Parasitic
Diseases and Malaria Vaccine Development Unit, National Institute of
Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, MD; Department of Medicine, University of Alberta, Edmonton,
AB, Canada; and Faculty of Tropical Medicine, Mahidol
University, Bangkok, Thailand.
The parasite ligand Plasmodium falciparum erythrocyte
membrane protein 1 (PfEMP1) and host endothelial receptors represent potential targets for antiadhesive therapy for cytoadherence. In the
present study, the major host receptor CD36 was targeted in vitro and
in vivo with a recombinant peptide, PpMC-179, corresponding to the
minimal CD36-binding domain from the cysteine-rich interdomain region 1 (CIDR1) within the MCvar1 PfEMP1. The in vitro inhibitory effect of PpMC-179 on human dermal microvascular endothelial
cells (HDMECs) expressing multiple relevant adhesion molecules
was investigated using a parallel-plate flow chamber. Pretreatment of
endothelial monolayers with PpMC-179 (2 µM) inhibited the adhesion of
infected erythrocytes (IRBCs) from all clinical isolates tested by
84.4% on resting and 62.8% on tumor necrosis factor (TNF- )-stimulated monolayers. Adhesion to stimulated cells was
further inhibited (90.4%) when PpMC-179 was administered with an
inhibitory anti-intercellular adhesion molecule 1 (ICAM-1) monoclonal
antibody 84H10 (5 µg/mL). To determine the in vivo effectiveness of
PpMC-179, we used a human/severe combined immunodeficiency (SCID) mouse
chimeric model that allowed direct visualization of cytoadherence on
intact human microvasculature. In unstimulated skin grafts, PpMC-179
inhibited adhesion by 86.3% and by 84.6% in TNF- -stimulated skin
grafts. More importantly, PpMC-179 administration resulted in the
detachment of already adherent IRBCs by 80.7% and 83.3% on resting
and stimulated skin grafts, respectively. The antiadhesive effect of
PpMC-179 was rapid and sustained in vivo for at least 30 minutes. Our
data indicate that targeting cytoadhesion in vivo is feasible and may offer a rapid antimalarial therapy.

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