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Prepublished online as a Blood First Edition Paper on November 14, 2002; DOI 10.1182/blood-2002-07-2016.
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Blood, 15 March 2003, Vol. 101, No. 6, pp. 2405-2411
RED CELLS
Heparan sulfate on endothelial cells mediates the binding of
Plasmodium falciparum-infected erythrocytes via the DBL1
domain of PfEMP1
Anna M. Vogt,
Antonio Barragan,
Qijun Chen,
Fred Kironde,
Dorothe Spillmann, and
Mats Wahlgren
From the Microbiology and Tumor Biology Center
(MTC), Karolinska Institutet, Stockholm, Sweden; the
Swedish Institute for Infectious Disease Control (SMI), Stockholm,
Sweden; the Department of Biochemistry, University of
Makerere, Kampala, Uganda; and the Department of Medical Biochemistry
and Microbiology, Biomedical Center, Uppsala University, Uppsala,
Sweden.
Plasmodium falciparum may cause severe forms of malaria
when excessive sequestration of infected and uninfected erythrocytes occurs in vital organs. The capacity of wild-type isolates
of P falciparum-infected erythrocytes (parasitized red
blood cells [pRBCs]) to bind glycosaminoglycans (GAGs) such
as heparin has been identified as a marker for severe disease. Here we
report that pRBCs of the parasite FCR3S1.2 and wild-type clinical
isolates from Uganda adhere to heparan sulfate (HS) on endothelial
cells. Binding to human umbilical vein endothelial cells (HUVECs) and to human lung endothelial cells (HLECs) was found to be inhibited by
HS/heparin or enzymes that remove HS from cell surfaces.
35S-labeled HS extracted from HUVECs bound directly
to the pRBCs' membrane. Using recombinant proteins corresponding to
the different domains of P falciparum erythrocyte
membrane protein 1 (PfEMP1), we identified Duffy-binding-like
domain-1 (DBL1 ) as the ligand for HS. DBL1 bound in
an HS-dependent way to endothelial cells and blocked the adherence of
pRBCs in a dose-dependent manner. 35S-labeled HS bound to
DBL1 -columns and eluted as a distinct peak at 0.4 mM NaCl.
35S-labeled chondroitin sulfate (CS) of HUVECs did not bind
to PfEMP1 or to the pRBCs' membrane. Adhesion of pRBCs of FCR3S1.2 to
platelet endothelial cell adhesion molecule-1 (PECAM-1)/CD31,
mediated by the cysteine-rich interdomain region 1
(CIDR1 ), was found be operative with, but independent of,
the binding to HS. HS and the previously identified HS-like GAG on
uninfected erythrocytes may act as coreceptors in endothelial and
erythrocyte binding of rosetting parasites, causing excessive
sequestration of both pRBCs and RBCs.

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