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Prepublished online as a Blood First Edition Paper on November 27, 2002; DOI 10.1182/blood-2002-09-2841.
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Blood, 1 April 2003, Vol. 101, No. 7, pp. 2850-2857
RED CELLS
Src-family kinase signaling modulates the adhesion of
Plasmodium falciparum on human microvascular endothelium
under flow
Bryan G. Yipp,
Stephen M. Robbins,
Mary E. Resek,
Dror I. Baruch,
Sornchai Looareesuwan, and
May Ho
From the Immunology Research Group, Department of
Microbiology and Infectious Diseases, and Departments of Oncology and
Molecular Biology and Biochemistry, University of Calgary, AB,
Canada; the Laboratory for Parasitic Disease, National
Institute of Allergy and Infectious Diseases, National Institutes of
Health, Bethesda, MD; and the Faculty of Tropical Medicine, Mahidol
University, Bangkok, Thailand.
The pathogenicity of Plasmodium falciparum is due
to the unique ability of infected erythrocytes (IRBCs) to adhere to
vascular endothelium. We investigated whether adhesion of IRBCs to
CD36, the major cytoadherence receptor on human dermal microvascular endothelial cells (HDMECs), induces intracellular signaling and regulates adhesion. A recombinant peptide corresponding to the minimal
CD36-binding domain from P falciparum erythrocyte
membrane protein 1 (PfEMP1), as well as an anti-CD36 monoclonal
antibody (mAb) that inhibits IRBC binding, activated the
mitogen-activated protein (MAP) kinase pathway that was
dependent on Src-family kinase activity. Treatment of HDMECs with a
Src-family kinase-selective inhibitor (PP1) inhibited adhesion
of IRBCs in a flow-chamber assay by 72% (P < .001).
More importantly, Src-family kinase activity was also required for
cytoadherence to intact human microvessels in a human/severe combined
immunodeficient (SCID) mouse model in vivo. The effect of PP1
could be mimicked by levamisole, a specific alkaline-phosphatase
inhibitor. Firm adhesion to PP1-treated endothelium was restored by
exogenous alkaline phosphatase. In contrast, inhibition of the
extracellular signal-regulated kinase 1/2 (ERK 1/2)
and p38 MAP kinase pathways had no immediate effect on IRBC adhesion.
These results suggest a novel mechanism for the modulation of
cytoadherence under flow conditions through a signaling pathway
involving CD36, Src-family kinases, and an ectoalkaline phosphatase.
Targeting endothelial ectoalkaline phosphatases and/or signaling
molecules may constitute a novel therapeutic strategy against severe
falciparum malaria.

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