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Blood, 1 November 2000, Vol. 96, No. 9, pp. 3231-3240
RED CELLS
Nonopsonic monocyte/macrophage phagocytosis of Plasmodium
falciparum-parasitized erythrocytes: a role for CD36 in
malarial clearance
Ian D. McGilvray,
Lena Serghides,
Andras Kapus,
Ori D. Rotstein, and
Kevin C. Kain
From the Departments of Medicine and Surgery,
University of Toronto, Toronto, Ontario, Canada.
Plasmodium falciparum is the most lethal form of
malaria and is increasing both in incidence and in its resistance to
antimalarial agents. An improved understanding of the mechanisms of
malarial clearance may facilitate the development of new therapeutic
interventions. We postulated that the scavenger receptor CD36, an
important factor in cytoadherence of P
falciparum-parasitized erythrocytes (PEs), might also
play a role in monocyte- and macrophage-mediated malarial clearance. Exposure of nonopsonized PEs to Fc receptor-blocked monocytes resulted in significant PE phagocytosis, accompanied by
intense clustering of CD36 around the PEs. Phagocytosis was blocked
60% to 70% by monocyte pretreatment with monoclonal anti-CD36 antibodies but not by antibodies to v 3,
thrombospondin, intercellular adhesion molecule-1, or
platelet/endothelial cell adhesion molecule-1. Antibody-induced CD36
cross-linking did result in the early increase of surface CD11b
expression, but there was no increase in, or priming for, tumor
necrosis factor (TNF)- secretion following either CD36 cross-linking
or PE phagocytosis. CD36 clustering does support intracellular
signaling: Antibody-induced cross-linking initiated intracellular
tyrosine phosphorylation as well as extracellular signal-regulated
kinase (ERK) and p38 mitogen-activated protein kinase (MAPK)
phosphorylation. Both broad-spectrum tyrosine kinase inhibition
(genistein) and selective ERK and p38 MAPK inhibition (PD98059 and SB203580, respectively) reduced PE uptake to almost the
same extent as CD36 blockade. Thus, CD36-dependent binding and
signaling appears to be crucial for the nonopsonic clearance of PEs and
does not appear to contribute to the increase in TNF- that is
prognostic of poor outcome in clinical malaria.

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