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Blood, 15 May 2001, Vol. 97, No. 10, pp. 3268-3274
RED CELLS
Modifications in the CD36 binding domain of the Plasmodium
falciparum variant antigen are responsible for the inability
of chondroitin sulfate A adherent parasites to bind CD36
Benoit Gamain,
Joseph D. Smith,
Louis H. Miller, and
Dror I. Baruch
From the Laboratory of Parasitic Diseases, National
Institute of Allergy and Infectious Diseases, National Institutes of
Health, Bethesda, MD; and the Department of Pathology, Colorado State
University, Fort Collins, CO.
Adhesion of mature Plasmodium falciparum parasitized
erythrocytes to microvascular endothelial cells or to placenta
contributes directly to the virulence and severe pathology of P
falciparum malaria. Whereas CD36 is the major endothelial
receptor for microvasculature sequestration, infected erythrocytes
adhering in the placenta bind chondroitin sulfate A (CSA) but not CD36.
Binding to both receptors is mediated by different members of the large
and diverse protein family P falciparum erythrocyte
membrane protein-1 (PfEMP-1) and involves different regions of the
molecule. The PfEMP-1-binding domain for CD36 resides in the
cysteine-rich interdomain region 1 (CIDR-1). To explore why CSA-binding
parasites do not bind CD36, CIDR-1 domains from CD36- or CSA-binding
parasites were expressed in mammalian cells and tested for adhesion.
Although CIDR-1 domains from CD36-adherent strains strongly bound CD36,
those from CSA-adherent parasites did not. The CIDR-1 domain has also
been reported to bind CSA. However, none of the CIDR-1 domains tested
bound CSA. Chimeric proteins between CIDR-1 domains that bind or do not
bind CD36 and mutagenesis experiments revealed that modifications in the minimal CD36-binding region (M2 region) are responsible for the
inability of CSA-selected parasites to bind CD36. One of these modifications, mapped to a 3-amino acid substitution in the M2 region,
ablated binding in one variant and largely reduced binding of another.
These findings provide a molecular explanation for the inability of
placental sequestered parasites to bind CD36 and provide additional
insight into critical residues for the CIDR-1/CD36 interaction.

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