Probing the cytoadherence of malaria infected red blood cells under flow

PLoS One. 2013 May 28;8(5):e64763. doi: 10.1371/journal.pone.0064763. Print 2013.


Malaria is one of the most widespread and deadly human parasitic diseases caused by the Plasmodium (P.) species with the P. falciparum being the most deadly. The parasites are capable of invading red blood cells (RBCs) during infection. At the late stage of parasites' development, the parasites export proteins to the infected RBCs (iRBC) membrane and bind to receptors of surface proteins on the endothelial cells that line microvasculature walls. Resulting adhesion of iRBCs to microvasculature is one of the main sources of most complications during malaria infection. Therefore, it is important to develop a versatile and simple experimental method to quantitatively investigate iRBCs cytoadhesion and binding kinetics. Here, we developed an advanced flow based adhesion assay to demonstrate that iRBC's adhesion to endothelial CD36 receptor protein coated channels is a bistable process possessing a hysteresis loop. This finding confirms a recently developed model of cell adhesion which we used to fit our experimental data. We measured the contact area of iRBC under shear flow at different stages of infection using Total Internal Reflection Fluorescence (TIRF), and also adhesion receptor and ligand binding kinetics using Atomic Force Microscopy (AFM). With these parameters, we reproduced in our model the experimentally observed changes in adhesion properties of iRBCs accompanying parasite maturation and investigated the main mechanisms responsible for these changes, which are the contact area during the shear flow as well as the rupture area size.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • CD36 Antigens / metabolism
  • Cell Adhesion
  • Erythrocytes / parasitology*
  • Erythrocytes / pathology*
  • Fluorescence
  • Hemorheology*
  • Humans
  • Kinetics
  • Malaria, Falciparum / parasitology
  • Malaria, Falciparum / pathology*
  • Microfluidics
  • Models, Biological
  • Plasmodium falciparum / physiology*
  • Protein Binding
  • Protozoan Proteins / metabolism
  • Temperature


  • CD36 Antigens
  • Protozoan Proteins

Grant support

This work was supported by Singapore-MIT alliance for Research and Technology (SMART) Center and the Global Enterprise for Micro-Mechanics and Molecular Medicine (GEM4) fund. X. Xu was supported by SMART fellowship J. Cao is also supported by DOD-ARO (W 911 NF-09-0480) and NSF (Grant No.1112825). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.