title: The hydration state of human red blood cells and their susceptibility to invasion by Plasmodium falciparum.
abstract: In most inherited red blood cell (RBC) disorders with high gene frequencies in malaria-endemic regions, the distribution of RBC hydration states is much wider than normal. The relationship between the hydration state of circulating RBCs and protection against severe falciparum malaria remains unexplored. The present investigation was prompted by a casual observation suggesting that falciparum merozoites were unable to invade isotonically dehydrated normal RBCs. We designed an experimental model to induce uniform and stable isotonic volume changes in RBC populations from healthy donors by increasing or decreasing their KCl contents through a reversible K(+) permeabilization pulse. Swollen and mildly dehydrated RBCs were able to sustain Plasmodium falciparum cultures with similar efficiency to untreated RBCs. However, parasite invasion and growth were progressively reduced in dehydrated RBCs. In a parallel study, P falciparum invasion was investigated in density-fractionated RBCs from healthy subjects and from individuals with inherited RBC abnormalities affecting primarily hemoglobin (Hb) or the RBC membrane (thalassemias, hereditary ovalocytosis, xerocytosis, Hb CC, and Hb CS). Invasion was invariably reduced in the dense cell fractions in all conditions. These results suggest that the presence of dense RBCs is a protective factor, additional to any other protection mechanism prevailing in each of the different pathologies.
authors.affiliation: Physiological Laboratory, University of Cambridge, Cambridge, United Kingdom. jtt1000@cam.ac.uk
authors.forename: Teresa
authors.initials: T
authors.lastname: Tiffert
authors.forename: Virgilio L
authors.initials: VL
authors.lastname: Lew
authors.forename: Hagai
authors.initials: H
authors.lastname: Ginsburg
authors.forename: Miriam
authors.initials: M
authors.lastname: Krugliak
authors.forename: Laure
authors.initials: L
authors.lastname: Croisille
authors.forename: Narla
authors.initials: N
authors.lastname: Mohandas
mesh_terms: D000818:Animals; D000953:Antigens, Protozoan / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D047388:Casein Kinases / Q000378:metabolism; D003599:Cytoskeleton / Q000378:metabolism; D004910:Erythrocyte Membrane / Q000378:metabolism / Q000469:parasitology*; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism / Q000469:parasitology*; D005685:Galactans / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D019271:Hypoxanthine / Q000737:chemistry; D016014:Linear Models; D046911:Macromolecular Substances; D009154:Mutation; D009995:Osmosis; D010963:Plasmodium falciparum / Q000378:metabolism*; D011188:Potassium / Q000737:chemistry; D013997:Time Factors; D014867:Water / Q000378:metabolism
chemical_list: D000953:Antigens, Protozoan; D005685:Galactans; D006454:Hemoglobins; D046911:Macromolecular Substances; D014867:Water; D019271:Hypoxanthine; D047388:Casein Kinases; D011188:Potassium; C005653:arabinogalactan; D002118:Calcium
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