Plasmodium falciparum is the most deadly human malaria parasite, causing more than 800,000 deaths per year. After the parasite enters the blood stream, it travels to the liver, where it serially invades liver cells (hepatocytes), until it settles down to form a parasitophorous vacuole (PV). Once ensconced in its PV, the parasite undergoes a process known as liver stage (LS) development during which it spawns tens of thousands of new parasites. In this issue of the JCI, Vaughan et al. report on a human liver-chimeric mouse that replicates P. falciparum LS development in humans. The frames above depict P. falciparum at home in the liver.
Plasmodium falciparum, which causes the most lethal form of human malaria, replicates in the host liver during the initial stage of infection. However, in vivo malaria liver-stage (LS) studies in humans are virtually impossible, and in vitro models of LS development do not reconstitute relevant parasite growth conditions. To overcome these obstacles, we have adopted a robust mouse model for the study of P. falciparum LS in vivo: the immunocompromised and fumarylacetoacetate hydrolase–deficient mouse (Fah–/–, Rag2–/–, Il2rg–/–, termed the FRG mouse) engrafted with human hepatocytes (FRG huHep). FRG huHep mice supported vigorous, quantifiable P. falciparum LS development that culminated in complete maturation of LS at approximately 7 days after infection, providing a relevant model for LS development in humans. The infections allowed observations of previously unknown expression of proteins in LS, including P. falciparum translocon of exported proteins 150 (PTEX150) and exported protein-2 (EXP-2), components of a known parasite protein export machinery. LS schizonts exhibited exoerythrocytic merozoite formation and merosome release. Furthermore, FRG mice backcrossed to the NOD background and repopulated with huHeps and human red blood cells supported reproducible transition from LS infection to blood-stage infection. Thus, these mice constitute reliable models to study human LS directly in vivo and demonstrate utility for studies of LS–to–blood-stage transition of a human malaria parasite.
Ashley M. Vaughan, Sebastian A. Mikolajczak, Elizabeth M. Wilson, Markus Grompe, Alexis Kaushansky, Nelly Camargo, John Bial, Alexander Ploss, Stefan H.I. Kappe