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Infection and Immunity, February 2002, p. 655-660, Vol. 70, No. 2
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.70.2.655-660.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Department of Parasitology, Biomedical Primate Research Centre, 2280 GH Rijswijk, The Netherlands,1 Departments of Infectious Diseases and Reproductive Biology, Institute of Primate Research, National Museums of Kenya, Karen, Nairobi, Kenya2
Received 26 July 2001/ Returned for modification 19 September 2001/ Accepted 31 October 2001
| ABSTRACT |
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| INTRODUCTION |
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Four species of Plasmodium are natural to humans (9), and two of them, Plasmodium falciparum and Plasmodium vivax, are the most prevalent and important in terms of disease. Phylogenetically, P. falciparum, the more deadly form of the two, forms a separate clade with Plasmodium reichenowi, which causes chimpanzee malaria, and P. vivax clusters with simian malarias (11). The nonhuman primate malaria, caused by Plasmodium knowlesi, a natural parasite of Macaca fascicularis, has a relatively broad host range extending to humans, where it causes a mild disease (8). The parasite is closely related to P. vivax (11), and many genes identified in P. vivax have homologues in P. knowlesi. To date, transfection techniques developed for malaria parasite blood stages (26) include episomal transfection and targeted integration with linear constructs for the rodent parasite Plasmodium berghei (24, 25), episomal transfection and targeted integration with circular DNA for the human parasite P. falciparum (28, 29), and episomal transfection for the nonhuman primate malaria parasites P. knowlesi (23) and Plasmodium cynomolgi (16). Targeted integration experiments in P. falciparum, exploiting the results from the genome project (4, 12), are time-consuming, requiring several cycles of drug pressure to select for integration events based on a single crossover (28). In addition, this system offers only restricted in vivo possibilities in scarce New World primate sytems. The P. berghei system offers a rapid targeted integration regime through double crossover (24). It has, however, only limited in vitro possibilities for blood-stage parasites due to reticulocyte restriction, precluding in vitro transfection and selection procedures and thus, for example, the use of selectable markers that are toxic to the host.
P. knowlesi offers an especially powerful experimental system, since both the natural host, M. fascicularis, and an experimental host, Macaca mulatta, are phylogenetically close to humans. Genetic manipulation of this parasite species (23) offers the unique possibility to study parasite-host interactions in a system that is highly predictive for the human situation (14, 15). A complete in vitro transfection and selection system for this parasite would greatly enhance the experimental possibilities, since some analyses could be carried out without any requirement for primates. Furthermore, where host-parasite interactions are being studied, in vitro selection of the cloned parasite of the correct genotype can be assured before primate use is required. Publications on in vitro cultivation of P. knowlesi blood-stage parasites are scarce, and the reported technology is cumbersome (5, 22, 27). Culture medium was refreshed at least twice daily (5), red blood cells were added five times per week leading to up to 40% erythrocyte concentrations, and multiplication rates of <2.5 per 24-h lifecycle were reported (5, 27). These labor-intensive culture conditions do not allow the generation of enough parasites of good quality to perform transfection experiments.
We set out to develop a complete in vitro system for P. knowlesi to allow long-term in vitro culture and an extremely rapid procedure for in vitro transfection, selection, and cloning of transfected parasites. In addition, we further developed the in vivo and in vitro transfection technology for P. knowlesi to include targeted integration with linear constructs. This was demonstrated by targeting the circumsporozoite protein (CSP) locus and phenotypical analysis of the CSP knockout. The P. knowlesi system now is the only malaria system that combines rapid genetic manipulation procedures with complete in vitro as well as in vivo possibilities, allowing full analysis of genotype-phenotype and parasite-host relationships in a host closely related to humans.
| MATERIALS AND METHODS |
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Adult rhesus monkeys (M. mulatta) of either sex, each weighing over 4 kg, were used in these studies. They were infected with cryopreserved stocks of P. knowlesi, in vitro-adapted blood-stage P. knowlesi parasites, or blood from another rhesus monkey. All experimental animal work in these studies was carried out under protocols approved by the independent Institutional Animal Care and Use Committee and performed according to Dutch and European laws.
Long-term in vitro culture of P. knowlesi. In vitro cultures were initiated with either cryopreserved or fresh P. knowlesi parasites isolated from an infected rhesus monkey. Rhesus red blood cells were used to culture P. knowlesi. White blood cells were removed by Plasmodipur filtration (Eurodiagnostica, Apeldoorn, The Netherlands), and red cells were stored for up to 2 weeks in RPMI at 4°C. Parasites were grown in static cultures at 36.5°C under reduced oxygen conditions (5% CO2, 5% O2, 90% N2) in RPMI 1640, supplemented with 20% pooled, heat-inactivated rhesus serum and rhesus erythrocytes at a 2.5% hematocrit. During the adaptation period medium was changed every 24 h, and fresh erythrocytes were added every 4 days to a maximum hematocrit of 5%. Once they had been established in culture, parasites were maintained under the same conditions except for medium changes every 48 h and subculturing when parasitemias exceeded 5%. Parasitemia was determined by microscopic examination of Giemsa-stained thick and thin films prepared from the cultured material at regular intervals. The culture-adapted parasites were subsequently adapted to growth in RPMI 1640 supplemented with 20% pooled, heat-inactivated human A or AB serum, by using a similar strategy. Parasites were cryopreserved at the young ring stage of development by standard protocols (19). Cloning of culture adapted P. knowlesi was performed by limiting dilution.
Transfection constructs. All transfection constructs contained a heterologous selection cassette based on mutagenized Toxoplasma gondii dihydrofolate reductase/thymidine synthase gene (dhfr/ts) conferring pyrimethamine resistance, flanked by P. berghei dhfr/ts flanking sequences (17).
Sequences for P. knowlesi CSP locus were retreived from GenBank entries (accession numbers K00822 and M19749). To prepare a CSP knockout construct, 5' and 3' regions from CSP were amplified by PCR. These regions were as follows: 5' nucleotides (nt) -1495 to -560 and 3' nt 1 to 1089 (for numbering, nt 1 is the start of open reading frame [ORF]). Through a series of cloning steps plasmid pDB.DTm.DB/CSPko was derived (Fig. 1A). After purification on Plasmid Maxi columns (Qiagen), the vector backbone was excised from the construct by EcoRI digestion, and the linear DNA was used for transfection of P. knowlesi. Recombinant DNA manipulations and analyses were performed according to standard procedures (20).
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resistance (the time constant ranged from 0.7 to 1.1 ms). Samples electroporated under the same conditions were pooled, incubated on ice for 5 min, and used to initiate 20-ml in vitro cultures at a 10% hematocrit. Culture medium was refreshed daily for 3 days to remove parasite material resulting from dead parasites and lysed erythrocytes. After that, the medium was replenished every other day. Pyrimethamine selection (25 ng/ml [final concentration] from a stock solution in 0.5% lactic acid in phosphate-buffered saline) was started 24 h after culture inoculation and maintained throughout the culture period. DNA analysis. Total parasite DNA was isolated (Gentra Systems, Inc., Minneapolis, Minn.) directly from in vitro cultures or after Plasmodipur filtration of P. knowlesi-infected rhesus monkey blood according to the manufacturers instructions. Parasite DNA was analyzed through plasmid rescue by electroporation into E. coli, PCR, and Southern blotting according to standard procedures (20). The PCR primers used for confirming integration into the CSP locus were A (5'-GTGTCTATATTACCAACTC-3') and B (5'-GTCAAAAAAGGGTCAGTCAAAAAGGG-3') (Fig. 1A).
Transmission studies. Rhesus monkeys were infected as described above, and Anopheles stephensi mosquitoes were allowed to feed for 10 min on the shaven chests of sedated monkeys 6 to 8 days after infection, when the parasitemia was between 0.5 and 3%. Unfed mosquitoes were removed, and engorged mosquitoes were maintained at 26°C and 80% relative humidity. From day 6 onward, midguts were dissected and examined by light microscopy (400x magnification) to monitor oocyst development and sporozoite formation within oocysts.
| RESULTS |
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Transfected P. knowlesi can be readily selected in vitro.
By using previously determined transfection conditions (23), P. knowlesi schizonts, derived either from an infected rhesus monkey or from an in vitro culture, were transfected with plasmids containing the T. gondii dhfr/ts selection cassette. After transfection, parasites were maintained in 20-ml cultures, and pyrimethamine selection was applied from day 1 onward. The only transfection condition that consistently resulted in selection of transfected parasites was at 2.5 kV, 200
, and 25 µF. Pyrimethamine-resistant parasites emerged in culture after 21 days for parasites derived from the monkey and after 8 days for in vitro-adapted parasites. Plasmid rescue from the resistant pools of parasites demonstrated the presence of plasmid DNA in an unrearranged form (not shown).
Targeted integration through double crossover can be obtained in vivo as well as entirely in vitro. Previously, we reported transfection of P. knowlesi with plasmids that were maintained as episomes (23). To determine whether targeted integration in this system is feasible with linear constructs, as has been reported for P. berghei (24), an integration construct for the P. knowlesi CSP locus was prepared. The construct had 0.93 kb of P. knowlesi CSP 5'-untranslated region (UTR) sequence located 5' of the selection cassette and 1.0 kb of P. knowlesi CSP ORF sequence located 3' of the selection cassette (Fig. 1A). Parasites derived from a rhesus monkey were transfected with linearized constructs and selected in vivo as described above. In parallel, the CSP knockout construct was used to transfect in vitro cultured schizonts, and selection was performed in vitro. As with the episomal transfections, 2.5 kV consistently resulted in selection of pyrimethamine-resistant parasites. In vivo and in vitro, pyrimethamine-resistant parasites were detected on day 8. Plasmid rescue experiments from these parasites consistently failed to produce ampicillin-resistant E. coli, suggesting the absense of (recircularized) episomes within the transfected parasite populations. Cloning by limiting dilution of in vitro-selected transfectants was started on day 8, and clones were observed in thin films by day 18. Multiplication rates for these transfected parasites were about four times per 24 h in vivo and about three times per 24 h in vitro. PCR on in vitro-selected and cloned PkCSPko genomic DNA with primers A and B (Fig. 1 A) (amplifying a 1.7-kb P. berghei dhfr/ts 5'-UTR-CSP ORF region only present when targeted integration has occurred) showed integration into the CSP locus (Fig. 1B, lanes 1 to 3). This was also confirmed by Southern blotting with a 0.89-kb HindIII fragment (Fig. 1A) of the CSP ORF as a probe. As shown in Fig. 1C, lanes 1 to 3, the 10-kb wild-type PstI fragment from the CSP locus (lane 2) is converted to a 2.5-kb fragment in PkCSPko (lane 3) due to the introduction of PstI sites contained in the transfection construct.
CSP knockout P. knowlesi does not produce sporozoites in oocysts. To examine the phenotype of CSP knockout P. knowlesi, rhesus monkeys were infected with either P. knowlesi H strain or the PkCSPko blood-stage parasites. The development of parasitemia in both monkeys was similar, showing a rapid rise to ca. 10% parasitemia on days 8 and 9 postinfection. A. stephensi mosquitoes were allowed to feed on day 8 on the wild-type infected monkey (0.9% parasitemia) and on days 6 and 7 on the PkCSPko-infected monkey (0.5 and 3% parasitemias, respectively). Fed mosquitoes were isolated and kept at 26°C to allow oocyst and sporozoite development. From day 6 postfeeding onward, mosquitoes were dissected and midguts were examined for the presence of oocysts and sporozoites. Day 7 feeding of the PkCSPko resulted in the highest transmission rates (100%), with ca. 50 oocysts per midgut. The wild-type feeding resulted in 83% infection and ca. 26 oocysts per midgut. Wild-type oocysts produced sporozoites in the hemocoel from day 8 postfeeding onward, as determined by lightmicroscopic examination of midguts (Fig. 3A and C). Spontaneously ruptured oocysts showed release of sporozoites, and rupture by applying gentle force to the coverslip also released sporozoites from the oocysts. As expected, due to rupture and release of sporozoites, the number of oocysts dramatically declined from days 8 to 11 postfeeding. Salivary gland sporozoites were not detected, since P. knowlesi sporozoites are not able to invade the salivary glands of A. stephensi (10). In contrast, in the PkCSPko oocysts no sporozoites developed, and this remained so until the experiment was stopped at a point when the great majority of the wild-type oocysts had matured and ruptured (Fig. 3B and D). The number of oocysts did not decline from days 8 to 12 as observed with wild-type oocysts. PkCSPko oocyst development otherwise appeared to be similar to that of wild-type oocysts, as observed by light microscopy (Fig. 3A and B), resulting in similar-sized oocysts at day 11.
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| DISCUSSION |
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We have now further improved and extended the P. knowlesi system in several ways to provide more widely available access to genetic manipulation of this parasite species. First, two P. knowlesi strains, Nuri and H, were adapted to long-term in vitro growth by using simple protocols. This is important since it obviates the need for primates as parasite donors to provide parasites for genetic manipulation. Second, by using protocols developed for in vivo selection of transfected parasites, transfected parasites were selected in vitro based on the T. gondii dhfr/ts gene providing resistance to pyrimethamine. This also obviates the need for primates as transfected parasite recipients during the initial selection for transfectants and allows development of new selectable markers, including those that would otherwise be toxic to the host, exploiting the benefits of complete in vitro selection.
Third, to determine whether gene targeting through double crossover was possible in P. knowlesi or whether the lengthy P. falciparum procedures needed to be adopted, transfection experiments with linear DNA constructs designed to target the CSP locus were performed. These experiments, performed in vivo as well as in vitro, showed that targeted integration could be obtained with linear constructs and entirely in vitro. Recently, by using similarly designed constructs, the P. knowlesi thrombospondin-related adhesive protein gene was also efficiently disrupted (H. Ozwara et al., unpublished results). The in vitro procedure allows for deriving cloned parasites within 18 days of transfection, demonstrating the relative speed of this procedure compared to in vitro P. falciparum procedures, and allowing high-throughput analysis of gene functions.
Recently, the P. knowlesi genome sequence to a threefold coverage has become available (http://www.sanger.ac.uk/Projects/P_knowlesi/). This greatly expands the possibilities for transfection studies since homologues from P. falciparum genes and from genes available from the expanding P. vivax gene sequence tag database (http://www.ncbi.nlm.nih.gov/Malaria/plasmodiumblcus.html) can now easily be identified in P. knowlesi.
Finally, we have shown that parasites that have been growing in vitro for a long period of time can readily readapt to in vivo growth, displaying wild-type H-strain growth characteristics after a single passage through an intact rhesus monkey. This observation is extremely important since in vitro-selected transfected parasites will be vital tools for studying host-parasite interactions. In vitro culture might lead to alteration of expression of SICAvar genes (1, 2, 3) and thus to loss of avoiding splenic clearence by sequestration, which can influence infectivity in nonsplenectomized rhesus monkeys. One passage through an intact rhesus is apparently sufficient to select for parasites that are readily able to infect rhesus monkeys and that can still be cultured in vitro.
In this study in a nonhuman primate malaria of the P. vivax type, we confirmed the earlier observations in a rodent malaria of the essential nature of CSP in sporozoite development (18). In P. knowlesi CSP is also critical for sporozoite formation in developing oocysts in mosquito midguts, and the lack of CSP expression results in absence of sporozoite formation. Unlike the situation in P. berghei, oocysts of the CSP knockout have similar morphology to wild-type oocysts, and the phenotype only becomes clear at the time of sporozoite release. This difference is mainly due to the fact that in P. knowlesi H-strain oocysts sporozoites are not visible "like rays from the sun" as described for P. berghei (18), and thus both wild-type and CSP knockout oocysts show an undefined morphology.
The P. knowlesi system now provides a unique malaria transfection system that allows for fast and simple in vitro genetic manipulations and combines this with the opportunity to perform in vivo studies in a nonhuman primate that is closely related to humans. It is the only malaria system described to date that is amenable to genetic manipulation that combines complete in vitro possibilities with studies in vivo in an animal model that is closely related to humans. This fact makes P. knowlesi highly suitable for the development of new antimalarial drugs and vaccines, as well as for studying basic biological questions in the postgenomic era at the parasite-host interface.
| ACKNOWLEDGMENTS |
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We thank John Barnwell for providing P. knowlesi H strain parasites and stimulating discussions and Wijnand Eling for provision of mosquitoes. We also thank Xander van der Linde, Geert-Jan van Gemert, and Willem Collignon for excellent technical assistance and members of the Animal Science Department of the BPRC for expert animal care.
This work was supported by EC DG XII contracts CT 97-9104 and CT99-10004, by ALW (805-33.332P and 809.35.004) of The Netherlands Organization for Scientific Research, and by PAD (9802.076.0) of the Dutch Health Research and Development Council. H.O. was funded in part by The Netherlands Foundation for the Advancement of Tropical Research (WOTRO).
| FOOTNOTES |
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