Perturbation of the pump-leak balance for Na(+) and K(+) in malaria-infected erythrocytes

In humanerythrocytes infected with the mature form of the malaria parasitePlasmodium falciparum, the cytosolic concentration ofNa⁺ is increased and that of K⁺ is decreased.In this study, the membrane transport changes underlying thisperturbation were investigated using a combination of⁸⁶Rb⁺, ⁴³K⁺, and²²Na⁺ flux measurements and a semiquantitativehemolysis technique. From >15 h postinvasion, there appeared in theinfected erythrocyte membrane new permeation pathways (NPP) that causeda significant increase in the basal ion permeability of theerythrocyte membrane and that were inhibited by furosemide (0.1 mM). The NPP showed the selectivity sequenceCs⁺ > Rb⁺ > K⁺ > Na⁺, with the K⁺-to-Na⁺permeability ratio estimated as 2.3. From 18 to 36 h postinvasion, the activity of the erythrocyte Na⁺/K⁺ pumpincreased in response to increased cytosolic Na⁺ (aconsequence of the increased leakage of Na⁺ via the NPP)but underwent a progressive decrease in the latter 12 h of theparasite's occupancy of the erythrocyte (36-48 h postinvasion). Incorporation of the measured ion transport rates into a mathematical model of the human erythrocyte indicates that the induction of the NPP,together with the impairment of the Na⁺/K⁺pump, accounts for the altered Na⁺ and K⁺levels in the host cell cytosol, as well as predicting an initial decrease, followed by a lytic increase in the volume of the host erythrocyte.