The role of hemoglobins C, S, and Nbalt in the inhibition of malaria parasite development in vitro.

The host cell competence of hemoglobin C (HbC)-containing erythrocytes for Plasmodium falciparum was studied by in vitro culture. HbC homozygous red cells did not support the growth of the intracellular parasite. Heterozygous cells, however, were competent. In addition, HbC increased the resistance of sicle cell hemoglobin (HbS) red cells when present in the double heterozygote, SC, cultured at low oxygen tension. This effect most likely resulted from the ability of HbC to enhance the sickling of HbS-containing red cells. Oxygenated SC cells were indistinguishable from normal and AS cells in host cell competence. Another double heterozygote, SNBalt, showed decreased sickling and decreased resistance to malaria parasite growth. The evolutionary significance of these results is discussed.