The time course of cytoadhesion, immunoglobulin binding, rosette formation, and serum-induced agglutination of Plasmodium falciparum-infected erythrocytes.

We describe morphologic characteristics of acridine orange-stained Plasmodium falciparum-infected erythrocytes and the sequential expression of several adhesion phenomena. In particular, we have studied when the adhesive and antigenic modifications appear on the infected erythrocyte surface that mediate binding to C32 melanoma cells (cytoadherence) or to erythrocytes (rosette formation) during a complete 48-hr life cycle of the parasite. The C32 melanoma cell binding started at about 12 hr and was seen during the whole life cycle with a peak around 28 hr (650 infected erythrocytes/100 C32 melanoma cells). Rosettes started to appear and immunoglobulin was found bound to the parasitized red blood cell (PRBC) somewhat later (16-20 hr). These adhesive events culminated at the mid-trophozoite/schizont stage (24-36 hr) with rosette formation and an immunoglobulin binding rate of about 50%, which decreased to about half of the peak values at the end of the life cycle. Serum-induced agglutination of the infected erythrocytes was also most extensive at 24-36 hr, but agglutination was seen with all late stage parasites, i.e., both trophozoites and schizonts at 24-48 hr of age. Taken together, adhesion to C32 melanoma cells starts prior to that of rosette formation, immunoglobulin binding, or serum-induced agglutination.