Host-mediated impairment of parasite maturation during blood-stage Plasmodium infection

Significance Adaptive immunity to Plasmodium falciparum takes years to develop in endemic regions, leaving young children vulnerable to high parasite burdens and severe malaria. Host innate immune responses clearly occur during infection and may control parasite numbers in nonimmune individuals, for example by accelerating parasite removal from circulation. However, evidence of whether and how this occurs in vivo remains sparse. We set out to measure host removal of parasites during acute blood-stage Plasmodium infection in mice. However, rather than being removed more rapidly, parasites unexpectedly persisted in circulation. Persistence resulted from host-dependent slowing of parasite maturation. Thus Plasmodium maturation within red blood cells does not occur at a constant rate in vivo and can be influenced by the host itself.