Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5): 519-541, Sep./Oct. 1996 519 The Biology of Malarial Parasite in the Mosquito - A Review Amauri Braga Simonetti

Departamento de Microbiologia, Instituto de Biociência Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170 Porto Alegre, RS, Brasil The purpose of this review is to summarize the biology of in the mosquito including recent data to contribute to better understanding of the developmental interaction between mosquito and malarial parasite. The entire sporogonic cycle is discussed taking into consideration different para- site/vector interactions and factors affecting parasite development to the mosquito.

Key words: malaria - mosquito - sporogonic cycle - cell biology

The control and prevention of malaria has been et al. 1996). This review foccuses on the cell biol- pursued for a long time. Although campaigns ogy of malarial parasites at different stages of its against malaria were initially successful in some development in the mosquito and also includes areas, the emergence of resistance of the parasite factors that may affect the parasite infectivity. to drugs and of the mosquito vector to insecticides, The sporogonic cycle combined with the difficulties in implementing and Some erythrocytic parasites differentiate into maintaining effective control schemes have led to sexual forms called gametocytes. Mature and func- a resurgence of the disease in many parts of the tional gametocytes ingested by an appropriate spe- world (Wernsdorfer 1991, Schapira et al. 1993, cies of mosquito in a bloodmeal are stimulated to Roush 1993). Much of the current work on ma- transform into the stages which establish the para- laria focuses on immunological aspects of the dis- sites in their vector (Garnham 1966). Under the in- ease and there has been remarkable progress in the fluence of changes in the mosquito midgut environ- identification of a variety of parasite antigens in ment the gametocytes become extracellular within different stages of the parasite development, some 8-15 min of ingestion. After emergence from the of which may be included in a future vaccine red blood cell (exflagellation) the male gametes fer- (Nussenzweig & Nussenzweig 1989, Mitchel 1989, tilize the female gametes within 60 min of ingestion Targett 1989, Nussenzweig 1990, Hommel 1991, of blood. The fertilized macrogamete (zygote) dif- Good 1991a). However, experimental and field ferentiates into a single motile ookinete over the next studies have shown the complexity of the immune 10-25 hr, which migrates from the bloodmeal response to parasites, indicating that an efficient through the midgut wall to form an oocyst under- malaria vaccine is difficult to achieve (Cattani neath the basal lamina of the midgut. Each oocyst 1989, Good 1991b, 1992, Philips 1992). There- produces many thousands of invasive sporozoites fore, for control of the disease greater understand- over a period of 7-12 days. The sporozoites escape ing of the biological mechanisms involved in host/ from the oocyst and then invade the salivary glands, parasite/vector interactions is essential. here they stay for possibly very long periods until In recent years an increasing number of stud- injected into another vertebrate host when the next ies have concentrated on the mosquito stages of bloodmeal is taken (Sinden 1984, Carter & Graves the parasite development. Comprehensive reviews 1988). A diagram of the sporogonic cycle in the on biological, ultrastructural, biochemical, molecu- mosquito is shown in Figure. lar and immunological aspects of the parasite and the vector can be obtained in the literature (Sinden Development of gametocytes (gametocytogen- 1978, 1983, 1984, Carter & Graves 1988, Carter esis) et al. 1988, Alano & Carter 1990, Billingsley 1990, As with other members of the order Crampton et al. 1990, 1994, Alano 1991, Brey Haemosporina, gametocytes of Plasmodium can 1991, Coluzzi 1992, Kaslow et al. 1994a, Sinden arise from merozoites from pre-erythrocytic para- sites. Nevertheless, during natural infections, most gametocytes arise from merozoites of blood-stage origin (Alano & Carter 1990). Two alternative possibilities by which malaria parasites could be- Fax: 55-51-3362779. E.mail: [email protected] come committed to either sexual or asexual devel- Received 20 December 1995 opment have been proposed (Inselburg 1983, Mons Accepted 13 May 1996 1985, 1986, Bruce et al. 1990): first, the merozoite 520 Biology of Malarial Parasites in Mosquito • AB Simonetti

EXOERYTHROCYTIC CYCLE ERYTHROCYTIC IN LIVER CYCLE IN BLOOD

Penetrates red cell

Merozoites

red cells

reinvade

Schizont

Merozoites

Sporozoites Macro- Micro- penetrates gametocyte gametocyte liver cell IN MAN

Gametocytes taken Sporozoites injected into mosquito IN MOSQUITO into man with saliva stomach with (ANOPHELES) of mosquito bloo meal

Sporozoites in Microgametes salivary gland FERTILISATION GAMETOGENESIS

Ookinete

Ookinete penetrates midgut wall of mosquito to develop into oocyst

SPOROGONY

Oocyst ruptures to liberate sporozoites which penetrate salivary gland

Life cycle of the malaria parasite in mammals (from Vickerman & Cox 1972). is not committed at the time of invasion of a red ronmental factors influence it so that at maturity blood cell. During early growth (as a ring form), the schizont produces merozoites that are the parasite is suceptible to factors that will com- precommitted to form asexual parasites or com- mit it to either sexual or asexual development. Sec- mitted to form gametocytes upon subsequent in- ond, during growth of an asexual parasite, envi- vasion of a red blood cell. Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 521

A number of studies have attempted to iden- showed in vitro that induction of exflagellation of tify factors that may influence the differentiation P. berghei is triggered by a rise in the intracellular ++ and production of sexual stage parasites including pH (pHi) which is mediated by Ca and cGMP cAMP, presence of antimalarial drugs and other regulation. pHi can be modulated by alkaline me- environmental factors associated to the host such dia and is controlled by a complex series of inter- as the presence of serum undetermined components dependent ion pumps and channels controlling Na+, + - - (reviewed by Sinden 1983, Mons 1986, Carter & K , Cl and HCO3 transport between the parasite Graves 1988, Dearsly et al. 1990). In a recent re- and the environment. Other influential factors de- port (Schneweis et al. 1991) it was claimed that scribed include cAMP analogues and inhibitors of the production of infective gametocytes in vitro phosphodiesterase (Martin et al. 1978). The dura- can be enhanced by products of haemolysis but tion of microgametogenesis is both temperature and the nature of the erythrocytic factor was not iden- species dependent, e.g. at 20-22°C it may take 7- tified. 15 min for P. falciparum in vitro, although Gametocyte development takes longer than exflagellation may be detected after shorter peri- asexual schizogony, e.g. 26 hr as opposed to 22.5 ods in the fluid excreted by feeding Anopheles hr in P. berghei (Mons et al. 1985) or in the more (Sinden 1983). There is no evidence that extreme case of P. falciparum 8-12 days as op- exflagellation is influenced by factors released by posed to 48 hr (Sinden 1983). The proportion of digestion of the blood meal since digestion nor- parasites that develop into gametocytes varies mally begins several hours later (Graf et al. 1986). greatly during the course of natural infections even Microgamete formation involves three mitotic di- at its peak but is very low in relation to the total visions with a rapid assembly of eight axonemes parasitaemia (Smalley et al. 1981). The growth and on the single microtubule organizing centre that differentiation of gametocytes of P. falciparum has divides and passes to the spindle poles. This divi- been divided into five stages (I to V) covering about sion simultaneously segregates the genome and the eight days from merozoite invasion to mature ga- axoneme so that each of the eight emergent ga- metocyte, each stage being distinguished by suc- metes receives a single axoneme and haploid ge- cessive changes in the organization of the cell nome, both being connected to a common micro- (Hawking et al. 1971). tubule organizing centre. After exflagellation the Little is known about commitment of gameto- microgametes, normally bearing a single axoneme, cytes to be male or female. The fact that both fe- a single condensed nucleus and a single kineto- male and male can be produced by haploid blood- some with its sphere and granule at the distal end, stage parasite, the of a gametocyte does not are torn from the microgametocyte surface and result from chromosomal differences between both rapidly move away into the blood meal (Sinden & types of cell but their development must be due to Croll 1975). selective gene expression. In general, the number Macrogametogenesis at the morphological of female gametocytes predominates over the num- level involves little more than escape from the host ber of male, but this predominance may vary at cell (Sinden 1984). At the cellular level there is de different times between cloned infections novo synthesis of the proteins which are expressed (Cornelissen 1988, Schall 1989). on the surface of macrogamete (Kumar & Carter 1984). It was recently identified a gametocyte spe- Gametogenesis Mature and functional gametocytes ingested by cific protein of P. falciparum called Pf11-1 and there is some evidence that this protein might be the mosquito in a bloodmeal are stimulated by the involved in the emergence of gametes from the midgut environment to transform into gametes. infected erythrocyte (Scherf et al. 1992, 1993). Studies indicate that various triggers induce game- Interactions between the vertebrate host and the tocytes to undergo differentiation. Microgameto- parasite do not cease when the blood meal is taken. genesis in vitro is, optimally, dependent upon a rise in pH (Nijhout & Carter 1978), a rise in pCO and Following induction of gametogenesis the parasite 2 is liberated into the blood meal. It has been shown bicarbonate levels (Carter & Nijhout 1977, Nijhout that the gametes are susceptible to the phagocytes & Carter 1978), a fall in temperature of a few de- in the host’s blood (Rutledge et al. 1969, Sinden & grees below that of the vertebrate host (Sinden & Smaley 1976) and that they are susceptible to acti- Croll, 1975) or a very potent factor termed mos- vation of the components of the complement path- quito exflagellation factor (MEF). The latter is a small heat stable molecule from the mosquito head way (Grotendorst et al. 1986, 1987). and gut which stimulates gametogenesis via a bi- Zygote formation (fertilization) and ookinete carbonate- and pH-independent mechanism development (Nijhout 1979). Recently, Kawamoto et al. (1991) Fertilization is rapid usually occurring within 522 Biology of Malarial Parasites in Mosquito • AB Simonetti

1 hr of gamete formation, the plasmalemma of the products in infectivity has been studied in differ- two gametes fuse and the microgamete axoneme ent parasite-vector models. Using a selected line and nucleus enter the macrogamete cytoplasm of An. stephensi, Feldmann and Ponnudurai (1989) (Sinden 1983). During zygote development, struc- found mature P. falciparum ookinetes in the mid- tural changes occur and its transformation to gut lumen of refractory mosquitoes but no further ookinete is in part determined by the gradual as- penetration of the gut epithelium was observed. The sembly of the apical complex including the collar reasons for this limited development in non-com- and pollar rings, rhoptries and micronemes (Can- patible mosquitoes could be related to digestive ning & Sinden 1973, Davies 1974, Sinden 1978). function since early initiation of hemoglobin deg- Intensive protein synthesis also begins in the fer- radation and higher aminopeptidase activity have tilized macrogamete and continues in the zygote been described in refractory strains of An. stephensi and developing ookinete as reported for different (Feldmann et al. 1990). It has also been shown that Plasmodium species (Kaushal et al. 1983a, Kaushal P. gallinaceum develops up to the ookinete stage & Carter 1984, Kumar & Carter 1985, Vermeulen in the non-compatible mosquito An. stephensi, this et al. 1985a, 1986, Sinden et al. 1987). Included in development occurring over the same time period this repertoir of proteins are many of the targets of and with the same success as in the compatible proposed transmission blocking immunity. It has vector Ae. aegypti. However, P. gallinaceum been reported that An. gambiae can concentrate ookinetes did not escape from the midgut lumen the bloodmeal by a factor of 1.2 to 1.8 reducing in An. stephensi mosquitoes (Rudin et al. 1991). the production of ookinetes when compared to An. Possible mechanism inhibiting parasite devel- freeborni which can not concentrate (Sinden et al. opment involves damage of the parasite by diges- 1996). The mature ookinete is a motile cell that tive enzymes present in the vector. Trypsin and varies from 7 to 18 mm in length and 2 to 4 mm in aminopeptidases are the major proteolytic enzymes diameter (Sinden, 1978). Locomotion of the involved in blood digestion by female mosquitoes, ookinete has been described in different Plasmo- and are produced by the midgut cells in direct re- dium species as a linear or snake-like gliding mo- sponse to blood feeding (Briegel & Lea 1975, Graf tion (Freyvogel 1966). Studying P. berghei & Briegel 1982, Billingsley 1990, Billingsley & ookinetes in primary mosquito cell cultures, Speer Hecker 1991). P. gallinaceum ookinetes 0-10 hr et al. (1974) described spiral waves on the surface old (i.e. zygote to ookinete transition) were shown of some ookinetes, especially in the anterior half to be susceptible to mosquito enzymes in double of the body, which might be involved in ookinete feeding experiments (Gass 1977) and in vitro dam- locomotion. age was observed to cultured ookinetes by protein- Some factors could influence the development, ases from Ae. aegypti (Gass & Yeates, 1979). How- survival and infectivity of the parasite during its ever, results found by Shahabuddin et al. (1993) residence in the midgut lumen. Eyles (1952) has using the same parasite/vector system suggest that showed that the parasite development ceases at the the parasite secretes an inactive or partially active ookinete stage unless a macromolecular (non-dia- chitinase that is activated by a mosquito-produced lyzable) component is present in the blood meal. serine protease. In a recent study Chege et al. (1996) Studying the influence of red blood cells on the examined the effect of digestive enzymes on the ability of P. gallinaceum zygotes fertilized in vitro kinetics of P. falciparum ookinete development and to infect Aedes aegypti Rosenberg et al. (1984) oocyst infection rates in An. albimanus, An. found a linear relationship between erythrocyte freeborni and An. gambiae. Their data indicated density and the number of oocysts up to a 50% that proteolytic enzymes alone do not limit the early hematocrit. Furthermore, they deduced that there stages of sporogonic development in these vector are one or more nondialyzable substances (eryth- species of Anopheles. rocytic factors) contained in normal erythrocytes, and released by mosquito digestion, that are es- Peritrophic layer sential for ookinete invasion of the gut epithelium. The peritrophic layer (PL) of the insect midgut When they added trypsin inhibitor to the bloodmeal forms a cylindrical sheet separating the midgut there was an inhibition of midgut penetration by contents from the single cell-layered midgut en- ookinetes. Recent studies have shown that when dothelium. It is secreted within hours of the blood mosquitoes are fed with cultured P. falciparum meal at different rates depending on the mosquito (Ponnudurai et al. 1989) and P. berghei (Sinden species (Billingsley 1990). Apical secretion gran- 1989) gametocytes, upon dilution with fresh red ules are present in the midgut cells of Anopheles cells, more oocysts result at initial (low) dilutions species, which are released into the periphery of whereas further dilution reduces oocyst counts. The the posterior midgut lumen during the feeding pro- involvement of blood factors and/or its digestive cess in response to stretching of the gut wall. The Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 523 vesicle contents coalesce and then condense to form nomena play a role in the orientation of the para- a compacted PL between 8 and 24 hr (Hecker 1977, sites on their way out of the midgut lumen and that Berner et al. 1983). In culicine mosquitoes the PL the PM and/or glycocalyx may be crucial struc- is formed de novo by the posterior midgut cells in tures for the penetration of the gut epithelium by the proventriculus. In A. aegypti, formation starts the ookinete. This does not exclude the possibility immediately after the blood meal, but about 12 hr that ookinetes penetrate the PL by an enzymatic later it is a mature structure (Perrone & Spielman, process (see below). Ultrastructural observations 1988). on Ae. aegypti infected with P. gallinaceum show- The role of the mosquito PL as a barrier to ing an electron dense amorphous material in front ookinete invasion of the gut wall and pathogenic of the parasite were consistent with a blockade of effects of Plasmodium species upon the vector are parasites within the PL (Sieber et al. 1991). The controversial. In ultrastructural studies on the in- ookinetes appeared to disrupt the layers of the PL, teraction of P. falciparum ookinetes with the mid- suggesting an enzymatic mechanism for penetra- gut epithelium of An. stephensi Meis & Ponnudurai tion. These observations were further investigated (1987) frequentely found parasites trapped in the by Huber et al. (1991) who, using the same vector/ membrane. They also observed that if the PL was parasite system, also suggested a possible role for dissected out 36 hr after the blood meal many GlcNAc in the binding of the ookinete to the PL, ookinetes were attached to its external surface. In and demonstrated the presence of chitin in the PL. the same study it was mentioned that the ookinete They observed that mature ookinetes transiently was capable of penetrating the newly formed, but secreted a soluble chitinase, thought to be respon- not the thickened and hardened PL 36 hr after the sible for the digestion of the PL. Recently, feeding. A failure to cross this barrier or retarded Shahabuddin et al. (1993) reported an inhibition penetration might increase the length of exposure of P. gallinaceum chitinase and a transmission of ookinetes to mosquito trypsin to which it is blocking activity of a chitinase inhibitor, known to be sensitive. In contrast, using P. berghei- allosamidin, on the sporogonic development of P. infected An. atroparvus mosquitoes, Sluiters et al. gallinaceum and P. falciparum in the respective (1986) concluded that the PL would not function vectors Ae. aegypti and An. freeborni. However, as physical barrier against migrating ookinetes enzymatic mechanisms of penetration may differ which can pass through fenestrations. Billingsley in other vector/parasite systems since the PL of An. and Rudin (1992) observed that infectivity of An. stephensi appears not to contain chitin (Berner et stephensi by P. berghei, measured by oocyst al. 1983). counts, was unnaffected by the presence or absence of the PL. However, in A. aegypti infected with P. Penetration of midgut epithelium gallinaceum its presence serves to reduce rather Ookinetes found in the epithelial cell layer be- than prevent infection (Ponnudurai et al. 1988, tween 24 and 48 hr post-infection have success- Billingsley & Rudin 1992). These observations fully evaded the obstacles presented by the mid- suggested to the authors that in compatible vector- gut lumen; however, they still might fail to develop parasite combinations, the PL acts as a limiting, at the normal site of development (Sinden 1984, rather than absolute barrier to the penetrating Ponnudurai et al. 1988). It has been shown that the ookinete while in incompatible combinations the midgut wall is negatively charged (Houk et al. PL appears to be an absolute barrier to ookinete 1986), but there is no evidence of electrical charge penetration. interactions between ookinetes and epithelial cells. To reach the midgut epithelium the ookinetes It has been a matter for discussion as to whether must first cross the partially or fully formed PL. the ookinete follows an intra- or intercellular route The PL may act as the recognition site for the pen- to reach the ultimate site of development and en- etrating ookinete via lectin-mediated mechanisms. cystment in the outer wall of the midgut epithe- The occurrence of sugar residues which could be lium. involved in vector recognition by the parasite has Intercellular movement of P. gallinaceum been demonstrated in the PL of An. stephensi and ookinetes was first described by Stohler (1957), Ae. aegypti (Berner et al. 1983). Rudin and Hecker but Mehlhorn et al. (1980) have found the same (1989) showed the presence of binding sites for parasite in an intracellular position. Recently, Torii different lectins in midguts of P. berghei-infected et al. (1992a) observed P. gallinaceum ookinetes An. stephensi, with high specificity for N-acetyl- in both intracellular and intercellular positions in D-galactosamine (GalNAc), and P. gallinaceum- the midgut epithelium of the mosquito Ae. aegypti, infected Ae. aegypti, with high specificity for N- which they interpret as that they first enter into the acetyl-D-glucosamine (GlcNAc). The authors con- epithelium, then exit into the intercellular space cluded that it seems likely that lectin-binding phe- and move to the basal lamina. Garnham et al. 524 Biology of Malarial Parasites in Mosquito • AB Simonetti

(1962) showed that the ookinete of P. cynomolgi Friedman, 1987). They observed similar mortality bastianelli enters the epithelial cell by liquifying rates in infected and uninfected batches of mos- the cell membrane. Davies (1974) again postulated quitoes. However, when ookinetes use an intracel- intercellular movement by P. berghei nigeriensis lular route, as described previously, increased dam- ookinetes. Although describing the ookinete of P. age to midgut cells might occur, resulting in higher berghei in an intracellular position, as did Garnham mosquito mortality. This is probably mediated by et al. (1969), Canning and Sinden (1973) stated invasion of the hemolymph by opportunistic gram- that the parasite might also migrate by an intercel- negative bacteria and/or microsporidia (Maier et lular route. More recently, P. yoelii nigeriensis al. 1987, Seitz et al. 1987). ookinetes have been described to take an intracel- Ultimately the ookinete penetrates the basement lular route to the external wall of the midgut (Maier membrane, but fails to pass through the basal et al. 1987). However, when the same parasite was lamina of the midgut adjacent to hemocoele used to infect An. omorii, an intercellular route was (Sinden 1984). Whether this is due to the inability mostly undertaken, although the intracellular oc- of the ookinete to penetrate the basal lamina, or to currence was also observed (Syaffruddin et al. the specific recognition of the lamina and conse- 1991). Meis and Ponnudurai (1987) presented evi- quent shut-down of the incisive process is not dence that P. falciparum ookinetes migrate between known. Interactions of parasites with vector extra- the epithelial midgut cells. Using a specific mono- cellular matrix proteins (ECM) cannot be dis- clonal antibody they also observed a track in the counted (Kaslow et al. 1994b). PL, which is related to the shedding of a 25 kD surface protein (Pfs25) during movement. The au- Oocyst development thors suggested that this protein may bind to re- Oocyst development is predominantly extracel- ceptors on the epithelial cells prior to an intercel- lular (Duncan et al. 1960, Garnham et al. 1969, lular invasion, since it is reported to have epider- Howells & Davies 1971, Sinden 1975), but occa- mal growth factor (EGF)-like domains (Kaslow et sionally occurs within the midgut epithelial cell al. 1988). It was recently shown that Pfs25 persits (Vanderberg et al. 1967, Bafort 1971, Beaudoin et in the oocyst wall during parasite development in al. 1974). The ookinete usually comes to rest be- the mosquito (Lensen et al. 1993). The same group neath the basal lamina 18-24 hr after the infective studied the migration of P. falciparum and P. blood meal (Sinden 1978). It rapidly rounds up be- berghei ookinetes through the midgut epithelium tween 18 and 72 hr after feeding and the apical in An. stephensi by using ruthenium red staining complex is resorbed into the oocyst cytoplasm (Meis et al. 1989). The results of previous studies (Garnham et al. 1969). There is some evidence were confirmed: P. falciparum ookinetes pen- suggesting a significant role of the basal lamina in etrated by intercellular route, but the rodent para- the development of the ookinete (Kaslow et al. site P. berghei appeared to take an intracellular 1994b). It was found that in vitro-cultured position, confirming that both mechanisms occur ookinetes injected directly into the hemolymph and are species-dependent. In the case of P. berghei form clusters of oocysts adherent to the basal a protein of 21 kD (Pbs21) present on the surface lamina throughout the hemocoele. Furthermore, of the ookinete (Sinden et al. 1987) could play a binding of ookinetes to artificial surfaces, such as role during the intracellular invasion of the mid- plastic, is enhanced at least 10-fold by addition of gut epithelium of An. stephensi mosquitoes. It was various components of basal lamina such as demonstrated in the midgut of P. berghei infected matrigel, collagen IV, and laminin (Warburg & mosquitoes that expression of Pbs21 was predomi- Miller, 1992). The young oocyst is enveloped by a nantly localized on the ookinete surface one day thick plasmalemma that is covered on the after the infectious blood meal and thereafter ex- hemocoelomic surface by a fibrous basal lamina. pression declined to a minimum on days 2 and 3, Oocysts from the second day onwards are also cov- the time of onset of oocyst development (Simonetti ered by an amorphous capsule which becomes re- et al. 1993). duced in thickness at maturity (Vanderberg et al. The mode of penetration by ookinetes can per- 1967, Aikawa 1971, Strome & Beaudoin 1974, haps be related to damage of the epithelial lining Sinden 1975). of the midgut. Intercellular migration may not dam- Despite the usual growth of the oocyst under age cell membranes, and increased mortality does the basal lamina of the midgut, oocyst develop- not occur in P. falciparum-infected An. stephensi ment is not site specific. Weathersby (1952, 1954, and An. gambiae during this period, even with very 1960) has shown by injection of gametocytes di- heavy parasite loads (Meis & Ponnudurai, 1987). rectly into the hemocoele of susceptible mosqui- Similar observations have been reported in P. toes that oocysts would develop to maturity if at- gallinaceum-infected Ae. aegypti (Freier & tached to other parts of the body than the stomach Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 525 or even if they were floating freely in the hemo- Little information is available on the uptake and coel fluid. In his experiments he used different source of nutrients for oocyst development. It is parasite-host combinations and concluded that the assumed that in vivo the source of nutrients is the site of oocyst development is probably not a criti- hemolymph. Mack and Vanderberg (1978) ana- cal factor in the maturation process. Furthermore, lyzed hemolymph of An. stephensi collected from the factors that are responsible for the death of uninfected and P. berghei-infected mosquitoes at parasite in refractory lines are not confined to the different stages of the parasite development. It was stomach wall. These results were supported by found that four days after the blood meal the os- those reported by Ball and Chao (1957, 1960, 1961, motic pressure and the specific gravity were lower 1976) who showed that oocysts of P. relictum may in infected mosquitoes compared with uninfected develop in vitro away from the intact stomach of ones. The difference, however, was attributed to the mosquito. The overall results of this series of indirect effects of the quality of the ingested blood studies by Ball and Chao demonstrated in vitro meal. These studies were complemented by analy- development of all stages from ookinetes to fully sis of the concentration of free amino acids in the infective sporozoites without attachment of oocysts hemolymph collected in similar conditions with to the midgut. However, it was not possible to ob- results showing significantly lower concentrations tain complete sporogonic development in a single in infected mosquitoes with decreases in valine and preparation. Rosenberg and Koontz (1984) injected histidine, and a total loss of detectable methionine cultured P. gallinaceum zygotes into the hemocoele suggesting it is incorporated (Mack et al. 1979). of Ae. aegypti mosquitoes and observed develop- This difference could be due to the utilization of ment of ectopic oocysts in approximately 50% of some of these amino acids by the developing oo- the mosquitoes, with sporozoites being found in cyst as suggested by Ball and Chao (1976) who the salivary glands. These observations suggest that analyzed the uptake of amino acids by P. relictum oocyst metabolism is not dependent upon direct oocysts in vitro, comparing growth of uninfected transfer of nutrients from the midgut epithelium. and infected guts of Culex tarsalis in Grace’s in- Occasional intracellular oocyst development has sect culture medium. They found significant de- been reported for P. berghei in An. stephensi and creases in the concentration of certain amino acids An. quadrimaculatus (Vanderberg et al. 1967). The including arginine, asparagine, proline and histi- same localization was described in P. vinckei by dine, and less marked decrease in concentrations Bafort (1971) who concluded that both mechani- of others like methionine, valine, leucine and iso- cal pressure and physiological mechanisms play a leucine. From these studies it appears that the re- role in the movement of oocysts to the duced amount of free aminoacids in the hemocoelomic surface. Studying the sporogonic hemolymph is due to oocyst metabolism. Autora- development of P. berghei in An. stephensi, diographic studies with P. gallinaceum in Ae. Beaudoin et al. (1974) found oocysts developing aegypti mosquitoes indicated that 3H-leucine is ectopically within the midgut epithelium follow- uniformly incorporated throught the oocyst within ing normal infection, eventually emptying their 15 min of injection into hemocoele (Vanderberg sporozoite content into the tissue itself or the mid- et al. 1967). gut lumen. In addition, they observed no morpho- logical and structural abnormalities in the luminal Sporogony parasites which displayed good viability. In con- With increasing maturation the oocyst under- trast to P. berghei, no ectopic development was goes considerable cytoplasmic subdivision. Ini- seen in P. falciparum-infected An. stephensi mos- tially the plasmalemma forms invaginations and quitoes (Meis et al. 1992b), confirming previous clefts that penetrate even deeper into the cytoplasm, results observed with P. falciparum in naturally thus subdividing the cell (Vanderberg et al. 1967, infected An. gambiae (Sinden & Strong 1978). Terzakis 1971, Posthuma et al. 1988). In a trans- Recent reports described an enhancement of oo- mission electron microscopy study of P. falciparum cyst development in vitro for P. berghei oocysts it was suggested that cleft formation was (Syaffruddin et al. 1992), P. gallinaceum (Warburg due to dilation of endoplasmic reticulum (Sinden & Miller, 1992) and P. falciparum (Warburg & & Strong 1978). Using immunogold labelling tech- Schneider, 1993), when insect cell lines were added nique during sporogonic stage of the same para- into the culture medium. From these observations site, Posthuma et al. (1988) considered the latter it appears that nutritional or other regulatory re- explanation unlikely. With increasing activity the quirements of the developing parasite can be met cytoplasmic clefts become extended and the ex- without a direct contact with midgut epithelium or panding vacuolar space more pronounced leading haemolymph. The question of how the oocyst is to the sporoblast formation. Along the clefts sporo- supplied with nutritive material is an intriguing one. zoites are formed by a budding process at the Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 519

face of the limiting membrane (Vanderberg et species (Collins et al. 1986). The authors demon- al. 1967, Howells & Davies 1971, Canning & strated that refractoriness is manifested by mela- Sinden 1973, Sinden & Strong 1978). nization of the ookinete after its passage through As the sporozoite continues to bud off, a the midgut epithelium. Paskewitz et al. (1989) lo- nucleus and various cytoplasmic components are calized phenoloxidase activity in the basal lamina passed into it from the sporoblast. The membranes of the epithelial cells of both encapsulating and of the developing sporozoite pellicle are formed susceptible mosquitoes prior to blood feeding. and other organelles like microtubules and However, after an infective blood meal, this activ- rhoptries become discernible (Vanderberg et al. ity was still observed close to invading ookinetes 1967, Sinden & Garnham 1973). When sporogony in refractory mosquitos but it was reduced or ab- is completed (about 10-12 days after the infective sent in susceptible mosquitoes. When the non-com- feed), the oocyst is filled with sporozoites and one patible vector An. gambiae was fed with ookinetes or more residual bodies (Sinden 1984). Estimations of P. gallinaceum, invasion of the midgut epithe- of number of sporozoites per oocyst have ranged lium by the ookinetes occurred but oocysts were widely. Garnham (1966) reported that the number infrequentely formed. Using the same system in a single P. vivax oocyst varies from 1,000 to Vernick et al. (1989) and Vernick and Collins 10,000. Pringle (1965) estimated that a single oo- (1989) tried to elucidate mechanisms involved in cyst of P. falciparum contains nearly 10,000 sporo- vector-parasite incompatibility by injecting in vitro- zoites. Studies carried out with mosquitoes fed on cultured ookinetes into the hemocoel of mosqui- infected volunteers from Thailand showed a mean toes and monitoring parasite development using count of approximately 3,700 sporozoites per oo- specific rRNA probes. As no differences were cyst for P. vivax and 3,400 for P. falciparum, found between susceptible and refractory mosqui- whereas for P. cynomolgi-infected mosquitoes a toes the authors suggested that the specific lytic single oocyst contained about 7,500 (Rosenberg factor(s) in the refractory line are intracellular. & Rungsiwongse 1991). Dependent upon species, the mature sporozoite varies from 9 to 16.5 mm in The sporozoite and salivary gland invasion length and from 0.4 to 2.7 mm in diameter; aber- The motile sporozoites emerge into the rant forms have been described up to 40 mm long hemocoele through holes from an area of weak- (Sinden 1978). ness in the oocyst wall. Holes are possibly pro- So far, studies on synthesis and expression of duced by a combination of the muscular action of proteins during sporogonic development have the gut wall and the activity of the sporozoites foccused on a polypeptide called the (Sinden 1978, Meis et al. 1992b). Within the hemo- circumsporozoite protein (CSP) found on the ma- coel the sporozoites are distributed throughout the ture sporozoite. Observations on the origin of CSP mosquito and can initially be found in many parts and its distribution through the mosquito stage were of the insect, even in the maxillary palps; within a reported by several authors. It is now well estab- day or two of their release from oocysts the sporo- lished that these proteins are synthesized in matur- zoites invade the salivary glands where they accu- ing oocysts of different Plasmodium species from mulate and remain until delivery (Vaughan et al. 6-7 days after the infective blood meal, before 1992). Thus, sporozoites do not adhere to most tis- sporozoites are visible (Nagasawa et al. 1987, 1988, sues, except for the salivary glands and rarely the Posthuma et al. 1988, Hamilton et al. 1988, midgut wall, hemocytes or thoracic muscles Boulanger et al. 1988, Torii et al. 1992b, Meis et (Vanderberg 1974, Sinden 1975, 1978, Golenda al. 1992a). At this stage, CSP is present on the plas- et al. 1990, Vaughan et al. 1992). The latter obser- malemma and at various sites within the cytoplasm vation, especially in heavily infected mosquitoes, and endoplasmic reticulum of the sporoblast. When could be associated with an impairment of flight the sporozoites bud from the sporoblast they are activity in malaria-infected An. stephensi vectors already covered with CSP which is also found in demonstrated by some authors (Rowland & salivary gland sporozoites (Yoshida et al. 1981, Boersma 1988). Santoro et al. 1983, Tsuji et al. 1992). It has been estimated that in mosquitoes fed on Humoral encapsulation of oocysts, which in individuals with naturally acquired P. vivax about malaria infected mosquitoes is known as Ross’ 850 sporozoites per oocyst reached the glands black spores, has been described in P. berghei (Sattabongkot et al. 1991) which follows, by cal- nigeriensis and P. vivax and seems to occur mainly culation, that approximately 23 % of all P. vivax in older oocysts which have begun to produce sporozoites released into the hemocoel sporozoites (Sinden & Garnham, 1973). This phe- subsequentely reach the salivary glands (Rosenberg nomenon was studied in a selected line of An. & Rungsiwongse 1991). Vaughan et al. (1992), gambiae that encapsulates different Plasmodium using regression analysis, calculated the approxi- 520 Biology of Malarial Parasites in Mosquito • AB Simonetti mately 650 salivary gland sporozoites were pro- 1988, 1991, 1992). Soluble CSP was shown to be duced per oocyst and reported that virtually all present throughout the hemocoel (Robert et al. oocyst infections produced salivary gland infec- 1988). Beier et al. (1992a) concluded that the re- tions in An. gambiae infected with P. falciparum lease of CSP by sporozoites is a normal but com- by membrane feeding. The same group has found plex mechanism that they interpreted to be associ- a similar number by studying the sporogonic de- ated with sporozoite survival in the host, is not site- velopment of cultured P. falciparum in six species specific and it would be regulated in response to of laboratory-reared Anopheles mosquitoes background levels of soluble CSP in the environ- (Vaughan et al. 1994). This is in contrast to obser- ment (negative feedback mechanism). This idea is vations on wild-caught An. gambiae from Burkino- supported by previous results showing that the Faso (Lombardi et al. 1987) and western Kenya parasites cease to synthesize CSP during their jour- (Beier et al. 1990) where sporozoites failed to en- ney through the hemolymph but shedding still oc- ter the salivary glands in 43% and 10% of infected curs (Posthuma et al. 1988, 1989). There is no evi- mosquitoes, respectively. However, when sporo- dence yet for chemotaxis but the congregation of zoites from P. gallinaceum oocysts were injected sporozoites in the vicinity of the glands before in- into Ae. aegypti female mosquitoes only 6.5 to vasion may support, according to some workers, a 10.4% of inoculated sporozoites invaded the sali- tactile mechanism (Golenda et al. 1990, Meis et vary glands. Interestingly, injected salivary gland al. 1992b). Several polysacharides have been iden- sporozoites did not reinvade the glands (Touray et tified that may orient protozoa towards or away al. 1992). Recently, a laboratory study on An. from a stimulus (Van Houten 1988). tesselatus mosquitoes infected with different iso- The selective invasion of mosquito salivary lates of P. vivax and P. falciparum from patients glands by malarial parasites is not well understood. living in Sri Lanka showed that approximately 15% Specific recognition of the glands was shown in P. of mosquito batches in which oocysts developed knowlesi. Oocysts developed normally on the gut failed to produce salivary gland sporozoites of An. freeborni but sporozoites were never found (Gamage-Mendis et al. 1993). This discrepancy in salivary glands. When glands from the suscep- between naturally and laboratory-infected mosqui- tible vector An. dirus were implanted into the ab- toes could be attributed to different environmental domen, they did become infected (Rosenberg conditions or mixed mosquito populations. 1985). These experiments demonstrated that the It could be expected sporozoites would elicit a salivary glands themselves determined specificity. humoral response in the mosquito by activation of Although invasion of salivary glands seems to re- the prophenoloxidase cascade and as a result be quire specific recognition, the mechanism by which killed by melanization. However, sporozoites in sporozoites recognize, attach to, and penetrate the the hemocoele are rarely seen to be melanized glands remains to be determined. (Brey 1991). Sporozoites might be protected from Sporozoites preferentially invade the medial mosquito defense reactions against ‘non-self’ by lobe and the distal portions of the lateral lobes of antigen sharing. This has been demonstrated as a the salivary glands where the salivary duct is not potential mechanism for avoidance of mosquito chitinous in Anopheles species (Sterling et al. 1973, defence reactions by microfilariae of Brugia James & Rossignol 1991, Ponnudurai et al. 1991). pahangi (Maier et al. 1987). Immunoreactivity to Hence, the occurrence of a specific receptor-me- CSP was observed on the midgut wall of mosqui- diated invasion by sporozoites is plausible. Perrone toes infected with P. falciparum (Boulanger et al. et al. (1986) used lectins to characterize carbohy- 1988) and P. yoelii (Beaudoin et al. 1990). The drate moieties on the basal lamina of Ae. aegypti latter authors also detected reactivity on uninfected salivary glands. As the median and distal lateral midguts and suggest the presence of a common lobes bound a common lectin, RCA 120, whose determinant between the parasite and the mosquito. substrate is b-D-galactose, the authors suggested The migration of sporozoites from oocysts to that sugars that bind this lectin serve as candidate salivary glands could be active (in contact with residues to which sporozoites may attach. In con- basal lamina), passive (in suspension) or both. If trast, the sporozoite coat binds some lectins with active, the parasite would use a gliding motility to very low efficiency (Schulman et al. 1980, Turner move across the basal lamina and reach the gland. & Gregson 1982). However, in a recent scanning Vanderberg (1974) described circular gliding and electron microscopic study Meis et al. (1992b) lo- attached waving locomotion and movement in calized P. falciparum sporozoites in proximal and sporozoites of different species when bovine se- distal parts but were unable to identify any spe- rum albumin was added to Medium 199. Sporo- cific regions on the glands where sporozoites pen- zoites that move over a substratum in vitro leave etrate. These authors also showed sites where the behind trails of CS proteins (Stewart & Vanderberg sporozoites have pierced the basal lamina, which Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 521 probably explains the presence of CSP on the basal zoites could cause pathological vesiculation and lamina induced by shedding during penetration cytoskeletal changes in salivary gland tissues as (Posthuma et al. 1989) and the presence of immu- the infected cells are often deformed and swollen noreactive spots of 1-2 mm on the surface of in- (Sterling et al. 1973, Maier et al. 1987). The effi- fected glands (Golenda et al. 1990). Recently, ciency of salivary gland invasion is poorly under- Touray et al. (1994) developed an in vivo salivary stood. It has been estimated that the median sporo- gland invasion assay and have found that anti-sali- zoite load in the glands is less than 10,000 in colo- vary gland antibodies, sulfated glycosaminogly- nized or wild Anopheles species (Shute 1945, cans and some lectins, particularly Suc-WGA, Pringle 1966, Wirtz et al. 1987, Beier et al. 1991b, block invasion of sporozoites. Although the mecha- Sattabongkot et al. 1991) or slightly higher nism of blocking is not yet known, those lectins (Ponnudurai et al. 1991). that blocked invasion bound to salivary glands but The development of infectivity by the sporo- did not bind to sporozoites. Beier et al. (1992a) zoites appears to be asynchronous, in some cases and Beier (1993) proposed that as sporozoites in- taking place in the hemocoele, while in others not vade the salivary glands, the build-up of CSP is occuring until after they have invaded the salivary the signal for sporozoites to halt their active motil- glands. Thus, it seems to be time-dependent rather ity, and thus their release of CSP (down-regula- than site-dependent (Vanderberg 1975, Daher & tion). The involvement of CSP and other proteins Krettli 1980). It was demonstrated in P. berghei- distinct from CSP such as PySSP2 (Charoenvit et infected mice that populations of salivary gland al. 1987) and PfSSP2 (Robson et al. 1988, Rogers sporozoites were more than 10,000 times as infec- et al. 1992a,b) in binding of sporozoites to the basal tive to the vertebrate host as populations of oocyst lamina of mosquito salivary glands is speculative. sporozoites from the same mosquitoes (Vanderberg As they share similarities in their structure they 1975). Touray et al. (1992) found that as few as might be related to this process since it has been 10-50 salivary gland P. gallinaceum sporozoites suggested region II of CSP is involved in hepato- were required to induce infection in chickens com- cyte invasion (Cerami et al. 1992a,b, Pancake et pared to 5,000 oocyst sporozoites. Sporozoite in- al. 1992). fectivity increases with time during the first week Rosenberg (1985) and King (1988) have sug- after the invasion of the salivary gland (Vanderberg gested that sporozoites invade the salivary gland 1975). Degeneration of sporozoites is not frequent cells using a mechanism similar to invasion of in nature as observed by Barber (1936) who stud- erythrocytes by merozoites although there is no ied anophelines collected in Mediterranean areas. evidence of parasitophorous vacuole membrane When degeneration occurred in a salivary gland formation observed in other stages of the parasite or a lobe of a gland, in another gland or lobe the cycle (Sinden & Strong 1978, Meis & Verhave sporozoites were normal or in a different stage of 1988). Membrane-limited vacuoles beneath the degeneration. plasma membrane in An. stephensi distal salivary The number of sporozoites injected into the tis- gland cells invaded by P. berghei have been de- sue or capillary of the vertebrate is very small com- scribed (Sterling et al. 1973). Penetration could also pared to that found in the salivary glands. It has involve an unusual intercellular route as suggested been estimated, by employing different methods, by Golenda et al. (1990) who detected CSP in the that each bite delivers fewer than 50 sporozoites region between cells of the median lobe of the with a tendency for most sporozoites to be ejected gland. Posthuma et al. (1989) observed many in the first droplets of saliva (Vanderberg 1977, sporozoites on the basal side of the cells, but also Rosenberg et al. 1990, Ponnudurai et al. 1991, found trail-like CSP immunoreactivity at the lat- Beier et al. 1991a,b, Beier et al. 1992b, Li et al. eral space between the cells. 1992). Although a correlation between salivary After penetration, sporozoites are present in gland sporozoite load and sporozoite inoculum has bundles in the accini of gland cells in both proxi- been reported (Rosenberg et al. 1990) ejection of mal and distal areas. Most probably, the sporozoi- sporozoites is probably a random process, more tes which are present in proximal areas of the glands related to the architecture of the salivary gland duct are unable to reach the draining duct because of system than to the number of sporozoites in this the chitinized layer in that area whereas distally organ (Ponnudurai et al. 1991). localized sporozoites reach the draining duct via Some studies reported that P. falciparum-in- the large unchitinized collecting tube (Meis et al. fected mosquitoes deliver sporozoites in an unpre- 1992b). This explanation would not be valid for dictable fashion, sometimes not at all (Ponnudurai Aedes species since the salivary ducts are lined with et al. 1991), and others transmit inconsistently chitin and extend the full length of the glands (Rickman et al. 1990). Clumping of sporozoites (James & Rossignol 1991). Penetration by sporo- has been reported in infected salivary glands (Ster- 522 Biology of Malarial Parasites in Mosquito • AB Simonetti ling et al. 1973) and clusters of sporozoites were of Ae. aegypti result in reduced levels of salivary detected after delivery when An. stephensi mos- apyrase. Mosquitoes deficient in salivary apyrase quitoes infected with P. falciparum were allowed experience difficulty in locating host blood and en- to feed through fresh mouse skin (Ponnudurai et gorging; they therefore probe more often and may al. 1991). It has been observed that salivary glands attempt to feed on several hosts in succession are not depleted of sporozoites even in vectors that (Rossignol et al. 1984, 1986, Ribeiro et al. 1985). feed up to 15 times (Shute 1945), which allows Li et al. (1992) demonstrated that probing time of infected mosquitoes to remain potentially infec- P. berghei-infected An. stephensi is not affected tious for life. by sporozoite invasion of salivary glands. The low sporozoite inoculum and the low en- Blood meal size may influence infectivity since tomological inoculation rates in natural conditions it determines the number of gametocytes ingested (Mendis et al. 1990a, Gordon et al. 1991) demon- and therefore subsequent infection. It has been strates the high efficiency with which injected shown that larger An. dirus females took larger sporozoites will develop malaria. bloodmeals by artificial feeding with cultured P. Factors affecting parasite development to the falciparum and developed significantly more oo- mosquito cysts (Kitthawee et al. 1990). In a field study, The process of infection of mosquitoes is ex- Lyimo and Koella (1992) reported that the pro- ceedingly complex and regulated by a range of portion of An. gambiae mosquitoes infected with factors originating from the parasite, the vertebrate P. falciparum during a blood meal was indepen- host and the mosquito vector, and from the inter- dent of size but the number of oocysts harboured actions between all three (Sinden 1991). Many of by infected mosquitoes increased with size of the these and other factors are known to affect fertili- mosquito. zation and subsequent stages of parasite develop- b) Gametocyte carriers/transmission blocking im- ment, thus having great influence on transmission munity - Malarial infections induce host responses of the disease. To have an idea, when sporogonic to both asexual and sexual stage malaria parasites development of cultured P. falciparum was evalu- that may modulate gametocyte infectivity. Great ated in six species of Anopheles mosquitoes there heterogeneity in infectiousness of different carri- was a total loss of approximately 31,600-fold in ers has been noted, with apparently poor correla- the parasite population from macrogametocyte to tion between infectiousness and gametocyte den- oocyst stage (Vaughan et al. 1994). sity (Graves et al.1988). However, it remains un- a) Host location and feeding behaviour - Of pri- clear whether symptomatic and asymptomatic mary importance in malaria transmission is the asexual infections differ in their ability to influ- proportion of mosquito feeds taken from humans ence gametocyte infectivity. It has been reported and the proportion of these feeds taken from in- that asymptomatic P. falciparum patients were fected individuals. In nature a vector needs to sur- more infectious than symptomatic patients (Boyd vive longer than the sporogonic period after tak- & Kitchen 1937, Jeffery & Eyles 1955, Muirhead- ing an infective blood meal; during this period the Thomson 1957, Carter & Graves 1988) while, in mosquito probably takes blood meals every 2-3 contrast, another report suggested that days, depending on its gonotrophic cycle and the asymptomatic and symptomatic P. malariae pa- availability of breeding sites (Ponnudurai et al. tients were equally infective (Young & Burgess 1989). Parasitemic hosts tend to be sick and often 1961). less irritated by mosquito feeding. Additionally, Specific and non-specific responses are be- the thrombocytopenia which is commonly associ- lieved to modulate parasite transmission. The in- ated with blood-borne parasitic diseases leads to duction of specific immunological responses to facilitation of vessel location, resulting in increased Plasmodium shows marked heterogeneity within feeding success by mosquitoes on parasitemic hosts human populations (Mendis et al. 1987, Graves et (Rossignol et al. 1985). Salivary glands and saliva al. 1988, Targett 1990, Snow et al. 1993). The contain a whole range of components with phar- sexual stages can induce trasmission blocking im- macological activities important for blood feeding munity (TBI) and effective targets include antigens success and subsequent bloodmeal processing, in- identified on the surface of the macro- and/or cluding anticoagulants, anti-inflammatory, microgemetes (‘pre-fertilization’antigens) as well vasodilatory and immunosuppressive compounds as antigens present on the surface of the gamete, (Ribeiro et al. 1984, 1989, Ribeiro 1987, Titus & zygote and ookinete (‘post-fertilization’ antigens). Ribeiro 1990, James & Rossignol 1991). Rossignol Antibodies to ‘pre-fertilization’ antigens of P. et al. (1984) concluded that the lesions caused by falciparum such as Pfs230, Pfs48/50 and Pfs16 P. gallinaceum sporozoites in the salivary glands have been detected in humans (Graves et al. 1988, Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 523

Premawansa et al. 1994, Hogh et al. 1994). A sig- changes in gametocyte infectivity. Acute phase nificant association between lacking of infectivity reactants like C-reactive protein (CRP), which are of P. falciparum gametocyte carriers and recogni- non-specific indicators of inflammatory activity, tion of epitope IIa on Pfs48/50 by antibodies in are elevated in patients with P. falciparum malaria their sera has been observed (Graves et al. 1992). (Ree 1971, Naik & Voller 1984, Chagnon et al. Naturally acquired TBI to P. vivax sexual stage 1992). Some cytokines such as interferon (IFN-g), antigens has also been demonstrated (Mendis et tumor necrosis factor (TNF-a) and interleukin 6 al. 1987, 1990b, Mendis & Carter 1991, Ranawaka (IL-6) are elevated in sera fom patients with P. et al. 1988, Goonewardene et al. 1990, Gamage- falciparum and P. vivax malaria (Grau et al. 1989, Mendis et al. 1992) and appears to play a role on Kern et al. 1989, Kwiatkowski et al. 1990, Mendis transmission of the disease (de Zoysa et al. 1988). et al. 1990c, Karunaweera et al. 1992). Both IFN- In P. vivax malaria antibodies, at low concentra- g and TNF-a appear to cause a transient but marked tions, can also have a transmission-enhancing ef- drop in the infectivity of gametocytes to mosqui- fect on infectivity of malarial parasite to mosqui- toes due to the intraerythrocytic killing of para- toes (Mendis et al. 1987, Peiris et al. 1988, sites (Naotunne et al. 1991, Karunaweera et al. Naotunne et al. 1990, Gamage-Mendis et al. 1992). 1992). However, a recent study has shown no el- A recent report described TBI in P. vivax malaria evation in blood levels of cytokines IL-2, IL-6, when antibodies raised against a peptide blocked TNF-a and IFN-g nor reactive nitrogen intermedi- parasite development in the mosquito An. tesselatus ates (Hogh et al. 1994). The authors suggested that (Snewin et al. 1995). As shown in a variety of Plas- this could be explained by the inability of modium species, within the mosquito vector anti- asymptomatic gametocyte carriers, unlikely to body to the ‘pre-fertilization’ antigens may pre- harbour high asexual parasitaemias, to promote the vent fertilization by any of four mechanisms: (1) responses. the agglutination of macro/microgametes limiting The concept that anti-sexual stage immunity their mobility; (2) antibody coating of macro/ may regulate infection of the moquito vector by microgamentes inhibiting cell-cell recognition; (3) gametocyte-infected malarial blood has gained opsonization in the bloodmeal or (4) complement considerable support and must be considered for dependent/independent lysis (Gwadz 1976, Carter the development of malaria trasmission blocking & Chen 1976, Carter et al. 1979, 1985, 1990, vaccines (Kaslow et al. 1992). Kaushal et al. 1983a,b, Rener et al. 1983, Harte et c) Antibodies against sporozoites - There is evi- al. 1985a, Vermeulen et al. 1985b, Grotendorst et dence that naturally acquired or experimentally al. 1986, Grotendorst & Carter 1987, Quakyi et al. elicited anti-sporozoite antibodies ingested by 1987, Peiris et al. 1988, Premawansa et al. 1990). mosquitoes may affect the dynamics of the Cellular responses are also involved in TBI and sporogonic development in the vector. Several may have some influence on parasite infectivity studies with P. falciparum-infected Anopheles spe- (Harte et al. 1985b, Mendis et al. 1990b, Riley & cies (Vaughan et al. 1988, Beier et al. 1989, Greenwood 1990, Goonewardene et al. 1990). Hollingdale & Rosario 1989) showed that (1) in- Immunity to ‘post-fertilization’ antigens such gested human CSP antibodies were detected in the as Pfs25, Pbs21, Pgs25 and Prs25 also plays an blood meal of field collected mosquitoes up to 36 important role on transmission of the disease by hr after feeding, (2) antibodies crossing the mid- suppressing parasite infectivity at different stages gut into hemocoel persist from 4 to 36 hr post-in- of its development in the mosquito as demonstrated fection in hemolymph, (3) ingested CSP antibod- by many workers in different Plasmodium species ies on day 5 after infection bound to developing (Grotendorst et al. 1984, Vermeulen et al. 1985a, oocysts, (4) enhancement of the sporozoite pro- Sinden et al. 1987, Winger et al. 1988, Fries et al. duction, (5) ingestion of CSP antibodies on day 10 1989, Carter & Kaushal 1984, Carter et al. 1989a,b, after feeding had no effect on oocyst maturation Kaslow et al. 1991, 1992, 1994b, Foo et al. 1991, or sporozoite production, (6) contact between CSP Sieber et al. 1991, Tirawanchai et al. 1991, Duffy antibodies and sporozoites in the hemocoel did not et al. 1993, Paton et al. 1993, Ranawaka et al. 1993, block sporozoite invasion of salivary glands, (7) 1994). The mechanisms of blockade could be the exposure to CSP antibody increased sporozoite same four described above and/or the antibody may infectivity and (8) human IgG antibodies were act by damaging the parasite surface coat present on salivary gland sporozoites from field- (Ponnudurai et al. 1987). collected mosquitoes. It has been recently demon- Non-specific responses to the asexual stages are strated that antibodies to P. gallinaceum CSP pre- believed to modulate parasite trasmission vent sporozoites from invading salivary glands of (Naotunne et al. 1991, Kwiatkowski 1992). Nu- Ae. aegypti (Warburg et al. 1992). Ponnudurai et merous non-specific factors may correlate with al. (1989) did not find any influence of anti-sporo- 524 Biology of Malarial Parasites in Mosquito • AB Simonetti zoite antibodies on the number of salivary gland Coluzzi 1992, Collins 1994, Curtis 1994). Intro- sporozoites but concluded that a second blood duction and expression of genes coding for anti- meal, with or without antibody, simply functions bodies against target antigens present on the as a nutritional stimulus for faster oocyst matura- ookinete surface into the mosquito embryos is one tion. However, when transmission blocking anti- of the possibilities to examine the potential of this bodies anti-Pbs21 (a surface antigen present on the technology (Crampton et al. 1993). surface of P. berghei zygote/ookinete) were added f) Anti-malarial drugs - Sub-therapeutic doses of to second bloodfeeds at different stages of parasite antimalarial drugs have been reported to enhance development in the mosquito, a significant reduc- infectivity of Plasmodium species to their vectors tion in oocyst intensity but no detectable change (Shute & Maryon 1954). Additionally, numerous in prevalence occurred. Furthermore, at all times compounds including chloroquine (Wilkinson et anti-Pbs21 reduced sporozoite number in the tho- al. 1976), sulphamethoxazole-trimethroprim rax but highest gland intensities were obtained (Wilkinson et al. 1973), pyrimethamine (Shute & when the second bloodfeed was given on day 4 Maryon 1951), Fansidar (Carter & Graves 1988) (Ranawaka et al. 1993). These results were inter- and Berenil (Ono et al. 1993) have been suggested preted as two opposing roles of second bloodfeeds to induce gametocyte formation but no influence containing trasmission blocking antibody: (1) in- of chloroquine (Jeffery et al. 1956, Smalley 1977, hibition of parasite development and (2) the sup- Chutmongkonkul et al. 1992, Hogh et al. 1994) ply of nutrients which permit more sporozoites to and Fansidar (Hogh et al. 1994) on gametocyte be produced by each oocyst. Despite some contro- infectivity was observed by some investigators. It versy these results potentially have significant im- was demonstrated that pyrimethamine- and plications for natural malaria transmission and for halofantrine-treated gametocytes of P. falciparum a possible vaccine development. are more infective to An. stephensi mosquitoes than d) Anti-mosquito antibodies - In addition to anti- untreated controls (Chutmongkonkul et al. 1992). parasite antibodies, it has been tested experimen- Other studies examined the effects of some tally the effect on malaria trasmission of antibod- schizontocidal agents on the sporogonic cycle of ies raised against parts of the mosquito which could P. falciparum and P. berghei in anopheline mos- be included in a malaria vaccine. Ramasamy and quitoes (Coleman et al. 1988, do Rosario et al. Ramasamy (1990), studying the P. berghei/An. 1988). It was found that chloroquine, when fed farauti model, found that mosquitoes feeding on during late sporogony (10-12 days post-infection), mice immunised with midgut antigens exhibited a may increase the vectorial capacity of some mos- reduction in mosquito infection rates. Similar re- quito species. The effects of chloroquine on the sults were reported by Billingsley et al. (1990) us- infectivity of chloroquine-sensitive and -resistant ing monoclonal antibodies produced against mos- populations of P. yoelii nigeriensis to An. stephensi quito midgut tissue in P. berghei/An. stephensi mosquitoes were studied by Ichimori et al. (1990). system. The results showed an enhancement of infectivity e) Genetic manipulation of the vector - Experiments in sensitive strains but no effect was detected in with refractory lines of An. gambiae (Collins et al. 1986) and studies on the effects of broad antimi- resistant clones and sublines. Chloroquine use and crobial and antiparasitic components, e.g. the subsequent development of resistance over the magainins and cecropins (Gwadz et al. 1989), past years is associated with an increasing human showed that it may be feasible to induce effective malaria infectiousness (Lines et al. 1991) which disruption in the normal development of Plasmo- may be indirect effects of parasitaemia on the host. dium species in the vector by the introduction and The sporontocidal activity of chloroquine, expression of appropriate genes into the mosquito halofantrine and pyrimethamine was evaluated by genome. Two types of useful target genes can be administration to An. stephensi mosquitoes, either used in transgenic mosquitoes. First, those that ren- in the first bloodmeal containing P. falciparum der populations vulnerable to subsequent control gametocytes from in vitro cultures, or in the sec- measures, such as insecticide susceptibility or tem- ond, parasite-free bloodmeal, given four days af- perature sensitivity, and second, those that inter- ter infection. A sporontocidal effect was observed rupt disease transmission by replacing vector with only when pyrimethamine was administred with non-vector forms (Crampton et al. 1990, Kidwell the infective bloodmeal (Chutmongkonkul et al. & Ribeiro 1992, Crampton 1994). Although many 1992). It has been demonstrated recently an inhibi- technical, and perhaps ethical, problems associated tory action of the anti-malarial Atovaquone with the wild-release of transgenic insects have yet (566C80) against ookinete, oocysts and sporozoi- to be overcome, the potential of this technology tes of in An. stephensi (Fowler has received greater attention recently (Brey 1991, et al.1994, 1995). Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(5), Sep./Oct. 1996 525

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