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J. Cell Biol.,
Volume 145, Number 2, April 19, 1999 363-376

* Department of Pharmacology and Therapeutics, The University of Liverpool, Liverpool L69 3BX, United Kingdom; and Here we provide definitive evidence that
chloroquine (CQ) uptake in Plasmodium falciparum
is determined by binding to ferriprotoporphyrin IX
(FPIX). Specific proteinase inhibitors that block the
degradation of hemoglobin and stop the generation of
FPIX also inhibit CQ uptake. Food vacuole enzymes
can generate cell-free binding, using human hemoglobin as a substrate. This binding accounts for CQ uptake
into intact cells and is subject to identical inhibitor specificity. Inhibition of CQ uptake by amiloride derivatives occurs because of inhibition of CQ-FPIX binding rather than inhibition of the Na+/H+ exchanger
(NHE). Inhibition of parasite NHE using a sodium-free medium does not inhibit CQ uptake nor does it alter
the ability of amilorides to inhibit uptake. CQ resistance is characterized by a reduced affinity of CQ-FPIX
binding that is reversible by verapamil. Diverse compounds that are known to disrupt lysosomal pH can
mimic the verapamil effect. These effects are seen in sodium-free medium and are not due to stimulation of the
NHE. We propose that these compounds increase CQ
accumulation and overcome CQ resistance by increasing the pH of lysosomes and endosomes, thereby causing an increased affinity of binding of CQ to FPIX.
Department of Biological Chemistry, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
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