Plasmodium falciparum Calcium-Dependent Protein Kinase 2 Is Critical for Male Gametocyte Exflagellation but Not Essential for Asexual Proliferation

Abstract
Drug development efforts have focused mostly on the asexual blood stages of the malaria parasite Plasmodium falciparum . Except for primaquine, which has its own limitations, there are no available drugs that target the transmission of the parasite to mosquitoes. Therefore, there is a need to validate new parasite proteins that can be targeted for blocking transmission. P. falciparum calcium-dependent protein kinases ( Pf CDPKs) play critical roles at various stages of the parasite life cycle and, importantly, are absent in the human host. These features mark them as attractive drug targets. In this study, using CRISPR/Cas9 we successfully knocked out Pf CDPK2 from blood-stage parasites, which was previously thought to be an indispensable protein. The growth rate of the Pf CDPK2 knockout (KO) parasites was similar to that of wild-type parasites, confirming that Pf CDPK2 function is not essential for the asexual proliferation of the parasite in vitro . The mature male and female gametocytes of Pf CDPK2 KO parasites become round after induction. However, they fail to infect female Anopheles stephensi mosquitoes due to a defect(s) in male gametocyte exflagellation and possibly in female gametes. IMPORTANCE Despite reductions in the number of deaths it causes, malaria continues to be a leading infectious disease of the developing world. For effective control and elimination of malaria, multiple stages of the parasite need to be targeted. One such stage includes the transmission of the parasite to mosquitoes. Here, we demonstrate the successful knockout of Pf CDPK2, which was previously thought to be indispensable for parasite growth in red blood cells. The Pf CDPK2 KO parasites are incapable of establishing an infection in mosquitoes. Therefore, our study suggests that targeting Pf CDPK2 may be a good strategy to control malaria transmission in countries with high transmission. Moreover, molecular understanding of the signaling pathway of Pf CDPK2 may provide additional targets for malaria control.