Plasmodium falciparum, the causative organism of
Malaria is a
mosquito-borne parasitic disease which infects red blood cells (RBCs), where it multiplies rapidly and goes through different stages of its life cycle. When the parasite load exceeds >3% in the blood,
malaria transforms into severe
malaria which requires immediate attention as death occurs within hours to days. The increase in people traveling to
malaria-endemic areas and resistance/partial resistance to most known
antimalarial drugs has put the current management scheme in jeopardy. To improve the patient outcome at this point, the physician may opt to perform exchange transfusions from another individual as an adjunct
therapy to reduce parasitized RBCs, but the strategy has many drawbacks, including chances of
infection. These limitations can be mitigated if the patient's own blood is withdrawn/extracted, sterilized from the parasitic load and then re-transfused almost similar to what is done in extracorporeal blood treatment for
sepsis,
poisoning and
graft versus host disease. Thus, in the present study a light-based photochemical approach,
Photodynamic Therapy (
PDT) built on
delta-aminolevulinic acid-
protoporphyrin IX (ALA-
PpIX) synthesis is exploited. This modality was effective at destruction of both resistant and susceptible strains of parasites, including at a high load mimicking severe drug resistant
malaria. The current findings have set the stage for concept of an ALA-
PpIX based
PDT platform, "the REAP (Rapid Elimination of Active Plasmodium) strategy". This approach provides an additional tool towards the defense against multi-drug resistant severe
malaria, and other intracellular blood pathogens, dependent on
heme-synthesis.