Genomics and epigenetics of sexual commitment in Plasmodium

Malaria is the disease caused by the apicomplexan parasites belonging to the genus Plasmodium. Expanding our arsenal to include transmission-blocking agents in our fight against malaria is becoming increasingly important. Such an implementation requires detailed understanding of the biology of the Plasmodium life cycle stages that are transmissible. Plasmodium gametocytes are the only parasite stage that can be transmitted to the mosquito vector and are the product of sexual development in a small percentage of parasites that continually proliferate in host blood. The critical decision made by asexual erythrocytic stages to cease further proliferation and differentiate into gametocytes, as well as the first steps they take into maturity, have long remained unknown. Recent studies have contributed to a breakthrough in our understanding of this branch point in development. In this review, we will discuss the findings that have allowed us to make this major leap forward in our knowledge of sexual commitment in Plasmodium. We will further propose a model for the mechanism triggering the switch to sexual development, constructed around the proteins currently known to regulate this process. Further insight into sexual commitment and gametocyte development will help identify targets for the development of transmission-blocking malaria therapies.