Hemin acts as CD36 ligand to activate down-stream signalling to disturb immune responses and cytokine secretion from macrophages.

Inflammatory responses to hemin are believed to play an important role in tissue damage and cerebral malaria pathology. Macrophage exposed to hemin exhibits modulation of non-opsonic phagocytosis of aged RBCs, ability to kill bacteria and secretion of cytokines. Immuno-fluorescence study indicates translocation and sequestration of CD36 within the intracellular storage in the hemin treated macrophages. It in-turn modulates the global cytokine secretion from macrophages. CD36 has strong affinity for hemin with a dissociation constant of 1.26±0.24 μM. CD36 has hemin bio-phoric environment involving R292, D372 and Q382. The mutation in biophoric residues significantly reduced the affinity towards hemin. Hemin stimulated MG63 cells (transfected with CD36) showed several folds increment in cytokines TNFα, MCP-1, RANTES and CCL1 and CD36-hemin interaction is crucial for aberrant cytokine secretion. CD-36: Hemin interaction is driving down-stream signalling and subsequent recruitment of adaptor proteins to the cytosolic domain of CD36. Immunoprecipitation of membrane bound CD36 gives Lyn kinase as potential adaptor protein down-stream to CD36: hemin signalling. Interestingly, disruption of Lyn kinase abolishes the hemin mediated dysregulation of immune responses. In summary, hemin-CD36-Lyn kinase signalling axis could be a contribution factor to severe malaria pathology and prognosis.