# Host-directed therapeutic strategies against apicomplexan parasites: targeting purinergic P2 receptors

**Authors:** Mariana M. Chaves, Nayara Carvalho-Barbosa, Luiz Eduardo Baggio Savio, Robson Coutinho-Silva

PMC · DOI: 10.1007/s11302-026-10145-7 · Purinergic Signalling · 2026-03-21

## TL;DR

This review explores how targeting host purinergic P2 receptors could offer new therapeutic strategies against apicomplexan parasites like Toxoplasma and Plasmodium.

## Contribution

The paper highlights the dual role of P2 receptors in immune coordination and parasite viability, proposing them as novel host-directed therapeutic targets.

## Key findings

- Purinergic P2 receptors integrate danger signals with immune and microbicidal pathways during apicomplexan infections.
- Extracellular nucleotides modulate innate immune responses and influence parasite survival and dissemination.
- P2 receptors show potential as targets for host-directed therapies against Toxoplasma gondii and Plasmodium spp.

## Abstract

Apicomplexan parasites establish intracellular infections that profoundly alter host cell physiology and elicit complex immune responses. The long-standing coevolution between these parasites and vertebrate hosts has resulted in extensive overlap between parasite and host metabolic pathways, limiting the feasibility of conventional parasite-centered therapeutic approaches. Increasing evidence indicates that host-derived signals generated during infection play a decisive role in shaping parasite survival and dissemination. Among these signals, extracellular nucleotides released in response to cellular stress and tissue damage have emerged as key modulators of innate immune responses. These molecules are sensed by purinergic P2 receptors, which integrate danger signals with inflammatory and microbicidal pathways. This review examines how purinergic signaling contributes to host–parasite interactions during apicomplexan infections, with particular emphasis on Toxoplasma gondii and Plasmodium spp. We discuss the dual role of P2 receptors in coordinating immune responses and directly affecting parasite viability, highlighting their potential as targets for host-directed therapeutic strategies.

## Linked entities

- **Species:** Toxoplasma gondii (taxon 5811), Plasmodium sp. P (taxon 3036559)

## Full-text entities

- **Genes:** P2RX7 (purinergic receptor P2X 7) [NCBI Gene 5027] {aka P2X7}, IL18 (interleukin 18) [NCBI Gene 3606] {aka IGIF, IL-18, IL-1g, IL1F4}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, Cd4 (CD4 antigen) [NCBI Gene 12504] {aka L3T4, Ly-4}, P2rx7 (purinergic receptor P2X, ligand-gated ion channel, 7) [NCBI Gene 18439] {aka P2X(7), P2X7R}
- **Diseases:** Cerebral malaria (MESH:D016779), deaths (MESH:D003643), intestinal injury (MESH:D007410), Malaria (MESH:D008288), cyst (MESH:D003560), hemorrhage (MESH:D006470), encephalitis (MESH:D004660), toxoplasmosis (MESH:D014123), Infection (MESH:D007239), intracranial calcifications (MESH:C537905), HIV/AIDS (MESH:D015658), ocular toxoplasmosis (MESH:D014126), axonal injury (MESH:D001480), neurological complications (MESH:D002493), febrile (MESH:D000071072), hematologic toxicity (MESH:D006402), Congenital toxoplasmosis (MESH:D014125), neurological and ocular disease (MESH:D020271), parasitic diseases (MESH:D010272), neurodevelopmental impairment (MESH:D009422), AIDS (MESH:D000163), headache (MESH:D006261), chorioretinitis (MESH:D002825), cerebral toxoplasmosis (MESH:D016781), P. falciparum malaria (MESH:D016778), cognitive decline (MESH:D003072), Anemia (MESH:D000740), cytotoxic (MESH:D064420), neuropsychiatric (MESH:C000631768), hydrocephalus (MESH:D006849), type II ME-49 infection (OMIM:617237), chills (MESH:D023341), fetal damage (MESH:D005315), hypoxia (MESH:D000860), liver damage (MESH:D056486), hemolysis (MESH:D006461), inflammation (MESH:D007249), seizures (MESH:D012640), ileitis (MESH:D007079), hypoglycemia (MESH:D007003), parasitemia (MESH:D018512), P. vivax infections (MESH:D016780), edema (MESH:D004487), lymphadenopathy (MESH:D008206), necrosis (MESH:D009336), brain swelling (MESH:D001929), infectious (MESH:D003141), neurological deficits (MESH:D009461), fever (MESH:D005334)
- **Chemicals:** artesunate (MESH:D000077332), azithromycin (MESH:D017963), NO (MESH:D009569), dinucleotides (MESH:D015226), atovaquone (MESH:D053626), BioRender (-), clindamycin (MESH:D002981), acetaminophen (MESH:D000082), calcium (MESH:D002118), folinic acid (MESH:D002955), lipid (MESH:D008055), sulfadiazine (MESH:D013411), potassium (MESH:D011188), lumefantrine (MESH:D000078102), UDP (MESH:D014530), spiramycin (MESH:D015572), artemether-lumefantrine (MESH:D000077611), mefloquine (MESH:D015767), leukotriene B4 (MESH:D007975), pyrimethamine (MESH:D011739), quinine (MESH:D011803), ROS (MESH:D017382), artemisinin (MESH:C031327), atovaquone-proguanil (MESH:C109496), nucleotide (MESH:D009711), amodiaquine (MESH:D000655), trimethoprim-sulfamethoxazole (MESH:D015662), ATP (MESH:D000255), UTP (MESH:D014544), Chloroquine (MESH:D002738)
- **Species:** Plasmodium malariae (species) [taxon 5858], Toxoplasma gondii (species) [taxon 5811], Mus musculus (house mouse, species) [taxon 10090], Anopheles (series) [taxon 44484], Bos taurus (bovine, species) [taxon 9913], Homo sapiens (human, species) [taxon 9606], Plasmodium knowlesi (species) [taxon 5850], Plasmodium vivax (malaria parasite P. vivax, species) [taxon 5855], Plasmodium (subgenus) [taxon 418103], Plasmodium falciparum (malaria parasite P. falciparum, species) [taxon 5833]
- **Mutations:** Gln460Arg

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC13005795/full.md

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13005795/full.md

## References

5 references — full list in the complete paper: https://tomesphere.com/paper/PMC13005795/full.md

---
Source: https://tomesphere.com/paper/PMC13005795