Transmission of Plasmodium falciparum requires the differentiation of asexual parasites into male and female gametocytes, which undergo extensive cytoskeletal remodeling, assembling a non-canonical subpellicular microtubule (SPMT) network. Using single-particle cryo-electron microscopy, we determined structures of SPMTs isolated from developing gametocytes. Unexpectedly, we identified human hemoglobin as a prominent microtubule-associated factor that binds to P. falciparum SPMTs in a dimeric form rather than the canonical tetramer. Pharmacological perturbation of microtubules and hemoglobin isoform switching experiments demonstrate that this hemoglobin-SPMT association is essential for proper SPMT organization and gametocyte maturation. Together, these findings reveal a strategy by which P. falciparum repurposes a host metabolic protein to stabilize its cytoskeleton, highlight the intimate co-evolution between parasite and host, and suggest avenues to block malaria transmission. Wang et al. apply single particle cryo-EM to developing gametocytes of Plasmodium falciparum, and identify human hemoglobin as a prominent factor that binds to P. falciparum subpellicular microtubule (SPMT) network.
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