Generation of parasites with a homogenous placental binding phenotype and consequential dominant expression of var2csa. (A) The presence of in vivo relevant knob-structures on pRBCs was confirmed by SEM prior to phenotypic selection. Shown is a representative image of a pRBC with knobs appearing as white protrusions. (B) Flow cytometry-based antibody recognition of VAR2CSA surface expression on repeatedly selected pRBCs. NF54 ptefKO served as negative control, NF54 was the original and unselected parasite line, NF54CSAm was an intermediately selected line and NF54CSAh was panned enough to achieve a homogenous population of VAR2CSA expressing pRBCs. (C) Representative image of a Giemsa stained placental section with bound NF54CSAh pRBCs. Tissue boundaries are indicated by white dashed lines. (D) Quantification of relative placental binding of NF54CSAh from three biological replicates. pRBCs bound per mm2 were normalized to the VAR2CSA negative NF54 ptefKO parasite line (n=3). (E) Spearman correlation of var gene expression profiles determined by RNA-seq for three bio-replicates each of NF54CSAh and the original, unselected NF54. (F) Differential gene expression between NF54CSAh and NF54 identified a limited number of significant genes (FDR <0.05, Log2 fold change >1) of which the majority were var genes (var2csa in blue, all other var genes in green). (G) Normalized read counts for all var genes revealed NF54 to be phenotypically highly heterogeneous whereas var2csa was the only var gene expressed by NF54CSAh.