Anaplasma phagocytophilum is an obligate intracellular bacterium that invades neutrophils to cause the emerging infectious disease human granulocytic anaplasmosis. A. phagocytophilum undergoes a biphasic developmental cycle, transitioning between an infectious dense-cored cell (DC) and a noninfectious reticulate cell (RC). To gain insights into the organism's biology and pathogenesis during human myeloid cell infection, we conducted proteomic analyses on A. phagocytophilum organisms purified from HL-60 cells. A total of 324 proteins were unambiguously identified, thereby verifying 23.7% of the predicted A. phagocytophilum proteome. Fifty-three identified proteins had been previously annotated as hypothetical or conserved hypothetical. The second most abundant gene product, after the well-studied major surface protein 2 (P44), was the hitherto hypothetical protein APH_1235. APH_1235 homologs are found in other Anaplasma and Ehrlichia species but not in other bacteria. The aph_1235 RNA level is increased 70-fold in the DC form relative to that in the RC form. Transcriptional upregulation of and our ability to detect APH_1235 correlate with RC to DC transition, DC exit from host cells, and subsequent DC binding and entry during the next round of infection. Immunoelectron microscopy pronouncedly detects APH_1235 on DC organisms, while detection on RC bacteria minimally, at best, exceeds background. This work represents an extensive study of the A. phagocytophilum proteome, discerns the complement of proteins that is generated during survival within human myeloid cells, and identifies APH_1235 as the first known protein that is pronouncedly upregulated on the infectious DC form.Human granulocytic anaplasmosis (HGA) is an emerging and potentially deadly tick-borne disease (44,53). HGA is an acute febrile illness, the clinical manifestations of which range from subclinical infection to severe disease, including death. Nonspecific symptoms include fever, chills, headache, malaise, and myalgia. Severe complications include prolonged fever, shock, leukopenia, thrombocytopenia, high levels of C-reactive protein and hepatic transaminases, pneumonitis, acute renal failure, and hemorrhages. Immunocompromised and elderly individuals are at greatest risk for fatal opportunistic infections that can be associated with HGA (53). The causative agent of HGA is Anaplasma phagocytophilum, an obligate intracellular bacterium that displays an unusual tropism for granulocytes in humans and several domestic and wild reservoir animal hosts. The annotated genome of the A. phagocytophilum HZ strain, a human isolate, is available (20). The bacterium can be cultivated in the promyelocytic cell line , as well as other cell lines (15,18,37,53), which enables it to be grown in large quantities and has permitted in vitro modeling of infection.Following cellular adhesion, A. phagocytophilum promotes its own uptake into a host cell-derived vacuole that it remodels into a protective safe haven in which it remains and replicates (44,53).A. phagocytoph...