Re-evaluation of how artemisinins work in light of emerging evidence of in vitro resistance.

Re-evaluation of how artemisinins work in light of emerging evidence of in vitro resistance.
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DOI:
10.1016/j.molmed.2006.03.005
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发表时间:
2006-05
影响因子:
13.6
通讯作者:
Mercereau-Puijalon O
Mercereau-Puijalon O
中科院分区:
医学1区
文献类型:
--
作者:
Krishna S;Woodrow CJ;Staines HM;Haynes RK;Mercereau-Puijalon O

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每年有超过 5 亿例疟疾病例。现在,在大多数流行地区,青蒿素与其他抗疟药物的组合被推荐用于治疗恶性疟原虫疟疾。这些治疗方案可迅速缓解症状并实现治愈。关于青蒿素如何发挥作用以及对此类抗疟药产生耐药性的新迹象存在相当大的争议。除了青蒿素可能同时具有多个靶点的想法之外,还提出了几种单独的分子作为青蒿素的靶点。我们关于青蒿素抑制寄生虫编码的肌内质网 Ca2+-ATP酶 (SERCA) PfATP6 的观点得到了最近观察的支持,即编码 PfATP6 的基因的多态性与恶性疟原虫现场分离株对蒿甲醚的体外耐药性相关。
There are more than half a billion cases of malaria every year. Combinations of an artemisinin with other antimalarial drugs are now recommended treatments for Plasmodium falciparum malaria in most endemic areas. These treatment regimens act rapidly to relieve symptoms and effect cure. There is considerable controversy on how artemisinins work and over emerging indications of resistance to this class of antimalarial drugs. Several individual molecules have been proposed as targets for artemisinins, in addition to the idea that artemisinins might have many targets at the same time. Our suggestion that artemisinins inhibit the parasite-encoded sarco–endoplasmic reticulum Ca2+-ATPase (SERCA) PfATP6 has gained support from recent observations that a polymorphism in the gene encoding PfATP6 is associated with in vitro resistance to artemether in field isolates of P. falciparum.
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