Origin and dissemination of Plasmodium falciparum drug-resistance mutations in South America
Origin and dissemination of Plasmodium falciparum drug-resistance mutations in South America
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DOI：
10.1086/342946
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发表时间：
2002-10-01
影响因子：
6.4
通讯作者：
Plowe, CV
中科院分区：
文献类型：
--
作者：
Cortese, JF;Caraballo, A;Plowe, CV
多药耐药性是控制恶性疟原虫疟疾的一个主要障碍，人们对其起源和传播方式的了解也不完全。在这项研究中，来自南美洲亚马逊河流域5个地区的疟疾单倍型和微卫星分析支持这样的结论，即赋予抗叶酸剂组合磺胺嘧啶-乙胺嘧啶的中等和高水平抗性的寄生虫突变具有共同的起源。寄生虫窝藏这些突变也被发现共享耐药等位基因，赋予一个独特的氯喹耐药表型，并在不与耐药基因座相似，虽然不是遗传上相同。自20世纪80年代以来，耐多药恶性疟原虫以西北偏北的方式在整个非洲大陆传播，起源可能在亚马逊河下游。这项研究强调了整个大陆疟疾控制政策的重要性，并表明遏制对下一代疗法的耐药性可能是可行的。
Multidrug resistance is a major obstacle to the control of Plasmodium falciparum malaria, and its origins and modes of dissemination are imperfectly understood. In this study, haplotyping and microsatellite analysis of malaria from 5 regions of the South American Amazon support the conclusion that the parasite mutations conferring mid- and high-level resistance to the antifolate combination sulfadoxine-pyrimethamine have a common origin. Parasites harboring these mutations are also found to share drug-resistance alleles that confer a unique chloroquine resistance phenotype and to be similar at loci not linked to drug resistance, although not genetically identical. Since the 1980s, multidrug-resistant P. falciparum has spread in a north-northwest manner across the continent, from an origin likely in the lower Amazon. This study highlights the importance of continent-wide malaria-control policies and suggests that the containment of resistance to the next generation of therapies may be feasible.