Molecular assays for antimalarial drug resistance surveillance: A target product profile.
Molecular assays for antimalarial drug resistance surveillance: A target product profile.
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DOI：
10.1371/journal.pone.0204347
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Gonzalez IJ
中科院分区：
文献类型：
--
作者：
Nsanzabana C;Ariey F;Beck HP;Ding XC;Kamau E;Krishna S;Legrand E;Lucchi N;Miotto O;Nag S;Noedl H;Roper C;Rosenthal PJ;Schallig HDFH;Taylor SM;Volkman SK;Gonzalez IJ
抗疟药物耐药性是控制和消除疟疾努力的主要制约因素。以青蒿素为基础的联合疗法现在是疟疾治疗的主要方法。然而，使用青蒿素衍生物治疗后出现的寄生虫清除延迟现象现已在大湄公河次区域蔓延，并可能出现或蔓延到其他疟疾流行地区。这种传播引起疟疾控制规划的极大关注，因为预计在不久的将来不会有以青蒿素为基础的联合疗法的替代品。有必要加强监测系统，以便及早发现和应对抗疟药耐药性威胁。目前的监测主要是通过疗效研究完成的；然而，这些研究是复杂的，既费时又耗费资源。对于多种常见抗疟药，寄生虫耐药性与特定基因突变相关，与抗疟药耐药性相关的分子标记为监测耐药寄生虫的出现和传播提供了一种简单而有力的工具。目前有不同的技术来分析与抗疟药耐药性相关的分子标记，每种技术都有其优点和缺点。但是，没有适当地统一程序，以便于各场址之间的比较。在这里，我们描述了用于分析与抗疟药物耐药性相关的分子标记的测试的目标产品概况，讨论了如何使现有技术的使用标准化，并确定了理想产品的要求，使疟疾流行国家能够提供有关耐药性传播的有用空间和时间信息。
Antimalarial drug resistance is a major constraint for malaria control and elimination efforts. Artemisinin-based combination therapy is now the mainstay for malaria treatment. However, delayed parasite clearance following treatment with artemisinin derivatives has now spread in the Greater Mekong Sub region and may emerge or spread to other malaria endemic regions. This spread is of great concern for malaria control programmes, as no alternatives to artemisinin-based combination therapies are expected to be available in the near future. There is a need to strengthen surveillance systems for early detection and response to the antimalarial drug resistance threat. Current surveillance is mainly done through therapeutic efficacy studies; however these studies are complex and both time- and resource-intensive. For multiple common antimalarials, parasite drug resistance has been correlated with specific genetic mutations, and the molecular markers associated with antimalarial drug resistance offer a simple and powerful tool to monitor the emergence and spread of resistant parasites. Different techniques to analyse molecular markers associated with antimalarial drug resistance are available, each with advantages and disadvantages. However, procedures are not adequately harmonized to facilitate comparisons between sites. Here we describe the target product profiles for tests to analyse molecular markers associated with antimalarial drug resistance, discuss how use of current techniques can be standardised, and identify the requirements for an ideal product that would allow malaria endemic countries to provide useful spatial and temporal information on the spread of resistance.
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DOI：
10.1016/s1473-3099(15)00487-9
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