Artemisinin resistance in Plasmodium falciparum: A process linked to dormancy?
Artemisinin resistance in Plasmodium falciparum: A process linked to dormancy?
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DOI：
10.1016/j.ijpddr.2012.01.001
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发表时间：
2012-12-01
影响因子：
4
通讯作者：
Gatton, Michelle L.
中科院分区：
文献类型：
--
作者：
Cheng, Qin;Kyle, Dennis E.;Gatton, Michelle L.
以青蒿素(ART)为基础的联合疗法(ACT)在100多个国家被用作治疗非复杂性恶性疟疾的一线药物，是这些地区疟疾控制和消除计划的基石。然而，尽管ART衍生物具有高效和快速的寄生虫杀灭作用，但与ART单一疗法相关的复发率很高，即使使用ACT，复发也并不少见。使这一问题变得更加复杂的是，有报道称，柬埔寨的一些寄生虫--已知的耐药疫源地--对抗逆转录病毒药物的体内敏感性降低。这引起了人们对田间抗逆转录病毒药物抗性发展的严重关注，尽管尚未在这些寄生虫中发现重大的表型和基因变化。在这篇文章中，我们回顾了有关ART的特性及其对恶性疟原虫的影响的现有数据，并提出了一个假说来解释与这类有效药物相关的高复发率以及目前围绕ART耐药性的谜团。(C)爱思唯尔有限公司出版的2012澳大利亚寄生虫学学会。保留所有权利。
Artemisinin (ART) based combination therapy (ACT) is used as the first line treatment of uncomplicated falciparum malaria in over 100 countries and is the cornerstone of malaria control and elimination programs in these areas. However, despite the high potency and rapid parasite killing action of ART derivatives there is a high rate of recrudescence associated with ART monotherapy and recrudescence is not uncommon even when ACT is used. Compounding this problem are reports that some parasites in Cambodia, a known foci of drug resistance, have decreased in vivo sensitivity to ART. This raises serious concerns for the development of ART resistance in the field even though no major phenotypic and genotypic changes have yet been identified in these parasites. In this article we review available data on the characteristics of ART, its effects on Plasmodium falciparum parasites and present a hypothesis to explain the high rate of recrudescence associated with this potent class of drugs and the current enigma surrounding ART resistance. (C) 2012 Australian Society for Parasitology Published by Elsevier Ltd. All rights reserved.