Tafenoquine: A Step toward Malaria Elimination.

Tafenoquine: A Step toward Malaria Elimination.
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DOI:
10.1021/acs.biochem.9b01105
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发表时间:
2020-03-03
期刊:
影响因子:
2.9
通讯作者:
Derbyshire ER
Derbyshire ER
中科院分区:
生物学3区
文献类型:
--
作者:
Lu KY;Derbyshire ER

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迫切需要具有广谱活性的化合物来对抗各个生命周期阶段的疟疾寄生虫,以实现消灭疟疾的目标。然而,如果不针对在第一次发病后导致多次复发的顽强休眠的肝脏阶段催眠子,这个目标就无法实现。在寻找从根本上治愈间日疟原虫疟疾的灵丹妙药时,他非诺喹的表现优于其他候选药物,并于2018年获得美国食品和药物管理局的批准。他非诺喹是一种8-氨基喹啉,可抑制多种疟原虫物种的多个生命阶段。此外,其半衰期更长,允许单剂量治疗,这将提高依从率。尽管它的批准和其他8-氨基喹啉的长期使用,他非诺喹的活性和不良反应背后的机制仍然是未知的。在这个角度来看,我们讨论了他非诺喹的抗寄生虫活性的合理的潜在机制,并强调其作为细胞应激源的作用。我们还讨论了潜在的药物组合和下一代8-氨基喹啉的开发,以进一步提高他非诺喹用于疟疾治疗和预防的治疗指数。
There is a pressing need for compounds with broad-spectrum activity against malaria parasites at various life cycle stages to achieve malaria elimination. However, this goal cannot be accomplished without targeting the tenacious dormant liver-stage hypnozoite that causes multiple relapses after the first episode of illness. In the search for the magic bullet to radically cure Plasmodium vivax malaria, tafenoquine outperformed other candidate drugs and was approved by the U.S. Food and Drug Administration in 2018. Tafenoquine is an 8-aminoquinoline that inhibits multiple life stages of various Plasmodium species. Additionally, its much longer half-life allows for single-dose treatment, which will improve the compliance rate. Despite its approval and the long-time use of other 8-aminoquinolines, the mechanisms behind tafenoquine’s activity and adverse effects are still largely unknown. In this Perspective, we discuss the plausible underlying mechanisms of tafenoquine’s antiparasitic activity and highlight its role as a cellular stressor. We also discuss potential drug combinations and the development of next-generation 8-aminoquinolines to further improve the therapeutic index of tafenoquine for malaria treatment and prevention.
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