Artemisinin Antimalarials: Preserving the "Magic Bullet".
Artemisinin Antimalarials: Preserving the "Magic Bullet".
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DOI：
10.1002/ddr.20344
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发表时间：
2010-02
影响因子：
3.8
通讯作者：
White, Lisa J.
中科院分区：
文献类型：
--
作者：
Maude, Richard J.;Woodrow, Charles J.;White, Lisa J.
青蒿素是已知的最有效的抗疟疾药物。它们具有非常广泛的治疗指数。这些药物已经在传统的中草药中使用了2,000多年，但直到20世纪70年代才受到科学审查。青蒿素的第一次正式临床试验和工业规模生产方法的开发也很快进行。十年后，中国科学家与世界其他国家分享了他们的发现;从那时起，大量国际试验证据证实这些药物远远上级任何可用的替代品。特别是，它们能够在安全浓度下快速杀死广泛的无性寄生虫阶段，这些浓度通过标准给药方案始终可以实现。由于它们的半衰期很短，因此也被认为耐药性风险很低。这些发现与对所有其他主要抗疟药物的耐药性的出现和传播相吻合。因此，青蒿素现已成为全世界推荐的一线抗疟治疗方案的一个基本要素。为了尽量减少青蒿素耐药性的风险，建议将其作为青蒿素综合疗法与其他抗疟药物联合用于治疗无并发症的疟疾。这些方案的推出已使一些非洲和亚洲国家的疟疾流行率降低，这是有据可查的。不幸的是，柬埔寨西部已经出现了令人担忧的青蒿素耐药性的早期迹象。如果这种耐药性扩散，对全世界的疟疾控制工作将是灾难性的。国际社会面临的巨大挑战是如何避免这一灾难，保持这一抗疟“灵丹妙药”的效力。药物开发研究71：12-19，2010年。© 2009 Wiley-Liss公司。
The artemisinins are the most effective antimalarial drugs known. They possess a remarkably wide therapeutic index. These agents have been used in traditional Chinese herbal medicine for more than 2,000 years but were not subjected to scientific scrutiny until the 1970s. The first formal clinical trials of the artemisinins, and the development of methods for their industrial scale production, followed rapidly. A decade later, Chinese scientists shared their findings with the rest of the world; since then, a significant body of international trial evidence has confirmed these drugs to be far superior to any available alternatives. In particular, they have the ability to rapidly kill a broad range of asexual parasite stages at safe concentrations that are consistently achievable via standard dosing regimens. As their half-life is very short, there was also thought to be a low risk of resistance. These discoveries coincided with the appearance and spread of resistance to all the other major classes of antimalarials. As a result, the artemisinins now form an essential element of recommended first-line antimalarial treatment regimens worldwide. To minimize the risk of artemisinin resistance, they are recommended to be used to treat uncomplicated malaria in combination with other antimalarials as artemisinin combination therapies (ACTs). Their rollout has resulted in documented reductions in malaria prevalence in a number of African and Asian countries. Unfortunately, there are already worrisome early signs of artemisinin resistance appearing in western Cambodia. If this resistance were to spread, it would be disastrous for malaria control efforts worldwide. The enormous challenge for the international community is how to avert this catastrophe and preserve the effectiveness of this antimalarial “magic bullet”. Drug Dev Res 71: 12–19, 2010. © 2009 Wiley-Liss, Inc.
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影响因子：
3.3
作者：
Dondorp, AM;Newton, PN;White, NJ
通讯作者：
White, NJ
影响因子：
168.9
作者：
Mutabingwa, TK;Anthony, D;Whitty, CJM
通讯作者：
Whitty, CJM
影响因子：
56.9
作者：
KLAYMAN, DL
通讯作者：
KLAYMAN, DL
DOI：
10.1016/j.trstmh.2004.11.010
发表时间：
2005-07-01
影响因子：
2.2
作者：
Guthmann, JP;Ampuero, J;Legros, D
通讯作者：
Legros, D
影响因子：
3
作者：
Maude RJ;Pontavornpinyo W;Saralamba S;Aguas R;Yeung S;Dondorp AM;Day NP;White NJ;White LJ
通讯作者：
White LJ