Prolonged Selection of pfmdr1 Polymorphisms After Treatment of Falciparum Malaria With Artemether-Lumefantrine in Uganda
Prolonged Selection of pfmdr1 Polymorphisms After Treatment of Falciparum Malaria With Artemether-Lumefantrine in Uganda
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DOI：
10.1093/infdis/jir486
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发表时间：
2011-10-01
影响因子：
6.4
通讯作者：
Rosenthal, Philip J.
中科院分区：
文献类型：
--
作者：
Baliraine, Frederick N.;Rosenthal, Philip J.
我们在乌干达儿童纵向队列中比较了治疗前恶性疟原虫寄生虫分离株和单纯性疟疾治疗后出现的寄生虫之间关键pfmdr1等位基因的患病率。pfmdr 1 86 N、184 F和1246 D等位基因在蒿甲醚-苯芴醇治疗后被选择，但在青蒿琥酯-阿莫地喹或阿莫地喹-磺胺嘧啶-乙胺嘧啶治疗后未被选择。值得注意的是，选择持续存在于蒿甲醚-苯芴醇治疗后约60天的感染中。因此，选择降低药物敏感性的寄生虫可能在预期的抗疟药物暴露后很长时间才出现。有必要继续监测新联合治疗的临床疗效和体外活性。
We compared the prevalence of key pfmdr1 alleles between pretreatment Plasmodium falciparum parasite isolates and parasites that emerged after treatment of uncomplicated malaria in a longitudinal cohort of Ugandan children. The pfmdr1 86N, 184F, and 1246D alleles were selected after treatment with artemether-lumefantrine, but not after artesunate-amodiaquine or amodiaquine-sulfadoxine-pyrimethamine. Remarkably, selection persisted in infections presenting up to about 60 days after treatment with artemether-lumefantrine. Thus, parasites selected for decreased drug sensitivity can appear long after predicted exposure to antimalarial drugs. Continued surveillance of the clinical efficacy and in vitro activity of new combination therapies is warranted.