Return of chloroquine sensitivity to Africa? Surveillance of African Plasmodium falciparum chloroquine resistance through malaria imported to China.
Return of chloroquine sensitivity to Africa? Surveillance of African Plasmodium falciparum chloroquine resistance through malaria imported to China.
复制标题
非洲又恢复对氯喹的敏感性？
DOI：
10.1186/s13071-017-2298-y
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发表时间：
2017-07-26
影响因子：
3.2
通讯作者：
Gao Q
中科院分区：
文献类型：
--
作者：
Lu F;Zhang M;Culleton RL;Xu S;Tang J;Zhou H;Zhu G;Gu Y;Zhang C;Liu Y;Wang W;Cao Y;Li J;He X;Cao J;Gao Q
近50年来，氯喹(CQ)一直是非洲抗疟疾治疗的基石，但由于耐药性的出现和蔓延，已被广泛停用。最近的报道表明，在停止使用CQ后，CQ敏感性可能会恢复。在这里，我们监测CQ敏感性并确定新近从非洲输入中国的恶性疟原虫分离株CQ抗性转运蛋白基因(Pfcrt)的遗传多态发生率。采自非洲各国返回中国的恶性疟疾患者的血样。使用SYBR Green I体外试验测试了分离物对CQ的敏感性，并在培养适应后对部分样品进行了体外测试。对pfcrt基因第72-76位和220位密码子的突变进行测序分析，并用聚合酶链式反应-限制性片段长度多态性方法进行验证。对pfcrt基因多态性与药物敏感性的相关性进行研究。在32株培养适应菌株中，敏感菌株17株(53.1%)，中抗菌株6株(18.8%)，高度抗性菌株9株(28.1%)。在体外，CQ易感性与pfcrt基因点突变有关，结果表明pfcrt基因与药物敏感性有很强的相关性。在pfcrt基因座上共检测到292株分离物，其中东部、南部、北部、西部和中部非洲分离株的CVMNK单倍型频率分别为91.4%、80.0%、73.3%、53.3%和51.7%。唯一观察到的突变单倍型是CVIET，这几乎总是与A220S的另一个突变有关。我们的结果表明，停用CQ作为一线药物后，药物压力的降低可能会导致CQ敏感寄生虫的死灰复燃。来自东非、南非和北非的野生型pfcrt CQ敏感寄生虫的流行率高于来自西部和中部地区的流行率，但各国之间的差异很大。需要进一步监测，以评估在没有广泛使用CQ的情况下，耐CQ寄生虫的流行率是否会继续下降。
Chloroquine (CQ) was the cornerstone of anti-malarial treatment in Africa for almost 50 years, but has been widely withdrawn due to the emergence and spread of resistance. Recent reports have suggested that CQ-susceptibility may return following the cessation of CQ usage. Here, we monitor CQ sensitivity and determine the prevalence of genetic polymorphisms in the CQ resistance transporter gene (pfcrt) of Plasmodium falciparum isolates recently imported from Africa to China. Blood samples were collected from falciparum malaria patients returning to China from various countries in Africa. Isolates were tested for their sensitivity to CQ using the SYBR Green I test ex vivo, and for a subset of samples, in vitro following culture adaptation. Mutations at positions 72–76 and codon 220 of the pfcrt gene were analyzed by sequencing and confirmed by PCR-RFLP. Correlations between drug sensitivity and pfcrt polymorphisms were investigated. Of 32 culture adapted isolates assayed, 17 (53.1%), 6 (18.8%) and 9 (28.1%) were classified as sensitive, moderately resistant, and highly resistant, respectively. In vitro CQ susceptibility was related to point mutations in the pfcrt gene, the results indicating a strong association between pfcrt genotype and drug sensitivity. A total of 292 isolates were typed at the pfcrt locus, and the prevalence of the wild type (CQ sensitive) haplotype CVMNK in isolates from East, South, North, West and Central Africa were 91.4%, 80.0%, 73.3%, 53.3% and 51.7%, respectively. The only mutant haplotype observed was CVIET, and this was almost always linked to an additional mutation at A220S. Our results suggest that a reduction in drug pressure following withdrawal of CQ as a first-line drug may lead to a resurgence in CQ sensitive parasites. The prevalence of wild-type pfcrt CQ sensitive parasites from East, South and North Africa was higher than from the West and Central areas, but this varied greatly between countries. Further surveillance is required to assess whether the prevalence of CQ resistant parasites will continue to decrease in the absence of widespread CQ usage.
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DOI：
10.4269/ajtmh.13-0129
发表时间：
2013-11
期刊：
The American journal of tropical medicine and hygiene
影响因子：
--
作者：
Flegg JA;Metcalf CJE;Gharbi M;Venkatesan M;Shewchuk T;Hopkins Sibley C;Guerin PJ
通讯作者：
Guerin PJ
影响因子：
2.6
作者：
Oladipo OO;Wellington OA;Sutherland CJ
通讯作者：
Sutherland CJ
影响因子：
6.4
作者：
Alam, Md Tauqeer;de Souza, Dziedzom K.;Koram, Kwadwo A.
通讯作者：
Koram, Kwadwo A.
影响因子：
3
作者：
Berzosa P;Esteban-Cantos A;García L;González V;Navarro M;Fernández T;Romay-Barja M;Herrador Z;Rubio JM;Ncogo P;Santana-Morales M;Valladares B;Riloha M;Benito A
通讯作者：
Benito A
影响因子：
16
作者：
Fidock, DA;Nomura, T;Wellems, TE
通讯作者：
Wellems, TE