McCall Matthew B B, Beynon Andy J, Mylanus Emmanuel A M, van der Ven Andre J A M, Sauerwein Robert W
Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, 6500 HB, Nijmegen, The Netherlands.
Trans R Soc Trop Med Hyg. 2006 Dec;100(12):1098-104. doi: 10.1016/j.trstmh.2006.02.017. Epub 2006 Jun 30.
Artemisinin derivatives are becoming the first-line treatment for uncomplicated malaria in areas with widespread resistance to chloroquine. Although generally safe and well tolerated, it has been suggested from animal experiments, and more recently from one human study with artemether-lumefantrine, that these compounds are potentially neurotoxic, affecting particularly the brainstem auditory pathways. We report here the auditory analyses of 15 volunteers who underwent an experimental human malaria infection and were treated with artemether-lumefantrine. The subjects underwent audiological examination before the start of the study, during infection, and after treatment. Examination included standard tone audiometry, high frequency tone audiometry and auditory brainstem response (ABR). No effects on hearing loss that were deemed to be caused by drug treatment were found using tone audiometry. ABR analysis similarly failed to demonstrate any auditory pathway damage in the volunteers after treatment. We have thus not found any clear evidence of a detrimental effect on the auditory system by artemether-lumefantrine treatment in uncomplicated malaria. Our results support the continued implementation of artemisinin derivatives in the fight against drug-resistant malaria.
在对氯喹广泛耐药的地区，青蒿素衍生物正成为治疗非复杂性疟疾的一线药物。尽管这些药物总体上安全且耐受性良好，但动物实验以及最近一项针对蒿甲醚-本芴醇的人体研究表明，这些化合物可能具有神经毒性，尤其会影响脑干听觉通路。我们在此报告了15名志愿者的听觉分析结果，这些志愿者经历了实验性人体疟疾感染并接受了蒿甲醚-本芴醇治疗。受试者在研究开始前、感染期间和治疗后均接受了听力学检查。检查包括标准纯音听力测定、高频纯音听力测定和听觉脑干反应（ABR）。使用纯音听力测定未发现被认为是由药物治疗导致的听力损失影响。ABR分析同样未能证明治疗后志愿者的任何听觉通路受损。因此，我们未发现有明确证据表明蒿甲醚-本芴醇治疗非复杂性疟疾会对听觉系统产生有害影响。我们的结果支持在抗击耐药性疟疾中继续使用青蒿素衍生物。
