在苏丹中部的杰济拉州和东部的加达里夫州，从疟原虫分离株中抗疟药物耐药等位基因的频率分布。
Frequency distribution of antimalarial drug resistance alleles among Plasmodium falciparum isolates from Gezira State, central Sudan, and Gedarif State, eastern Sudan.
机构信息
Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
出版信息
Am J Trop Med Hyg. 2010 Aug;83(2):250-7. doi: 10.4269/ajtmh.2010.09-0514.
Abstract
In 2004, Sudan adopted artesunate + sulfadoxine/pyrimethamine (SP) combination as the first-line drug, in response to the high level of falciparum resistance to antimalarials. In 2007, a molecular study on antimalarial resistance linked genes, pfcrt, pfmdr1, pfdhfr, pfdhps, and pfATPase6, was conducted on 198 isolates from central and eastern Sudan. We observed a high frequency of point mutations at almost all loci analyzed, mainly of pfcrt 76T (72.7%), pfdhfr 51I (75.3%), and pfdhfr 108N (72.7%) alleles. The MARK III in vitro test for chloroquine sensitivity in 45 P. falciparum isolates showed that 37.8% of the isolates were low resistant and 6.7% were fully resistant. This study represents the most recent molecular investigation on antimalarial resistance in this area after the adoption of artemisinin-based combination therapy (ACT), and underlines the importance of the analysis of SP resistance evolution to monitor the efficacy of ACT therapy in endemic areas.
摘要
2004 年，苏丹采用青蒿琥酯+磺胺多辛/乙胺嘧啶（SP）组合作为一线药物，以应对恶性疟原虫对抗疟药物的高度耐药性。2007 年，对来自苏丹中部和东部的 198 个分离株进行了抗疟药耐药相关基因（pfcrt、pfmdr1、pfdhfr、pfdhps 和 pfATPase6）的分子研究。我们观察到在几乎所有分析的基因座上都存在高频点突变，主要是 pfcrt 76T（72.7%）、pfdhfr 51I（75.3%）和 pfdhfr 108N（72.7%）等位基因。对 45 株疟原虫分离株进行的氯喹敏感性 MARK III 体外试验表明，37.8%的分离株具有低度耐药性，6.7%的分离株具有完全耐药性。这项研究是在采用青蒿素为基础的联合疗法（ACT）后，对该地区抗疟药耐药性进行的最新分子调查，强调了分析 SP 耐药性演变以监测流行地区 ACT 治疗效果的重要性。
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