Peters W
London School of Hygiene and Tropical Medicine, Winches Farm Laboratories, St. Albans, Herts, England.
Ann Parasitol Hum Comp. 1990;65 Suppl 1:103-6. doi: 10.1051/parasite/1990651103.
Quinine-resistant Plasmodium falciparum was first reported in 1910 from Brazil. Today this parasite is resistant in most endemic areas to the widely used blood schizonticide, chloroquine. Many strains are resistant also to antifols (e.g. pyrimethamine, proguanil) and some are also no longer eliminated by quinine. These polyresistant parasites have an enhanced ability to resist also new drugs such as mefloquine and halofantrine. There are indications that P. vivax is also becoming resistant to chloroquine in Papua-New Guinea where primaquine resistance of the hypnozoites also exists. The modes of action of antimalarials and mechanisms by which parasites become resistant to them are discussed. Future developments include the search for radically new compounds, for drugs that reverse chloroquine resistance and for new strategies to impede the progress of this problem.
1910年首次在巴西报道了对奎宁耐药的恶性疟原虫。如今，在大多数疟疾流行地区，这种寄生虫对广泛使用的血液裂殖体杀灭剂氯喹具有耐药性。许多菌株对抗叶酸药物（如乙胺嘧啶、氯胍）也有耐药性，一些菌株对奎宁也不再敏感。这些多重耐药寄生虫对甲氟喹和卤泛群等新药的耐药能力也有所增强。有迹象表明，在巴布亚新几内亚，间日疟原虫对氯喹也产生了耐药性，并且存在对伯氨喹耐药的休眠子。本文讨论了抗疟药的作用方式以及寄生虫对其产生耐药性的机制。未来的发展方向包括寻找全新的化合物、能够逆转氯喹耐药性的药物以及阻止这一问题进一步发展的新策略。
