Department of Immunology and Medicine, US Army Medical Corps, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Malar J. 2012 Jun 13;11:198. doi: 10.1186/1475-2875-11-198.
In vitro drug susceptibility assay of Plasmodium falciparum field isolates processed "immediate ex vivo" (IEV), without culture adaption, and tested using histidine-rich protein-2 (HRP-2) detection as an assay, is an expedient way to track drug resistance.
From 2005 to 2010, a HRP-2 in vitro assay assessed 451 P. falciparum field isolates obtained from subjects with malaria in western and northern Cambodia, and eastern Thailand, processed IEV, for 50% inhibitory concentrations (IC50) against seven anti-malarial drugs, including artesunate (AS), dihydroartemisinin (DHA), and piperaquine.
In western Cambodia, from 2006 to 2010, geometric mean (GM) IC50 values for chloroquine, mefloquine, quinine, AS, DHA, and lumefantrine increased. In northern Cambodia, from 2009-2010, GM IC50 values for most drugs approximated the highest western Cambodia GM IC50 values in 2009 or 2010.
Western Cambodia is associated with sustained reductions in anti-malarial drug susceptibility, including the artemisinins, with possible emergence, or spread, to northern Cambodia. This potential public health crisis supports continued in vitro drug IC50 monitoring of P. falciparum isolates at key locations in the region.
体外药物敏感性检测疟原虫现场分离株处理“即时现场”（IEV），无培养适应，并用作为检测的富含组氨酸蛋白-2（HRP-2）检测，是跟踪耐药性的一种权宜之计。
从 2005 年到 2010 年，HRP-2 体外检测评估了从柬埔寨西部和北部以及泰国东部疟疾患者中获得的 451 株疟原虫现场分离株，处理 IEV，以评估对 7 种抗疟药物的 50%抑制浓度（IC50），包括青蒿琥酯（AS）、双氢青蒿素（DHA）和哌喹。
在柬埔寨西部，2006 年至 2010 年，氯喹、甲氟喹、奎宁、AS、DHA 和青蒿素的几何平均（GM）IC50 值增加。在柬埔寨北部，2009 年至 2010 年，大多数药物的 GM IC50 值接近 2009 年或 2010 年柬埔寨西部的最高 GM IC50 值。
柬埔寨西部与抗疟药物敏感性的持续下降有关，包括青蒿素类药物，可能出现或传播到柬埔寨北部。这种潜在的公共卫生危机支持在该地区的关键地点继续对疟原虫分离株进行体外药物 IC50 监测。
