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抗疟药物青蒿素的耐药基因组学

Drug resistance genomics of the antimalarial drug artemisinin.

作者信息

Winzeler Elizabeth A, Manary Micah J

出版信息

Genome Biol. 2014 Nov 25;15(11):544. doi: 10.1186/s13059-014-0544-6.

Abstract

Across the globe, over 200 million annual malaria infections result in up to 660,000 deaths, 77% of which occur in children under the age of five years. Although prevention is important, malaria deaths are typically prevented by using antimalarial drugs that eliminate symptoms and clear parasites from the blood. Artemisinins are one of the few remaining compound classes that can be used to cure multidrug-resistant Plasmodium falciparum infections. Unfortunately, clinical trials from Southeast Asia are showing that artemisinin-based treatments are beginning to lose their effectiveness, adding renewed urgency to the search for the genetic determinants of parasite resistance to this important drug class. We review the genetic and genomic approaches that have led to an improved understanding of artemisinin resistance, including the identification of resistance-conferring mutations in the P. falciparum kelch13 gene.

摘要

在全球范围内,每年有超过2亿例疟疾感染,导致多达66万人死亡,其中77%发生在5岁以下儿童。虽然预防很重要,但疟疾死亡通常通过使用抗疟药物来预防,这些药物可以消除症状并清除血液中的寄生虫。青蒿素是为数不多的可用于治疗耐多药恶性疟原虫感染的化合物类别之一。不幸的是,来自东南亚的临床试验表明,以青蒿素为基础的治疗方法正开始失去效力,这使得寻找寄生虫对这一重要药物类别的耐药性遗传决定因素的工作更加紧迫。我们回顾了那些有助于更好地理解青蒿素耐药性的遗传和基因组方法,包括在恶性疟原虫kelch13基因中鉴定赋予耐药性的突变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5501/4283579/af4fa20604f6/13059_2014_544_Fig1_HTML.jpg

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