Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Shandong Provincial Reference Laboratory for Malaria Diagnosis, Jining, 272033, China.
Sci Rep. 2018 Aug 28;8(1):12951. doi: 10.1038/s41598-018-31207-w.
Antimalarial drug resistance is a major public health problem in China. From 2012 to 2015, more than 75% of malaria cases in Shandong Province were P. falciparum returned from Africa. However, molecular marker polymorphisms of drug resistance in imported P. falciparum cases have not been evaluated. In this study, we analyzed polymorphisms of the Pfcrt, Pfmdr1, and Pfkelch13 genes in 282 P. falciparum cases returned from Africa to Shandong between 2012 and 2015. Among the isolates, polymorphisms were detected in codons 74-76 of Pfcrt and 86, 184, 1246 of Pfmdr1, among which K76T (36.6%) and Y184F (60.7%) were the most prevalent, respectively. Six Pfcrt haplotypes and 11 Pfmdr1 haplotypes were identified and a comparison was made on the prevalence of haplotypes among East Africa, West Africa, Central Africa and South Africa. One synonymous and 9 nonsynonymous mutations in Pfkelch13 were detected in the isolates (4.6%), among which a candidate artemisinin (ART) resistance mutation P553L was observed. The study establishes fundamental data for detection of chloroquine resistance (CQR) and ART resistance with molecular markers of the imported P. falciparum in China, and it also enriches the genetic data of antimalarial resistance for the malaria endemic countries in Africa.
抗疟药耐药性是中国的一个主要公共卫生问题。2012 年至 2015 年，山东省超过 75%的疟疾病例是从非洲返回的恶性疟原虫。然而，输入性恶性疟原虫病例的耐药性分子标记物多态性尚未得到评估。在本研究中，我们分析了 2012 年至 2015 年间从非洲返回山东的 282 例恶性疟原虫病例中 Pfcrt、Pfmdr1 和 Pfkelch13 基因的多态性。在这些分离株中，检测到 Pfcrt 基因 74-76 位密码子、Pfmdr1 基因 86、184、1246 位的多态性，其中 K76T（36.6%）和 Y184F（60.7%）最为常见。鉴定了 6 种 Pfcrt 单倍型和 11 种 Pfmdr1 单倍型，并比较了东非、西非、中非和南非分离株中各单倍型的流行情况。在这些分离株中检测到 Pfkelch13 中有 1 个同义突变和 9 个非同义突变（4.6%），其中观察到一个候选青蒿素（ART）耐药突变 P553L。该研究为在中国检测输入性恶性疟原虫的氯喹耐药（CQR）和 ART 耐药的分子标记物奠定了基础，也丰富了非洲疟疾流行国家的抗疟耐药遗传数据。
