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疟疾治疗的最新进展

Recent Advances in the Treatment of Malaria.

作者信息

Alghamdi Jawaher M, Al-Qahtani Arwa A, Alhamlan Fatimah S, Al-Qahtani Ahmed A

机构信息

Department of Zoology, College of Science, King Saud University, Riyadh 13242, Saudi Arabia.

Department of Family Medicine, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia.

出版信息

Pharmaceutics. 2024 Nov 4;16(11):1416. doi: 10.3390/pharmaceutics16111416.

Abstract

Malaria is still one of the major global health challenges affecting millions annually, particularly in non-Mediterranean Africa and Southeast Asia. Over the past two decades, substantial progress has been made in reducing malaria-related morbidity and mortality, primarily due to advancements in antimalarial therapeutics. This review provides a comprehensive overview of recent developments in malaria treatment, focusing on the evolution of drug therapies, mechanisms of action, and emerging resistance patterns. The cornerstone of current treatment strategies is artemisinin-based combination therapies (ACTs), which have proven highly effective against and , the most prevalent malaria-causing parasites. However, the onset of artemisinin resistance, particularly in Southeast Asian countries, poses a significant threat to these gains. Additionally, other antimalarial classes, including quinine derivatives, 8-aminoquinolines, and antifolate drugs, are examined for their efficacy, resistance mechanisms, and future potential. This review also discusses the challenges associated with drug resistance, the genetic underpinnings of resistance in malaria parasites, and the implications for future treatment protocols. Furthermore, the review examines combinational therapies, such as triple artemisinin combination therapies (TACTs), and vaccines that are approved or in development to circumvent resistance issues. The need for continuous surveillance, innovative therapeutic strategies, and advances in novel antimalarial therapeutic agents is emphasized to sustain and further progress in the control of malaria and its eventual eradication.

摘要

疟疾仍然是全球主要的健康挑战之一,每年影响数百万人,尤其是在非洲非地中海地区和东南亚。在过去二十年中,在降低疟疾相关的发病率和死亡率方面取得了重大进展,这主要归功于抗疟治疗方法的进步。本综述全面概述了疟疾治疗的最新进展,重点关注药物治疗的演变、作用机制和新出现的耐药模式。当前治疗策略的基石是以青蒿素为基础的联合疗法(ACTs),已证明其对最常见的致病疟原虫恶性疟原虫和间日疟原虫非常有效。然而,青蒿素耐药性的出现,尤其是在东南亚国家,对这些成果构成了重大威胁。此外,还研究了其他抗疟药物类别,包括奎宁衍生物、8-氨基喹啉和抗叶酸药物的疗效、耐药机制及未来潜力。本综述还讨论了与耐药性相关的挑战、疟原虫耐药性的遗传基础以及对未来治疗方案的影响。此外,该综述还研究了联合疗法,如三联青蒿素联合疗法(TACTs),以及已获批准或正在研发的用于规避耐药问题的疫苗。强调需要持续监测、创新治疗策略以及新型抗疟治疗药物的进展,以维持并进一步推进疟疾控制及最终根除工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d540/11597227/e995d21099ab/pharmaceutics-16-01416-g001.jpg

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