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Antimalarial Multi-Drug Resistance in Asia: Mechanisms and Assessment

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Book cover Malaria: Drugs, Disease and Post-genomic Biology

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 295))

Abstract

The emergence and spread of drug-resistant parasites poses a major problem for management of Plasmodium falciparum malaria in endemic areas. Nowhere is this more apparent than in southeast Asia, where multi-drug resistance to chloroquine and sulfadoxine-pyrimethamine was exacerbated when mefloquine monotherapy began failing in the 1980s. A better understanding of mechanisms of (multi-) drug resistance is urgently warranted to monitor and guide antimalarial chemotherapy regimens more efficiently. Here we review recent advances on identification of molecular markers that can be employed in predicting in vitro and in vivo resistance in southeast Asia. Examples include amplification of PfMDR1 (P. falciparum multi-drug resistant gene 1) and mefloquine, K76T PfCRT and chloroquine, as well as mutations in the dihydroperoate synthase and dihydrofolate reductase genes and the antifolate class of drugs.

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  1. Devision of Cellular and Molecular Medicine, Centre for Infection, St. George’s University of London, Cranmer Terrace, London, SW17 0RE, UK

    A.-C. Uhlemann & S. Krishna

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  1. A.-C. Uhlemann
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  2. S. Krishna
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Editors and Affiliations

  1. Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, The Johns Hopkins University, 615 North Wolfe Street, E5628, Baltimore, MD, 21205, USA

    David J. Sullivan M.D.

  2. Department of Cellular and Molecular Medicine, Infectious Diseases Group, St. George’s Hospital Medical School, Cranmer Terrace, London, SW17 ORE, UK

    Sanjeev Krishna D. Phil, F.R.C.P., F. MED. Sci.

  3. Atlanta, Georgia

    R. W. Compans

  4. Birmingham, Alabama

    M. D. Cooper

  5. Kyoto

    T. Honjo

  6. Philadelphia, Pennsylvania

    H. Koprowski

  7. Basel

    F. Melchers

  8. La Jolla, California

    M. B. A. Oldstone

  9. Oslo

    S. Olsnes

  10. Bethesda, Maryland

    M. Potter

  11. La Jolla, California

    P. K. Vogt

  12. Munich

    H. Wagner

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Uhlemann, AC., Krishna, S. (2005). Antimalarial Multi-Drug Resistance in Asia: Mechanisms and Assessment. In: Compans, R.W., et al. Malaria: Drugs, Disease and Post-genomic Biology. Current Topics in Microbiology and Immunology, vol 295. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29088-5_2

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