Exploring the contribution of candidate genes to artemisinin resistance in Plasmodium falciparum

Antimicrob Agents Chemother. 2010 Jul;54(7):2886-92. doi: 10.1128/AAC.00032-10. Epub 2010 Apr 26.

Abstract

The reduced in vivo sensitivity of Plasmodium falciparum has recently been confirmed in western Cambodia. Identifying molecular markers for artemisinin resistance is essential for monitoring the spread of the resistant phenotype and identifying the mechanisms of resistance. Four candidate genes, including the P. falciparum mdr1 (pfmdr1) gene, the P. falciparum ATPase6 (pfATPase6) gene, the 6-kb mitochondrial genome, and ubp-1, encoding a deubiquitinating enzyme, of artemisinin-resistant P. falciparum strains from western Cambodia were examined and compared to those of sensitive strains from northwestern Thailand, where the artemisinins are still very effective. The artemisinin-resistant phenotype did not correlate with pfmdr1 amplification or mutations (full-length sequencing), mutations in pfATPase6 (full-length sequencing) or the 6-kb mitochondrial genome (full-length sequencing), or ubp-1 mutations at positions 739 and 770. The P. falciparum CRT K76T mutation was present in all isolates from both study sites. The pfmdr1 copy numbers in western Cambodia were significantly lower in parasite samples obtained in 2007 than in those obtained in 2005, coinciding with a local change in drug policy replacing artesunate-mefloquine with dihydroartemisinin-piperaquine. Artemisinin resistance in western Cambodia is not linked to candidate genes, as was suggested by earlier studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Infective Agents / pharmacology*
  • Artemisinins / pharmacology*
  • Calcium-Transporting ATPases / genetics
  • Calcium-Transporting ATPases / metabolism
  • Drug Resistance / genetics*
  • Models, Biological
  • Multidrug Resistance-Associated Proteins / genetics
  • Multidrug Resistance-Associated Proteins / metabolism
  • Plasmodium falciparum / drug effects*
  • Plasmodium falciparum / genetics*
  • Polymerase Chain Reaction
  • Protozoan Proteins / genetics
  • Protozoan Proteins / metabolism

Substances

  • ATP6 protein, Plasmodium falciparum
  • Anti-Infective Agents
  • Artemisinins
  • Mdr1 protein, Plasmodium falciparum
  • Multidrug Resistance-Associated Proteins
  • Protozoan Proteins
  • artemisinin
  • Calcium-Transporting ATPases