Spread and evolution of Plasmodium falciparum drug resistance |
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| Authors: | Toshihiro Mita Kazuyuki Tanabe Kiyoshi Kita |
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| Institution: | aDepartment of International Affairs and Tropical Medicine, Tokyo Women's Medical University, School of Medicine, 9-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan;bLaboratory of Malariology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan;cDepartment of Biomedical Chemistry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan |
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| Abstract: | Worldwide spread of Plasmodium falciparum drug resistance to conventional antimalarials, chloroquine and sulfadoxine/pyrimethamine, has been imposing a serious public health problem in many endemic regions. Recent discovery of drug resistance-associated genes, pfcrt, pfmdr1, dhfr, and dhps, and applications of microsatellite markers flanking the genes have revealed the evolution of parasite resistance to these antimalarials and the geographical spread of drug resistance. Here, we review our recent knowledge of the evolution and spread of parasite resistance to chloroquine and sulfadoxine/pyrimethamine. In both antimalarials, resistance appears to be largely explained by the invasion of limited resistant lineages to many endemic regions. However, multiple, indigenous evolutionary origins of resistant lineages have also been demonstrated. Further molecular evolutionary and population genetic approaches will greatly facilitate our understanding of the evolution and spread of parasite drug resistance, and will contribute to developing strategies for better control of malaria. |
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| Keywords: | Malaria Drug resistance pfcrt dhfr Evolution Spread |
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