Sensitivity of Plasmodium falciparum to Antimalarial Drugs in Hainan Island, China
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Pyronaridine and artesunate have been shown to be effective in falciparum malaria treatment. However, pyronaridine is rarely used in Hainan Island clinically, and artesunate is not widely used as a therapeutic agent. Instead, conventional antimalarial drugs, chloroquine and piperaquine, are used, explaining the emergence of chloroquine-resistant Plasmodium falciparum. In this article, we investigated the sensitivity of P. falciparum to antimalarial drugs used in Hainan Island for rational drug therapy. We performed in vivo (28 days) and in vitro tests to determine the sensitivity of P. falciparum to antimalarial drugs. Total 46 patients with falciparum malaria were treated with dihydroartemisinin/piperaquine phosphate (DUO-COTECXIN) and followed up for 28 day. The cure rate was 97.8%. The mean fever clearance time (22.5±10.6 hr) and the mean parasite clearance time (27.3±12.2 hr) showed no statistical significance with different genders, ages, temperatures, or parasite density (P>0.05). The resistance rates of chloroquine, piperaquine, pyronarididine, and artesunate detected in vitro were 71.9%, 40.6%, 12.5%, and 0%, respectively (P<0.0001). The resistance intensities decreased as follows: chloroquine>piperaquine>pyronarididine>artesunate. The inhibitory dose 50 (IC50) was 3.77×10-6 mol/L, 2.09×10-6 mol/L, 0.09×10-6 mol/L, and 0.05×10-6 mol/L, and the mean concentrations for complete inhibition (CIMC) of schizont formation were 5.60×10-6 mol/L, 9.26×10-6 mol/L, 0.55×10-6 mol/L, and 0.07×10-6 mol/L, respectively. Dihydroartemisinin showed a strong therapeutic effect against falciparum malaria with a low toxicity.
Abstract
Pyronaridine and artesunate have been shown to be effective in falciparum malaria treatment. However, pyronaridine is rarely used in Hainan Island clinically, and artesunate is not widely used as a therapeutic agent. Instead, conventional antimalarial drugs, chloroquine and piperaquine, are used, explaining the emergence of chloroquine-resistant Plasmodium falciparum. In this article, we investigated the sensitivity of P. falciparum to antimalarial drugs used in Hainan Island for rational drug therapy. We performed in vivo (28 days) and in vitro tests to determine the sensitivity of P. falciparum to antimalarial drugs. Total 46 patients with falciparum malaria were treated with dihydroartemisinin/piperaquine phosphate (DUO-COTECXIN) and followed up for 28 day. The cure rate was 97.8%. The mean fever clearance time (22.5±10.6 hr) and the mean parasite clearance time (27.3±12.2 hr) showed no statistical significance with different genders, ages, temperatures, or parasite density (P>0.05). The resistance rates of chloroquine, piperaquine, pyronarididine, and artesunate detected in vitro were 71.9%, 40.6%, 12.5%, and 0%, respectively (P<0.0001). The resistance intensities decreased as follows: chloroquine>piperaquine>pyronarididine>artesunate. The inhibitory dose 50 (IC50) was 3.77×10-6 mol/L, 2.09×10-6 mol/L, 0.09×10-6 mol/L, and 0.05×10-6 mol/L, and the mean concentrations for complete inhibition (CIMC) of schizont formation were 5.60×10-6 mol/L, 9.26×10-6 mol/L, 0.55×10-6 mol/L, and 0.07×10-6 mol/L, respectively. Dihydroartemisinin showed a strong therapeutic effect against falciparum malaria with a low toxicity.
참고문헌 (25)
- Department of Endemic Disease, Ministry of Health, "Manual for malaria control. Beijing, China", pp.163~ (1988), People’s Medical Publishing House
- Waki S, "A field trial of a fluorometric in vitro drug sensitivity test for Plasmodium falciparum in Hainan Island", Trans R Soc Trop Med Hyg, 83, pp.165~166 (1989)
- Chen L, "Changes of prevalence of drug-resistant falciparum malaria in Hainan Province, China", Guangzhou Uni Trad Chin Med, 15, pp.35~38 (1998)
- Zhou MX, "Report of two chloroquine-resistant falciparum malaria cases in Hainan Island", Med J Chin PLA, 4, pp.125~ (1979)
- Xia ZG, "Malaria situation in the Peoples’ Republic of China in 2011", Chin J Parasitol Parasit Dis, 30, pp.419~422 (2012)
- World malaria report, "World Health Organization", WHO Press, 27~ (2013)
- Li XP, "Research progress in drug resistance of Plasmodium falciparum to artemisinin", Chin Trop Med, 8, pp.2250~2253 (2008)
- World Health Organization, "Call for ending using artemisinin alone in treatment of malaria by World Health Organization", Adv Drug Reaction J, 8, pp.152~ (2006)
- Lin SG, "Drug sensitivity test of Plasmodium falciparum to chloroquine, piperaquine, amodiaquine, mefloquine and quinine in vitro in Ledong county", Hainan Med J, 6, pp.71~72 (1995)
- Lin SG, "Test of Plasmodium falciparum to antimarials in vitro in Ledong county, Hainan province", China Trop Med, 5, pp.1707~1708 (2005)
- Bhumiratana A, "Border malaria associated with multidrug resistance on Thailand-Myanmar and Thailand-Cambodia borders: transmission dynamic, vulnerability, and surveillance", BioMed Res Int, 2013, pp.1~13 (2013)
- Rieckmann KH, "Drug sensitivity of Plasmodium falciparum. An in-vitro microtechnique", Lancet, 1, pp.22~23 (1978)
- Liu DQ, "Study on treatment of multi-drug resistant falciparum malaria by using a combination of dihydroartemisinin and pyronaridine", Chin J Parasitol Parasit Dis, 20, pp.193~196 (2002)
- Cai XZ, "Efficacy of artemisinin tablets in treatment of 108 falciparum malaria cases", Chin J Prev Treat Parasit Dis, 7, pp.175~178 (1994)
- Che LG, "Efficacy of dihydroartemisinin in treatment of falciparum malaria and vivax malaria", Chin J Parasitol Parasit Dis, 15, pp.119~ (1997)
- Wang SQ, "Therapeutic effect of dihydroartemisinin combined with naphthoquine phosphate in patients with falciparum malaria", Chin J Parasitol Parasit Dis, 20, pp.180~182 (2002)
- Cai XZ, "Preliminary study on the treatment of falciparum malaria with combined use of dihydroartemisinin and piperaquine", J Prac Parasit Dis, 7, pp.104~105 (1999)
- Liu D, "Change in chloroquine resistance of Plasmodium falciparum in Hainan province", Chin J Parasitol Parasit Dis, 17, pp.32~34 (1999)
- Dormoi J, "Improvement of the efficacy of dihydroartemisinin with atorvastatin in an experimental cerebral malaria murine model", Malaria J, 12, pp.302~ (2013)
- Liu D, "Changes in chloroquine resistance of Plamodium falciparum in Hainan province", Chin J Prasitol Parasit Dis, 17, pp.32~34 (1999)
- Zhang CL, "In vitro sensitivity of Plasmodium falciparum isolates from China-Myanmar border region to chloroquine, piperaquine and pyronaridine", Chin J Parasitol Parasit Dis, 30, pp.41~44 (2012)
- Wong RP, "In vitro sensitivity of Plasmodium falciparum to conventional and novel antimalarial drugs in Papua New Guinea", Trop Med Int Health, 15, pp.342~349 (2010)
- Leang R, "Therapeutic efficacy of fixed dose artesunate-mefloquine for the treatment of acute, uncomplicated Plasmodium falciparum malaria in Kampong Speu, Cambodia", Malaria J, 12, pp.343~ (2013)
- Xu XY, "Observation of Plasmodium vivax malaria on curative effect by chloroquine is combined with primaquine 4-days therapy", Hainan Med J, 5, pp.133~135 (1994)
- Huang ZS, "Comparative studies on the treatment of drug-resistant falciparum malaria with single-dose or two-day regimens of pyronaridine", sulfadoxine-pyrimethamine plus primaquine, 1996, pp.14, 314~317