Drug Resistance and in Vitro Susceptibility of Plasmodium falciparum in Thailand during 1988-2003
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The aim of the present study was to investigate antimalarial drug pressure resulting from the clinical use of different antimalarials in Thailand. The phenotypic diversity of the susceptibility profiles of antimalarials, i.e., chloroquine (CQ), quinine (QN), mefloquine (MQ), and artesunate (ARS) in Plasmodium falciparum isolates collected during the period from 1988 to 2003 were studied. P. falciparum isolates from infected patients were collected from the Thai-Cambodian border area at different time periods (1988-1989, 1991-1992, and 2003), during which 3 different patterns of drug use had been implemented: MQ + sulphadoxine (S) + pyrimethamine (P), MQ alone and MQ + ARS, respectively. The in vitro drug susceptibilities were investigated using a method based on the incorporation of [3H] hypoxanthine. A total of 50 isolates were tested for susceptibilities to CQ, QN, MQ, and ARS. Of these isolates, 19, 16, and 15 were adapted during the periods 1988-1989, 1991-1993, and 2003, respectively. P. falciparum isolates collected during the 3 periods were resistant to CQ. Sensitivities to MQ declined from 1988 to 2003. In contrast, the parasite was sensitive to QN, and similar sensitivity profile patterns were observed during the 3 time periods. There was a significantly positive but weak correlation between the IC50 values of CQ and QN, as well as between the IC50 values of QN and MQ. Drug pressure has impact on sensitivity of P. falciparum to MQ. A combination therapy of MQ and ARS is being applied to reduce the parasite resistance, and also increasing the efficacy of the drug.
Abstract
The aim of the present study was to investigate antimalarial drug pressure resulting from the clinical use of different antimalarials in Thailand. The phenotypic diversity of the susceptibility profiles of antimalarials, i.e., chloroquine (CQ), quinine (QN), mefloquine (MQ), and artesunate (ARS) in Plasmodium falciparum isolates collected during the period from 1988 to 2003 were studied. P. falciparum isolates from infected patients were collected from the Thai-Cambodian border area at different time periods (1988-1989, 1991-1992, and 2003), during which 3 different patterns of drug use had been implemented: MQ + sulphadoxine (S) + pyrimethamine (P), MQ alone and MQ + ARS, respectively. The in vitro drug susceptibilities were investigated using a method based on the incorporation of [3H] hypoxanthine. A total of 50 isolates were tested for susceptibilities to CQ, QN, MQ, and ARS. Of these isolates, 19, 16, and 15 were adapted during the periods 1988-1989, 1991-1993, and 2003, respectively. P. falciparum isolates collected during the 3 periods were resistant to CQ. Sensitivities to MQ declined from 1988 to 2003. In contrast, the parasite was sensitive to QN, and similar sensitivity profile patterns were observed during the 3 time periods. There was a significantly positive but weak correlation between the IC50 values of CQ and QN, as well as between the IC50 values of QN and MQ. Drug pressure has impact on sensitivity of P. falciparum to MQ. A combination therapy of MQ and ARS is being applied to reduce the parasite resistance, and also increasing the efficacy of the drug.
참고문헌 (19)
- Harinasuta T, "Chloroquine-resistant falciparum malaria in Thailand", Lancet, 2, pp.657~660 (1965)
- Wongsrichanalai C, "Epidemiology of drug-resistant malaria", Lancet Infect Dis, 2, pp.209~218 (2002)
- Escalante AA, "Assessing the effect of natural selection in malaria parasites", Trends Parasitol, 20, pp.388~395 (2004)
- Trager W, "Human malaria parasites in continuous culture", Science, 193, pp.673~675 (1976)
- Desjardins RE, "Quantitative assessment of antimalarial activity in vitro by a semiautomated microdilution technique", Antimicrob Agents Chemother, 16, pp.710~718 (1976)
- Cerutti Jr C, "Antimalarial drug susceptibility testing of Plasmodium falciparum in Brazil using a radioisotope method", Mem Inst Oswaldo Cruz, 94, pp.803~809 (1999)
- Pickard AL, "Resistance to antimalarials in Southeast Asia and genetic polymorphisms in pfmdr 1", Antimicrob Agents Chemother, 47, pp.2418~2423 (2003)
- Chaijaroenkul W, "In vitro antimalarial drug susceptibility in Thai border areas from 1998- 2003", Malaria J, 4, pp.37~ (2003)
- Laufer MK, "Withdrawing antimalarial drugs: impact on parasite resistance and implications for malaria treatment policies", Drug Resist Update, 7, pp.279~288 (2004)
- Laufer MK, "Impact of HIV-associated immunosuppression on malaria infection and disease in Malawi", J Infect Dis, 193, pp.872~878 (2006)
- Lim P, "In vitro monitoring of Plasmodium falciparum susceptibility to artesunate, mefloquine, quinine and chloroquine in Cambodia: 2001-2002", Acta Trop, 93, pp.31~40 (2005)
- Looareesuwan S, "Treatment of patients with recrudescent falciparum malaria with a sequential combination of artesunate and mefloquine", Am J Trop Med Hyg, 47, pp.794~799 (1992)
- McGready R, "Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy", Trans R Soc Trop Med Hyg, 94, pp.689~693 (2000)
- Pukrittayakamee S, "Quinine pharmacokinetic-pharmacodynamic relationships in uncomplicated falciparum malaria", Antimicrob Agents Chemother, 47, pp.3458~3463 (2003)
- Vijaykadga S, "In vivo sensitivity monitoring of mefloquine monotherapy and artesunate-mefloquine combinations for the treatment of uncomplicated falciparum malaria in Thailand in 2003", Trop Med Int Health, 11, pp.211~219 (2006)
- White N, "Antimalarial drug resistance and combination chemotherapy", Philos Trans R Soc Lond B Biol Sci, 354, pp.739~749 (1999)
- Cowman AF, "Selection for mefloquine resistance in Plasmodium falciparum is linked to amplification of the pfmdr 1 gene and cross-resistance to halofantrine and quinine", Proc Natl Acad Sci, 91, pp.1143~1147 (1994)
- Suebsaeng L, "Sensitivity to quinine and mefloquine of Plasmodium falciparum in Thailand", Bull WHO, 64, pp.759~765 (1986)
- Wilson CM, "Amplification of pfmdr 1 associated with mefloquine and halofantrine resistance in Plasmodium falciparum from Thailand", Mol Biochem Parasitol, 57, pp.151~160 (1993)