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INT J ANTIMICROB AG:K13基因多态性与恶性疟原虫之间缺乏关联

2017-05-13 MedSci MedSci原创

2006年,塞内加尔国家疟疾控制计划建议采用青蒿素联合疗法作为非重症疟疾治疗的一线疗法。此外,静脉注射(iv)青蒿琥酯和蒿甲醚的注射剂已逐渐替代奎宁治疗重症疟疾。Kelch 13基因(K13-螺旋桨,PF3D71343700)的螺旋桨域的突变,如Y493H,R539T,I543T和C580Y,最近报道在体内和体外与东南亚青蒿素的抗性有关。然而,这些突变尚未在非洲出现。

近日,国际杂志INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS在线发表一项关于K13基因多态性与恶性疟原虫之间缺乏关联的研究。

2006年,塞内加尔国家疟疾控制计划建议采用青蒿素联合疗法作为非重症疟疾治疗的一线疗法。此外,静脉注射(iv)青蒿琥酯和蒿甲醚的注射剂已逐渐替代奎宁治疗重症疟疾。Kelch 13基因(K13-螺旋桨,PF3D71343700)的螺旋桨域的突变,如Y493H,R539T,I543T和C580Y,最近报道在体内和体外与东南亚青蒿素的抗性有关。然而,这些突变尚未在非洲出现。

本研究从2015年8月至2016年1月期间,收集了来自塞内加尔达喀尔161名患者的181株恶性疟原虫分离株,并对该虫株的K13螺旋桨基因进行了测序。在2015年至2016年从达喀尔收集的181个分离株中进行K13螺旋桨区非同义突变的检测,并检测到三个同义突变(D464D,C469C和R471R)。在接受静脉注射青蒿琥酯或肌内注射蒿甲醚治疗并随后注射蒿甲醚/苯芴醇的119例患者中,9例患者在第3天仍然有原虫血症。来自这9名患者的疟原虫是K13螺旋桨的野生型,且没有检测到亚洲已知涉及青蒿素抗性的多态性。

这些结果表明K13不是非洲青蒿素抗性的最佳预测标记。因此需要从更多的临床失败病例或青蒿素衍生物治疗后寄生虫清除延迟的患者中获得分离株来鉴定新型分子标记物。 

原始出处:

Marylin Madameta, Mame Bou Kountad, Khalifa Ababacar Wade. et.al. Absence of association between polymorphisms in the K13 gene and the presence of Plasmodium falciparum parasites at day 3 after treatment with artemisinin derivatives in Senegal.

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    2017-06-29 xjy02
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    2018-04-17 医者仁心
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    2017-05-14 xzw120
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