恶性疟原虫与耐药性相关分子遗传标记的研究进展

Advances in the study of the antimalarial resistance and genetic molecular markers of Plasmodium falciparum

长期以来抗疟药在全球的广泛使用导致恶性疟原虫已普遍对氯喹等传统药物产生耐受性,并对青蒿素类药物造成潜在威胁。随着在基因水平上对疟疾抗药性的深入研究,分子遗传标记已广泛应用于恶性疟耐药性和控制疾病的监测。本文就常见抗疟药的主要作用机制、相关分子标记及其多态性特征的研究进展作一综述。

Due to the prolonged and extensive use of antimalarials worldwide, Plasmodium falciparum has become resistant to chloroquine and other common drugs, and P. falciparum could potentially become resistant to artemisinin- based drugs. Malarial resistance to drugs has been studied in-depth at the genetic level, and genetic molecular markers have been widely used to monitor the drug resistance of P. falciparum resistance and to control malaria transmission. Previous studies have indicated that the chloroquine resistance transporter gene and the multidrug resistance 1 gene of P. falciparurn are molecular markers associated with resistance to the conventional antimalarial chloroquine and that the di- hydrofolate reductase gene and the dihydropteroate synthase gene are molecular markers associated with resistance to the conventional antimalarial sulfadoxine/pyrimethamine. A recent study reported that kelch 13-propeller is a marker of P. falciparurn resistance to artemisinin. Mutations in these genes might cause changes in the protein＇s structure or function and lead to drug-resistant malaria. This paper summarizes advances in the study of the primary mechanism of action of common antimalarials, molecular markers of drug resistance, and characteristics of genetic polymorphisms in P. falciparum.