Chloroquine helped control or eliminate malaria throughout much of the world when it became widely used in the years following World War II. Chloroquine-resistant (CQR) P. falciparum emerged in Southeast Asia and South America in the 1950s and spread through much of Africa within two decades. Compared with chloroquine, drugs to treat CQR malaria are more expensive and cause more side effects while working less effectively. Resurgent malaria brings death and suffering to hundreds of millions and seriously impedes economic growth throughout malarious regions.
“Dr. Fidock’s work provides direct and conclusive evidence of what was formerly only suspected; namely, that mutations in a single gene give P. falciparum the ability to resist chloroquine,” says Michael Gottlieb, Ph.D., chief of NIAID’s parasitology and international programs branch. “Curiously, the presence of this gene, named pfcrt, also appears to make P. falciparum more susceptible to two other anti-malarial drugs, artemisinin and quinine,” he adds.
The gene finding has potentially important implications for malaria treatment and control, notes Dr. Gottlieb. “If we can develop further the methods we have of monitoring people for which variant of P. falciparum they are infected with, then health officials would be able to match whatever drugs work best against the most prevalent local or regional variant,” he explains.
Dr. Fidock conducted earlier phases of this research as a member of NIAID’s Laboratory of Malaria and Vector Research. The head of that lab, Thomas E. Wellems, M.D., Ph.D., contributed a “Viewpoint” article to the special issue of Science. In it, he writes, “Searches for new drugs to meet the need once filled by chloroquine require targets that are parasite-specific and can be hit with prompt and lethal effect.” The sequencing of the P. falciparum genome gives scientists new ways to identify and attack the parasite’s most vulnerable points, he notes.
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TE Wellems. Plasmodium chloroquine resistance and the search for a replacement antimalarial drug. Science 297: 124-26 (2002).