2023-09-11 ブラウン大学
◆これらの寄生虫はアフリカで広まり、アルテミシニンという抗マラリア薬に対する耐性を持っており、診断テストでは検出されないため、感染者の迅速な発見と治療が難しくなっています。
◆研究者は、これらの耐性株の拡散を監視し、新しい耐性株の出現と拡散のメカニズムを理解する必要があると指摘しています。また、新しい治療法やワクチンの開発も急務とされています。
<関連情報>
- https://www.brown.edu/news/2023-09-11/malaria-drug-resistance
- https://www.nature.com/articles/s41564-023-01461-4
エチオピアでアルテミシニンと診断薬に耐性を持つマラリア原虫が出現した。 Plasmodium falciparum resistant to artemisinin and diagnostics have emerged in Ethiopia
Abebe A. Fola,Sindew M. Feleke,Hussein Mohammed,Bokretsion G. Brhane,Christopher M. Hennelly,Ashenafi Assefa,Rebecca M. Crudal,Emily Reichert,Jonathan J. Juliano,Jane Cunningham,Hassen Mamo,Hiwot Solomon,Geremew Tasew,Beyene Petros,Jonathan B. Parr & Jeffrey A. Bailey
Nature Microbiology Published:28 August 2023
DOI:https://doi.org/10.1038/s41564-023-01461-4
Abstract
Diagnosis and treatment of Plasmodium falciparum infections are required for effective malaria control and are pre-requisites for malaria elimination efforts; hence we need to monitor emergence, evolution and spread of drug- and diagnostics-resistant parasites. We deep sequenced key drug-resistance mutations and 1,832 SNPs in the parasite genomes of 609 malaria cases collected during a diagnostic-resistance surveillance study in Ethiopia. We found that 8.0% (95% CI 7.0–9.0) of malaria cases were caused by P. falciparum carrying the candidate artemisinin partial-resistance kelch13 (K13) 622I mutation, which was less common in diagnostic-resistant parasites mediated by histidine-rich proteins 2 and 3 (pfhrp2/3) deletions than in wild-type parasites (P = 0.03). Identity-by-descent analyses showed that K13 622I parasites were significantly more related to each other than to wild type (P < 0.001), consistent with recent expansion and spread of this mutation. Pfhrp2/3-deleted parasites were also highly related, with evidence of clonal transmissions at the district level. Of concern, 8.2% of K13 622I parasites also carried the pfhrp2/3 deletions. Close monitoring of the spread of combined drug- and diagnostic-resistant parasites is needed.