Dr Olivo Miotto discusses key discoveries in the ongoing attempts to understand the genetic basis of artemsinin resistance, including the identification of artemisinin resistant P. falciparum founder populations in Cambodia and
the artemisinin resistance marker in the kelch propeller domain.
Analysing 1612 samples from 15 locations in Southeast Asia and Africa, the researchers were able to identify 20 mutations in the kelch13 gene, a known
artemisinin resistance marker, that appear to work in concert with a set of background mutations in four other genes to support artemisinin resistance.
Not exact matches
Last year, his group found the hotly sought molecular
marker of
artemisinin resistance, the Kelch 13 or K13 gene, enabling researchers to map its extent and spread in exquisite detail.
Laboratory tests showed the parasites from dihydroartemisinin - piperaquine failures contained a genetic
marker of
artemisinin resistance and had a decreased susceptibility to piperaquine, demonstrating that both
artemisinin and piperaquine
resistance contributed to treatment failures.
Researchers have been tracking the spread of
artemisinin - resistant parasites first by looking for signs in patients, and later by using multiple mutations in the parasite's Kelch13, or K13, gene, as molecular
markers for
resistance.
Scientists have not yet found unequivocal genetic
markers of
resistance to
artemisinin derivatives, either.
Taken together, these findings suggest that mutations in the K13 - propeller play an important role in determining
artemisinin resistance, act as a molecular
marker for
artemisinin - resistant parasites, and provide important clues into how
resistance is developing in parasite populations in Southeast Asia.
Importantly, these mutations could serve as a molecular
marker for large - scale surveillance efforts to contain
artemisinin drug
resistance in Southeast Asia.
Last year saw publications in Nature Genetics by Miotto and colleagues about multiple strains of
artemisinin - resistant parasites in Cambodia, and in Nature by Dr. Frédéric Ariey and colleagues from Institut Pasteur identifying a molecular
marker of
artemisinin resistance.
The World Health Organization (WHO) recently released an update on the state of
artemisinin confirming that parasites collected in Laos were positive for the newly - discovered
markers for
artemisinin resistance.