Plasmodium falciparum and Plasmodium vivax Demonstrate Contrasting Chloroquine Resistance Reversal Phenotypes. 2017

Grennady Wirjanata, and Irene Handayuni, and Pak Prayoga, and Leo Leonardo, and Dwi Apriyanti, and Leily Trianty, and Ruland Wandosa, and Basbak Gobay, and Enny Kenangalem, and Jeanne Rini Poespoprodjo, and Rintis Noviyanti, and Dennis E Kyle, and Qin Cheng, and Ric N Price, and Jutta Marfurt
Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Darwin, Australia.

High-grade chloroquine (CQ) resistance has emerged in both Plasmodium falciparum and P. vivax The aim of the present study was to investigate the phenotypic differences of CQ resistance in both of these species and the ability of known CQ resistance reversal agents (CQRRAs) to alter CQ susceptibility. Between April 2015 and April 2016, the potential of verapamil (VP), mibefradil (MF), L703,606 (L7), and primaquine (PQ) to reverse CQ resistance was assessed in 46 P. falciparum and 34 P. vivax clinical isolates in Papua, Indonesia, where CQ resistance is present in both species, using a modified schizont maturation assay. In P. falciparum, CQ 50% inhibitory concentrations (IC50s) were reduced when CQ was combined with VP (1.4-fold), MF (1.2-fold), L7 (4.2-fold), or PQ (1.8-fold). The degree of CQ resistance reversal in P. falciparum was highly correlated with CQ susceptibility for all CQRRAs (R2 = 0.951, 0.852, 0.962, and 0.901 for VP, MF, L7, and PQ, respectively), in line with observations in P. falciparum laboratory strains. In contrast, no reduction in the CQ IC50s was observed with any of the CQRRAs in P. vivax, even in those isolates with high chloroquine IC50s. The differential effect of CQRRAs in P. falciparum and P. vivax suggests significant differences in CQ kinetics and, potentially, the likely mechanism of CQ resistance between these two species.

UI MeSH Term Description Entries
D007214 Indonesia A republic stretching from the Indian Ocean east to New Guinea, comprising six main islands: Java, Sumatra, Bali, Kalimantan (the Indonesian portion of the island of Borneo), Sulawesi (formerly known as the Celebes) and Irian Jaya (the western part of New Guinea). Its capital is Djakarta. The ethnic groups living there are largely Chinese, Arab, Eurasian, Indian, and Pakistani; 85% of the peoples are of the Islamic faith. Celebes,Indonesian New Guinea,Irian Jaya,Java,Madoera,Netherlands East Indies,New Guinea, Indonesian,New Guinea, West,Sulawesi,Sumatra,Timor,West Irian,Bali,East Indies,Madura,Malay Archipelago
D010963 Plasmodium falciparum A species of protozoa that is the causal agent of falciparum malaria (MALARIA, FALCIPARUM). It is most prevalent in the tropics and subtropics. Plasmodium falciparums,falciparums, Plasmodium
D010966 Plasmodium vivax A protozoan parasite that causes vivax malaria (MALARIA, VIVAX). This species is found almost everywhere malaria is endemic and is the only one that has a range extending into the temperate regions. Plasmodium vivaxs,vivax, Plasmodium
D002738 Chloroquine The prototypical antimalarial agent with a mechanism that is not well understood. It has also been used to treat rheumatoid arthritis, systemic lupus erythematosus, and in the systemic therapy of amebic liver abscesses. Aralen,Arechine,Arequin,Chingamin,Chlorochin,Chloroquine Sulfate,Chloroquine Sulphate,Khingamin,Nivaquine,Sulfate, Chloroquine,Sulphate, Chloroquine
D004351 Drug Resistance Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from DRUG TOLERANCE which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. Resistance, Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000962 Antimalarials Agents used in the treatment of malaria. They are usually classified on the basis of their action against plasmodia at different stages in their life cycle in the human. (From AMA, Drug Evaluations Annual, 1992, p1585) Anti-Malarial,Antimalarial,Antimalarial Agent,Antimalarial Drug,Anti-Malarials,Antimalarial Agents,Antimalarial Drugs,Agent, Antimalarial,Agents, Antimalarial,Anti Malarial,Anti Malarials,Drug, Antimalarial,Drugs, Antimalarial
D016778 Malaria, Falciparum Malaria caused by PLASMODIUM FALCIPARUM. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. Plasmodium falciparum Malaria,Malaria, Plasmodium falciparum
D016780 Malaria, Vivax Malaria caused by PLASMODIUM VIVAX. This form of malaria is less severe than MALARIA, FALCIPARUM, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. Plasmodium vivax Malaria,Malaria, Plasmodium vivax,Vivax Malaria
D021261 Parasitic Sensitivity Tests Tests that demonstrate the relative effectiveness of chemotherapeutic agents against specific parasites. Drug Sensitivity Tests, Helminth,Drug Sensitivity Tests, Parasitic,Drug Sensitivity Tests, Protozoal,Helminth Drug Sensitivity Tests,Parasite Sensitivity Tests,Protozoa Drug Sensitivity Tests,Protozoal Drug Sensitivity Tests,Parasite Sensitivity Test,Parasitic Sensitivity Test,Sensitivity Test, Parasite,Sensitivity Test, Parasitic,Sensitivity Tests, Parasite,Test, Parasite Sensitivity,Test, Parasitic Sensitivity,Tests, Parasite Sensitivity,Tests, Parasitic Sensitivity

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