Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
권호 표지
DOI QR코드

DOI QR Code

Drug Resistance and in Vitro Susceptibility of Plasmodium falciparum in Thailand during 1988-2003

  • Suwandittakul, Nantana (Pharmacology and Toxicology Unit, Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University) ;
  • Chaijaroenkul, Wanna (Pharmacology and Toxicology Unit, Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University) ;
  • Harnyuttanakorn, Pongchai (The College of Public Health Sciences, Chulalongkorn University) ;
  • Mungthin, Mathirut (Department of Parasitology, Pharmongkutklao College of Medicine) ;
  • Bangchang, Kesara Na (Pharmacology and Toxicology Unit, Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University)
  • Published : 2009.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of the present study was to investigate antimalarial drug pressure resulting from the clinical use of different antimalarials in Thailand. The phenotypic diversity of the susceptibility profiles of antimalarials, i.e., chloroquine (CQ), quinine (QN), mefloquine (MQ), and artesunate (ARS) in Plasmodium falciparum isolates collected during the period from 1988 to 2003 were studied. P. falciparum isolates from infected patients were collected from the Thai-Cambodian border area at different time periods (1988-1989, 1991-1992, and 2003), during which 3 different patterns of drug use had been implemented: MQ+sulphadoxine (S)+pyrimethamine (P), MQ alone and MQ+ARS, respectively. The in vitro drug susceptibilities were investigated using a method based on the incorporation of $[^3H]$ hypoxanthine. A total of 50 isolates were tested for susceptibilities to CQ, QN, MQ, and ARS. Of these isolates, 19, 16, and 15 were adapted during the periods 1988-1989, 1991-1993, and 2003, respectively. P. falciparum isolates collected during the 3 periods were resistant to CQ. Sensitivities to MQ declined from 1988 to 2003. In contrast, the parasite was sensitive to QN, and similar sensitivity profile patterns were observed during the 3 time periods. There was a significantly positive but weak correlation between the $IC_{50}$ values of CQ and QN, as well as between the $IC_{50}$, values of QN and MQ. Drug pressure has impact on sensitivity of P. falciparum to MQ. A combination therapy of MQ and ARS is being applied to reduce the parasite resistance, and also increasing the efficacy of the drug.

Keywords

References

  1. Harinasuta T, Suntharasamai P, Viravan C. Chloroquine-resistant falciparum malaria in Thailand. Lancet 1965; 2: 657-660
  2. Wongsrichanalai C, Pickard AL, Wernsdorfer WH, Meshnick SR. Epidemiology of drug-resistant malaria. Lancet Infect Dis 2002; 2: 209-218 https://doi.org/10.1016/S1473-3099(02)00239-6
  3. Escalante AA, Cornejo OE, Rojas A, Udhayakumar V, Lal AA. Assessing the effect of natural selection in malaria parasites. Trends Parasitol 2004; 20: 388-395 https://doi.org/10.1016/j.pt.2004.06.002
  4. Trager W, Jensen JB. Human malaria parasites in continuous culture. Science 1976; 193: 673-675 https://doi.org/10.1126/science.781840
  5. Desjardins RE, Canfield CJ, Haynes JD, Chulay JD. Quantitative assessment of antimalarial activity in vitro by a semiautomated microdilution technique. Antimicrob Agents Chemother 1979; 16: 710-718 https://doi.org/10.1128/AAC.16.6.710
  6. Cerutti Jr C, Marques AC, de Alencar FE, Durlacher RR, Alween A, Segurado AA, Pang L, Zalis MG. Antimalarial drug susceptibility testing of Plasmodium falciparum in Brazil using a radioisotope method. Mem Inst Oswaldo Cruz 1999; 94: 803-809 https://doi.org/10.1590/S0074-02761999000600017
  7. Pickard AL, Wongsrichanalai C, Purfield A, Kamwendo D, Emery K, Zalewski C, Kawamoto F, Miller RS, Meshnick SR. Resistance to antimalarials in Southeast Asia and genetic polymorphisms in pfmdr 1. Antimicrob Agents Chemother 2003; 47: 2418-2423 https://doi.org/10.1128/AAC.47.8.2418-2423.2003
  8. Chaijaroenkul W, Bangchang KN, Mungthin M, Ward SA. In vitro antimalarial drug susceptibility in Thai border areas from 1998-2003. Malaria J 2005; 4: 37 https://doi.org/10.1186/1475-2875-4-37
  9. Laufer MK, Plowe CV. Withdrawing antimalarial drugs: impact on parasite resistance and implications for malaria treatment policies. Drug Resist Update 2004; 7: 279-288 https://doi.org/10.1016/j.drup.2004.08.003
  10. Laufer MK, van Oosterhout JJ, Thesing PC, Thumba F, Zijlstra EE, Graham SM, Taylor TE, Plowe CV. Impact of HIV-associated immunosuppression on malaria infection and disease in Malawi. J Infect Dis 2006; 193: 872-878 https://doi.org/10.1086/500245
  11. Lim P, Chim P, Sem R, Nemh S, Poravuth Y, Lim C, Seila S, Tsuyuoka R, Denis MB, Socheat D, Fandeur T. In vitro monitoring of Plasmodium falciparum susceptibility to artesunate, mefloquine, quinine and chloroquine in Cambodia: 2001-2002. Acta Trop 2005; 93: 31-40 https://doi.org/10.1016/j.actatropica.2004.09.002
  12. Looareesuwan S, Kyle DE, Viravan C, Vanijanonta S, Wilairatana P, Charoenlarp P, Canfield CJ, Webster HK. Treatment of patients with recrudescent falciparum malaria with a sequential combination of artesunate and mefloquine. Am J Trop Med Hyg 1992; 47: 794-799 https://doi.org/10.4269/ajtmh.1992.47.794
  13. McGready R, Brockman A, Cho T, Cho D, van Vugt M, Luxemburger C, Chongsuphajaisiddhi T, White NJ, Nosten F. Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy. Trans R Soc Trop Med Hyg 2000; 94: 689-693 https://doi.org/10.1016/S0035-9203(00)90235-9
  14. Pukrittayakamee S, Wanwimolruk S, Stepniewska K, Jantra A, Huyakorn S, Looareesuwan S, White NJ. Quinine pharmacokinetic-pharmacodynamic relationships in uncomplicated falciparum malaria. Antimicrob Agents Chemother 2003; 47: 3458-3463 https://doi.org/10.1128/AAC.47.11.3458-3463.2003
  15. Vijaykadga S, Rojanawatsirivej C, Cholpol S, Phoungmanee D, Nakavej A, Wongsrichanalai C. In vivo sensitivity monitoring of mefloquine monotherapy and artesunate-mefloquine combinations for the treatment of uncomplicated falciparum malaria in Thailand in 2003. Trop Med Int Health 2006; 11: 211-219 https://doi.org/10.1111/j.1365-3156.2005.01557.x
  16. White N. Antimalarial drug resistance and combination chemotherapy. Philos Trans R Soc Lond B Biol Sci 1999; 354: 739-749
  17. Cowman AF, Galatis D, Thompson JK. Selection for mefloquine resistance in Plasmodium falciparum is linked to amplification of the pfmdr 1 gene and cross-resistance to halofantrine and quinine. Proc Natl Acad Sci USA 1994; 91: 1143-1147 https://doi.org/10.1073/pnas.91.3.1143
  18. Suebsaeng L, Wernsdorfer WH, Rooney W. Sensitivity to quinine and mefloquine of Plasmodium falciparum in Thailand. Bull WHO 1986; 64: 759-765
  19. Wilson CM, Volkman SK, Thaithong S, Martin RK, Kyle DE, Milhous WK, Wirth DF. Amplification of pfmdr 1 associated with mefloquine and halofantrine resistance in Plasmodium falciparum from Thailand. Mol Biochem Parasitol 1993; 57: 151-160 https://doi.org/10.1016/0166-6851(93)90252-S

Cited by

  1. Is it too soon to eliminate quinine? vol.10, pp.3, 2009, https://doi.org/10.1016/s1473-3099(10)70009-8
  2. Pyronaridine-Artesunate versus Chloroquine in Patients with Acute Plasmodium vivax Malaria: A Randomized, Double-Blind, Non-Inferiority Trial vol.6, pp.1, 2009, https://doi.org/10.1371/journal.pone.0014501
  3. Ex vivo drug sensitivity profiles of Plasmodium falciparum field isolates from Cambodia and Thailand, 2005 to 2010, determined by a histidine-rich protein-2 assay vol.11, pp.None, 2009, https://doi.org/10.1186/1475-2875-11-198