title: Detection of atovaquone and Malarone resistance conferring mutations in Plasmodium falciparum cytochrome b gene (cytb).
abstract: Clinical treatment failures of the hydroxynaphthoquinone atovaquone or its combination with proguanil (Malarone) in Plasmodium falciparum malaria has been recently documented. These events have been associated to single nucleotide polymorphisms (SNPs) in the parasite cytochrome b gene (cytb). In this report we describe a set of nest PCR-RFLP methods developed for the fast detection of all known cytb mutations associated to resistance to these drugs. The methods were successfully applied for the analysis of phenol-chloroform extracted DNA samples from patients not cured by Malarone, and from an established parasite clone. Further, the protocol for the detection of the A803C mutation was applied to 164 DNA field samples extracted through crude methanol-based protocols, originated from several malaria settings. The PCR-RFLP methods here presented can be used as a valuable for the clinical detection and study of Malarone and atovaquone P. falciparum resistance.
authors.affiliation: UEI Malária, Centro de Malária e outras Doenças Tropicais, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal. pedro.gil@ks.se
authors.forename: J P
authors.initials: JP
authors.lastname: Gil
authors.forename: F
authors.initials: F
authors.lastname: Nogueira
authors.forename: J
authors.initials: J
authors.lastname: Strömberg-Nörklit
authors.forename: J
authors.initials: J
authors.lastname: Lindberg
authors.forename: M
authors.initials: M
authors.lastname: Carrolo
authors.forename: C
authors.initials: C
authors.lastname: Casimiro
authors.forename: D
authors.initials: D
authors.lastname: Lopes
authors.forename: A P
authors.initials: AP
authors.lastname: Arez
authors.forename: P V
authors.initials: PV
authors.lastname: Cravo
authors.forename: V E
authors.initials: VE
authors.lastname: Rosário
mesh_terms: D000818:Animals; D000962:Antimalarials; D053626:Atovaquone; D045303:Cytochromes b / Q000235:genetics; D004252:DNA Mutational Analysis; D017931:DNA Primers; D016054:DNA, Protozoan / Q000097:blood; D004338:Drug Combinations; D004351:Drug Resistance / Q000235:genetics*; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis*; D009154:Mutation; D009285:Naphthoquinones; D010963:Plasmodium falciparum / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods*; D002727:Proguanil
chemical_list: D000962:Antimalarials; D017931:DNA Primers; D016054:DNA, Protozoan; D004338:Drug Combinations; D009285:Naphthoquinones; C109496:atovaquone, proguanil drug combination; D045303:Cytochromes b; D002727:Proguanil; D053626:Atovaquone