title: pfmdr1 genotyping and in vivo mefloquine resistance on the Thai-Myanmar border.
abstract: Molecular markers have been proposed as a method of monitoring malaria drug resistance and could potentially be used to prolong the life span of antimalarial drugs. Single nucleotide polymorphisms (SNPs) in the Plasmodium falciparum gene pfmdr1 and increased gene copy number have been associated with in vitro drug resistance but have not been well studied in vivo. In a prospective cohort study of malaria patients receiving mefloquine treatment on the Thai-Myanmar border, there was no significant association between either pfmdr1 SNPs or in vitro drug sensitivity and mefloquine resistance in vivo. Increased pfmdr1 gene copy number was significantly associated with recrudescence (relative risk 2.30, 95% CI 1.27-4.15). pfmdr1 gene copy number may be a useful surveillance tool for mefloquine-resistant falciparum malaria in Thailand.
authors.affiliation: University of North Carolina School of Public Health, Department of Epidemiology, Chapel Hill, North Carolina 27599-7435, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Nelson
authors.forename: Anne
authors.initials: A
authors.lastname: Purfield
authors.forename: Philip
authors.initials: P
authors.lastname: McDaniel
authors.forename: Nichipat
authors.initials: N
authors.lastname: Uthaimongkol
authors.forename: Nillawan
authors.initials: N
authors.lastname: Buathong
authors.forename: Sabaitip
authors.initials: S
authors.lastname: Sriwichai
authors.forename: R Scott
authors.initials: RS
authors.lastname: Miller
authors.forename: Chansuda
authors.initials: C
authors.lastname: Wongsrichanalai
authors.forename: Steven R
authors.initials: SR
authors.lastname: Meshnick
mesh_terms: D018528:ATP-Binding Cassette Transporters / Q000235:genetics*; D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology*; D004351:Drug Resistance / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology; D008297:Male; D015767:Mefloquine / Q000494:pharmacology*; D002052:Myanmar / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011446:Prospective Studies; D015800:Protozoan Proteins / Q000235:genetics*; D013785:Thailand / Q000453:epidemiology
chemical_list: D018528:ATP-Binding Cassette Transporters; D000962:Antimalarials; D015800:Protozoan Proteins; C059987:mdr gene protein, Plasmodium; D015767:Mefloquine