Current status of malaria control.
Malaria caused by Plasmodium parasites kills approximately 1-3 million people and causes disease in 300-500 million people annually throughout the world. The current approaches to curtail this disease include vector control, vaccination, immunotherapy and chemotherapy. The vector control is achieved by reducing vector density, interrupting their life cycle, and creating a barrier between the human host and mosquitoes. A number of vaccine candidates are being clinically tried and R&D effort in this direction is coming in a big way. Currently there are only limited safe drugs for the treatment of this disease, however, reports of emerging resistance against existing drugs warrant the introduction of new drugs, which are unlikely to come from pharmaceutical industries because of limited commercial opportunities. One of the most important current approaches to develop new drugs involves the synthesis of chemical libraries and evaluate them against most validated biochemical targets of malarial parasite. Although a number of such targets in antimalarial drug development are known today, yet only validated and selective biochemical targets including mitochondrial transport, glycolic pathway, folate pathway, proteases and heme metabolism, apicoplast metabolism, glycophospatidyl inositol, lipid metabolism (glycerophospholipids), peptidyl deformylase and oxidative stress in parasite-infected erythrocytes have been discussed here. The well known antimalarial drugs and different drug combinations for the treatment of malaria are also briefly reviewed. A survey of the recently discovered new molecules active against malaria has also been narrated. Lastly, the future of malaria chemotherapy and new directions emerging from literature has been elucidated.
Tripathi
R P
RP
Medicinal and Process Chemistry Division, Central Drug Research Institute, Lucknow-226001, India. rpt_56@yahoo.com
Mishra
R C
RC
Dwivedi
N
N
Tewari
N
N
Verma
S S
SS
D000818:Animals; D000962:Antimalarials / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D023281:Genomics; D006801:Humans; D007167:Immunotherapy; D008288:Malaria / Q000276:immunology / Q000378:metabolism / Q000469:parasitology / Q000628:therapy*; D010716:Phosphatidylinositols / Q000378:metabolism; D010965:Plasmodium malariae / Q000187:drug effects* / Q000502:physiology*
D000962:Antimalarials; D010716:Phosphatidylinositols