Antifolates can have a role in the treatment of Plasmodium vivax.
Plasmodium vivax is a serious health concern in many regions and is sometimes inadvertently treated with sulfadoxine-pyrimethamine (SP). Mutations in the genes that encode dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) confer resistance to pyrimethamine and sulfadoxine, respectively. Numerous studies have examined the prevalence and diversity of mutations in P. vivax dhfr and some have assessed the relationship between dhfr genotype and clinical or in vitro response to pyrimethamine. Other studies have examined the impact of dhps genotype on response to sulfadoxine. These data indicate that, under certain circumstances, SP could be a valuable tool in the fight against P. vivax.
Hawkins
Vivian N
VN
Department of Genome Sciences, University of Washington, Box 355065, Seattle, WA 98195, USA.
Joshi
Hema
H
Rungsihirunrat
Kanchana
K
Na-Bangchang
Kesara
K
Sibley
Carol Hopkins
CH
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D004094:Dihydropteroate Synthase / Q000235:genetics; D004338:Drug Combinations; D004351:Drug Resistance; D005493:Folic Acid Antagonists / Q000627:therapeutic use*; D005838:Genotype; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy*; D009154:Mutation; D010966:Plasmodium vivax / Q000187:drug effects* / Q000201:enzymology; D011739:Pyrimethamine / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*; D013762:Tetrahydrofolate Dehydrogenase / Q000235:genetics; D016896:Treatment Outcome
D000962:Antimalarials; D004338:Drug Combinations; D005493:Folic Acid Antagonists; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D013762:Tetrahydrofolate Dehydrogenase; D004094:Dihydropteroate Synthase; D011739:Pyrimethamine