title: Update on genetic markers of quinine resistance in Plasmodium falciparum.
abstract: The emergence and spread of antimalarial resistance remain burgeoning issues. Any strategy to slow down or overcome these problems requires an understanding of the genetic changes underlying this resistance. Quinine, the first antimalarial, has been central in the treatment of severe malaria, and has been proposed as second line treatment for uncomplicated malaria in many African countries. Some reports have indicated the emergence of quinine resistance in South East Asia and in Africa, however doubts have been raised about this quinine resistance in Africa. New and interesting data are emerging on the mechanism of quinine reduced susceptibility. In this report, we have reviewed work on the in vivo efficacy and in vitro activity of quinine, and discussed recent data on genetic markers of resistance to this drug. Overall, quinine still remains efficacious in Africa, and pfnhe, the sodium hydrogen exchanger, may be one of the genetic markers underlying quinine in vitro resistance.
authors.affiliation: Kenya Medical Research Institute (KEMRI)/Wellcome Trust Collaborative Research Program, Kilifi, Kenya.
authors.forename: John
authors.initials: J
authors.lastname: Okombo
authors.forename: Eric
authors.initials: E
authors.lastname: Ohuma
authors.forename: Stephane
authors.initials: S
authors.lastname: Picot
authors.forename: Alexis
authors.initials: A
authors.lastname: Nzila
mesh_terms: D000349:Africa; D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use; D001210:Asia, Southeastern; D004351:Drug Resistance; D005819:Genetic Markers; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics*; D011803:Quinine / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D005819:Genetic Markers; D011803:Quinine