Host immunity to Plasmodium falciparum and the assessment of emerging artemisinin resistance in a multinational cohort

• DOI: 10.1073/pnas.1615875114
• Publication Date: 2017-03-14T01:09:36Z
• Authors: Ricardo Ataide; Elizabeth A. Ashley; Rosanna Powell; Jo-Anne Chan; Michael J. Malloy; Katherine O’Flaherty; Eizo Takashima; Christine Langer; Takafumi Tsuboi; Arjen M. Dondorp; Nicholas P. Day; Mehul Dhorda; Rick M. Fairhurst; Pharath Lim; Chanaki Amaratunga; Sasithon Pukritta...; Tran Tinh Hien; Ye Htut; Mayfong Mayxay; M. Abul Faiz; James G. Beeson; Francois Nosten; Julie A. Simpson; Nicholas J. White; Freya J. I. Fowkes
• Keywords: Adult; Male; Asia; Adolescent; Plasmodium falciparum; Drug Resistance; Infant; Middle Aged; Artemisinins; 3. Good health; Cohort Studies; Antimalarials; Young Adult; 03 medical and health sciences; Phenotype; 0302 clinical medicine; Child, Preschool; Humans; Female; Malaria, Falciparum; Child; Aged

Significance Slow-clearing artemisinin-resistant malaria parasites are now well established in the Greater Mekong Subregion. This large multinational therapy efficacy study incorporating clinical data, molecular drug-resistance markers, and immune profiling aimed to understand how variations population levels of naturally acquired malarial immunity affect slow-clearing phenotype, emergence artemisinin resistance-associated mutations, assessment geographical spread resistance. We found that mutant occur at higher frequencies areas where is lowest, patients with have faster clearance times, has greatest effect on parasites. Immunity plays an important role resistant can confound World Health Organization’s phenotype genotype definitions