Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
Ta Kung Pao reporter Dai Rimou reports
2005-12-22
Artemisinin-based drugs can be considered the last line of defense against malaria parasites, but this line of defense is now at risk of collapsing, as scientific research has confirmed that artemisinin is beginning to face the threat of drug resistance. Experts suggest that artemisinin-based drugs should be used in combination with other antimalarial drugs to prevent the spread of resistance.
According to a report by the World Health Organization, malaria is an infectious disease with a significant upward trend worldwide, second only to AIDS. It is a communicable disease in tropical and subtropical regions, endangering the health of two billion people globally. Severe malaria causes over 400 million infections and at least one million deaths annually, particularly in Africa, where it has become the leading killer. The global medical community has been continuously searching for effective treatments for malaria. In recent years, they have focused on artemisinin and its derivatives.
It is understood that the use of extracts from the sweet wormwood plant, Artemisia annua, for treating malaria has a history of several hundred years in traditional Chinese medicine. The treatment experiences of past generations of physicians have provided rich clinical evidence for modern antimalarial research on artemisinin, directly leading to the significant invention of artemisinin-based antimalarial treatment in the 1970s. The artemisinin used today is derived from the effective antimalarial monomer isolated from Artemisia annua by Chinese scientists at that time. Clinical studies have shown that artemisinin and its derivatives are particularly effective against cerebral malaria and chloroquine-resistant severe malaria, with no significant toxic side effects.
Abuse Leads to Resistance
Due to their high efficacy, rapid action, and low toxicity, artemisinin-based drugs have been widely used in malaria-endemic regions worldwide, becoming the first-line treatment for malaria and hailed by the World Health Organization (WHO) as the "greatest hope for malaria treatment." Even in regions where malaria parasites have developed resistance to multiple drugs, artemisinin-based drugs can still cure over 90% of malaria patients within a few days.
Given this, the global demand for artemisinin is rapidly increasing, with the market size expected to reach hundreds of millions of dollars within a few years. However, this has also led to the overuse and even abuse of artemisinin, resulting in the emergence of drug resistance in malaria parasites. In July of this year, scientists discovered that artemisinin-based drugs selectively target a crucial protein in malaria parasites—the calcium pump protein—by inhibiting its activity to attack the parasites, thereby treating malaria without harming nearby human proteins. Scientists noted that a single amino acid residue in the calcium pump protein determines this selectivity. If this amino acid mutates to correspond to the residue in related human proteins, artemisinin-based drugs can no longer inhibit the activity of the mutated calcium pump protein, leading to the development of artemisinin resistance in malaria parasites.
Now, this discovery has been confirmed. According to a study published in the latest issue of the British medical journal The Lancet, scientists have recently found the first experimental evidence of malaria parasites developing resistance to artemisinin. The study's authors, immunologist Ronan Jambou and his colleagues from the Pasteur Institute in Dakar, Senegal, stated that to establish an early warning system for signs of drug resistance in malaria parasites, they collected 530 blood samples from malaria patients in Cambodia, French Guiana, and Senegal, comparing the responses of malaria parasites from different regions to various drugs.
Combination Therapy Helps Avoid Resistance
The results showed that in Cambodia, where the use of artemisinin is strictly managed and only used in combination therapies, researchers found no evidence of malaria parasites developing resistance to artemisinin-based drugs.However, in French Guiana and Senegal, due to the lack of regulatory control over the use of artemisinin-based drugs or their allowance for standalone use, malaria parasites in the blood samples of patients from these regions have developed the ability to evade the effects of artemisinin. Researchers have also found evidence suggesting that several genetically mutated malaria parasites may have already developed drug resistance. Jambou stated, "This is likely the first step towards the failure of this treatment method."
Although this study was conducted in a laboratory setting and no patients have yet died from artemisinin-resistant malaria, experts warn that this discovery raises an alarm. The global community must use artemisinin with great caution; otherwise, this widely used malaria treatment and its derivatives face the risk of failure.
Pascal Ringwald, an official from the World Health Organization, noted that this finding is not surprising. Resistance to a drug is inevitable when it is used alone, though this discovery has come a few years earlier than most expected. Nevertheless, Jambou believes that if governments heed early warnings and curb the misuse of artemisinin-based drugs, there is still a significant chance to prevent the spread of resistance and maintain the efficacy of artemisinin-based treatments against malaria.
In fact, medical experts have long emphasized the importance of combining artemisinin-based drugs with other antimalarial treatments rather than using them extensively alone. This approach aims to prevent the misuse of artemisinin from leading to drug resistance in malaria parasites. This malaria treatment strategy is known as Artemisinin-based Combination Therapy (ACT), through which scientists hope to decisively defeat malaria.
Source: http://www. takungpao. com/ news/ 05/ 12/ 22/ GY- 501461. htm
According to reports, the malaria parasite has begun to develop resistance to artemisinin. It has only been 40 years since the effective antimalarial compound was isolated from Artemisia annua in the 1970s. However, traditional Chinese medicine has used Artemisia annua, rhubarb, coptis, and phellodendron for hundreds of years without encountering resistance issues. Why is this? The key lies in the fact that traditional Chinese medicine does not rely on so-called "single active ingredients" to treat diseases. Instead, it focuses on restoring the balance and smooth circulation of the internal environment of the human body, allowing the body's own immune system to naturally combat bacteria and viruses. Additionally, it employs a "cocktail" therapy, using multiple antibacterial and antiviral herbs simultaneously. Because there are too many components attacking the pathogens at once, the pathogens cannot develop resistance. This advanced concept has yet to take root in modern medicine, which is why modern medicine remains stuck in the cycle of "resistance → development of new drugs → resistance again → development of new drugs again."
Artemisinin Faces Drug Resistance Threat
2005-12-22
Artemisinin-based drugs can be considered the last line of defense against malaria parasites, but this line of defense is now at risk of collapsing, as scientific research has confirmed that artemisinin is beginning to face the threat of drug resistance. Experts suggest that artemisinin-based drugs should be used in combination with other antimalarial drugs to prevent the spread of resistance.
According to a report by the World Health Organization, malaria is an infectious disease with a significant upward trend worldwide, second only to AIDS. It is a communicable disease in tropical and subtropical regions, endangering the health of two billion people globally. Severe malaria causes over 400 million infections and at least one million deaths annually, particularly in Africa, where it has become the leading killer. The global medical community has been continuously searching for effective treatments for malaria. In recent years, they have focused on artemisinin and its derivatives.
It is understood that the use of extracts from the sweet wormwood plant, Artemisia annua, for treating malaria has a history of several hundred years in traditional Chinese medicine. The treatment experiences of past generations of physicians have provided rich clinical evidence for modern antimalarial research on artemisinin, directly leading to the significant invention of artemisinin-based antimalarial treatment in the 1970s. The artemisinin used today is derived from the effective antimalarial monomer isolated from Artemisia annua by Chinese scientists at that time. Clinical studies have shown that artemisinin and its derivatives are particularly effective against cerebral malaria and chloroquine-resistant severe malaria, with no significant toxic side effects.
Abuse Leads to Resistance
Due to their high efficacy, rapid action, and low toxicity, artemisinin-based drugs have been widely used in malaria-endemic regions worldwide, becoming the first-line treatment for malaria and hailed by the World Health Organization (WHO) as the "greatest hope for malaria treatment." Even in regions where malaria parasites have developed resistance to multiple drugs, artemisinin-based drugs can still cure over 90% of malaria patients within a few days.
Given this, the global demand for artemisinin is rapidly increasing, with the market size expected to reach hundreds of millions of dollars within a few years. However, this has also led to the overuse and even abuse of artemisinin, resulting in the emergence of drug resistance in malaria parasites. In July of this year, scientists discovered that artemisinin-based drugs selectively target a crucial protein in malaria parasites—the calcium pump protein—by inhibiting its activity to attack the parasites, thereby treating malaria without harming nearby human proteins. Scientists noted that a single amino acid residue in the calcium pump protein determines this selectivity. If this amino acid mutates to correspond to the residue in related human proteins, artemisinin-based drugs can no longer inhibit the activity of the mutated calcium pump protein, leading to the development of artemisinin resistance in malaria parasites.
Now, this discovery has been confirmed. According to a study published in the latest issue of the British medical journal The Lancet, scientists have recently found the first experimental evidence of malaria parasites developing resistance to artemisinin. The study's authors, immunologist Ronan Jambou and his colleagues from the Pasteur Institute in Dakar, Senegal, stated that to establish an early warning system for signs of drug resistance in malaria parasites, they collected 530 blood samples from malaria patients in Cambodia, French Guiana, and Senegal, comparing the responses of malaria parasites from different regions to various drugs.
Combination Therapy Helps Avoid Resistance
The results showed that in Cambodia, where the use of artemisinin is strictly managed and only used in combination therapies, researchers found no evidence of malaria parasites developing resistance to artemisinin-based drugs.However, in French Guiana and Senegal, due to the lack of regulatory control over the use of artemisinin-based drugs or their allowance for standalone use, malaria parasites in the blood samples of patients from these regions have developed the ability to evade the effects of artemisinin. Researchers have also found evidence suggesting that several genetically mutated malaria parasites may have already developed drug resistance. Jambou stated, "This is likely the first step towards the failure of this treatment method."
Although this study was conducted in a laboratory setting and no patients have yet died from artemisinin-resistant malaria, experts warn that this discovery raises an alarm. The global community must use artemisinin with great caution; otherwise, this widely used malaria treatment and its derivatives face the risk of failure.
Pascal Ringwald, an official from the World Health Organization, noted that this finding is not surprising. Resistance to a drug is inevitable when it is used alone, though this discovery has come a few years earlier than most expected. Nevertheless, Jambou believes that if governments heed early warnings and curb the misuse of artemisinin-based drugs, there is still a significant chance to prevent the spread of resistance and maintain the efficacy of artemisinin-based treatments against malaria.
In fact, medical experts have long emphasized the importance of combining artemisinin-based drugs with other antimalarial treatments rather than using them extensively alone. This approach aims to prevent the misuse of artemisinin from leading to drug resistance in malaria parasites. This malaria treatment strategy is known as Artemisinin-based Combination Therapy (ACT), through which scientists hope to decisively defeat malaria.
Source: http://www. takungpao. com/ news/ 05/ 12/ 22/ GY- 501461. htm
Re: Artemisinin Faces Drug Resistance Threat
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