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Artemisinin susceptibility in the malaria parasite Plasmodium falciparum: propellers, adaptor proteins and the need for cellular healing.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Sutherland, Colin J  ORCID logo  https://orcid.org/0000-0003-1592-6407
Henrici, Ryan C 
Artavanis-Tsakonas, Katerina 

Abstract

Studies of the susceptibility of Plasmodium falciparum to the artemisinin family of antimalarial drugs provide a complex picture of partial resistance (tolerance) associated with increased parasite survival in vitro and in vivo. We present an overview of the genetic loci that, in mutant form, can independently elicit parasite tolerance. These encode Kelch propeller domain protein PfK13, ubiquitin hydrolase UBP-1, actin filament-organising protein Coronin, also carrying a propeller domain, and the trafficking adaptor subunit AP-2μ. Detailed studies of these proteins and the functional basis of artemisinin tolerance in blood-stage parasites are enabling a new synthesis of our understanding to date. To guide further experimental work, we present two major conclusions. First, we propose a dual-component model of artemisinin tolerance in P. falciparum comprising suppression of artemisinin activation in early ring stage by reducing endocytic haemoglobin capture from host cytosol, coupled with enhancement of cellular healing mechanisms in surviving cells. Second, these two independent requirements limit the likelihood of development of complete artemisinin resistance by P. falciparum, favouring deployment of existing drugs in new schedules designed to exploit these biological limits, thus extending the useful life of current combination therapies.

Description

Keywords

artemisinin resistance, endocytosis, haemoglobin, malaria parasites, proteasome, protein recycling, Antimalarials, Artemisinins, Drug Resistance, Plasmodium falciparum, Protozoan Proteins

Journal Title

FEMS Microbiol Rev

Conference Name

Journal ISSN

0168-6445
1574-6976

Volume Title

Publisher

Oxford University Press (OUP)

Rights

All rights reserved
Sponsorship
Biotechnology and Biological Sciences Research Council (BB/R001642/1)