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Malaria: progress, perils, and prospects for eradication
Brian M. Greenwood, … , Frank H. Collins, Patrick E. Duffy
Brian M. Greenwood, … , Frank H. Collins, Patrick E. Duffy
Published April 1, 2008
Citation Information: J Clin Invest. 2008;118(4):1266-1276. https://doi.org/10.1172/JCI33996.
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Malaria: progress, perils, and prospects for eradication

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Abstract

There are still approximately 500 million cases of malaria and 1 million deaths from malaria each year. Yet recently, malaria incidence has been dramatically reduced in some parts of Africa by increasing deployment of anti-mosquito measures and new artemisinin-containing treatments, prompting renewed calls for global eradication. However, treatment and mosquito control currently depend on too few compounds and thus are vulnerable to the emergence of compound-resistant parasites and mosquitoes. As discussed in this Review, new drugs, vaccines, and insecticides, as well as improved surveillance methods, are research priorities. Insights into parasite biology, human immunity, and vector behavior will guide efforts to translate parasite and mosquito genome sequences into novel interventions.

Authors

Brian M. Greenwood, David A. Fidock, Dennis E. Kyle, Stefan H.I. Kappe, Pedro L. Alonso, Frank H. Collins, Patrick E. Duffy

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Figure 2

Antimalarial drugs mediate their effects by disrupting processes or metabolic pathways in different subcellular organelles.

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Antimalarial drugs mediate their effects by disrupting processes or meta...
The 4-aminoquinolines, including chloroquine and amodiaquine, and the quinolinemethanols, including quinine and mefloquine, concentrate inside the acidic digestive vacuole, where they are believed to bind β-hematin and interfere with heme detoxification. The falcipain inhibitors that are under development target cysteine proteases that participate in hemoglobin degradation in this digestive vacuole. Antibiotics such as azithromycin, doxycycline, and clindamycin act inside the chloroplast-like plastid organelle, where they inhibit protein translation, resulting in the death of the progeny of drug-treated parasites (the “delayed-death” phenotype). Atovaquone and select other compounds inhibit electron transport in the mitochondrion, whereas antifolates disrupt de novo biosynthesis of folate in the cytosol. Only drugs for which the site of action is known with confidence are assigned to a subcellular location. Indeed, the targets and sites of action of other antimalarials, including artemisinin and artemisin derivatives, remain an area of active investigation. Reproduced with permission from Nature Publishing Group (44).

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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