The science of resistance

November 10, 2006 at 5:07 pm (Links, Sam's Posts)

Here is another informative perspective from the New England Journal of Medicine:

Malaria – Time to Act

It was published just a couple days ago, and it covers the viability of a possible reentry into malaria treatment protocol for chloroquinone. With only a small amount of knowledge about drug resistance in infectious disease treatment, I was previously under the impression that once a drug lost its utility, it was gone for good, and would never be helpful again. Not so.

In particular, I find it amazing that ‘chloroquine resistance presumably confers a fitness disadvantage, and stable compensatory mutations sufficient to counter these disadvantage apparently have not occurred.’ I often look at infectious disease treatment as a bacterial seige on humans, patiently mutating, waiting outside the walls until we run out of drug innovations and become defenseless. The fact that some of these stronger, mutated agents are weak enough in other ways to want to revert back to their original form once their original scourge is gone – this confers some hope. We still need long-term, all-encompassing solutions, but in the meantime, you, drug, circle around back and hop in the end of the line – your turn will come again.


p.s. I see that the clinical trial asserting the rebound of chloroquine efficacy is also in the current issue of NEJM. In case you want to read that:

Return of Chloroquine Antimalarial Efficacy in Malawi


1 Comment

  1. Gao-De Li said,

    Chloroquine resistance mechanism remains unknown. Pfcrmp may play a key role in chloroquine’s antimalarial action and resistance development.

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