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Scientists claim to have identified the genetics responsible for resistance to a frontline malaria drug, artemisinin.
A study, published in Nature Genetics, has found 20 mutations in the kelch13 gene of the malaria-causing parasite Plasmodium falciparum. These mutations appear to work with a set of background mutations in four other genes to support artemisinin resistance.
"It's similar to what we see with pre-cancerous cells which accumulate genetic changes but only become malignant when they acquire critical driver mutations that kick-off growth," said Roberto Amato, a first author and research associate at the Wellcome Trust Sanger Institute, according to an official release. The findings will help identify areas where artemisinin resistance could spread.
Researchers analysed 1,612 samples from 15 locations in Asia and Africa for the study. They found that the risk of a parasite developing a mutation in kelch13 was higher within southeastern Asia, though the reason for the phenomenon is still unclear. While it may be restricted to this region for now, researchers highlighted the need for monitoring the situation as the parasite population continues to evolve.
"We are at a pivotal point for malaria control. While malaria deaths have been halved, this progress is at risk if artemisinin ceases to be effective," said Nick Day, director of the Mahidol-Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand. "We need to use every tool at our disposal to protect this drug. Monitoring parasites for background mutations could provide an early warning system to identify areas at risk for artemisinin resistance."