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A Pharmacological Appraisal of Antimalarial Plant Species
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Mahwahwatse J. Bapela, Precious B. Ramontja, Mcebisi J. Mabuza
Ethiopia has done better than many sub-Saharan African countries in reducing the burden of malaria over the last decade. In 2018, the total number of cases dropped by almost 8.4 % since 2010 (Dabaro et al., 2020). Recently, the emergence of plasmodium resistance—particularly to the currently used malaria therapy—has exacerbated the economic as well as health impacts of malaria (Alemu et al., 2012; Taffese et al., 2018). About 80% of Ethiopians in rural societies depend solely on traditional medicinal remedies because of the cost and inaccessibility of modern health services and medications (Alebie et al., 2017). Traditional medicinal herbs used for malaria by Ethiopians include Allium sativum (Liliaceae), Lepidium sativum (Brassicaceae), Carica papaya (Caricaceae), Croton macrostachyus (Euphorbiaceae), Vernonia amygdalina (Asteraceae), Artemisia afra (Asteraceae) and Moringa stenopetala (Moringaceae). Crude plant extracts from these plant species are well documented for their antimalarial activities (Alebie et al., 2017).
Host and Pathogen-Specific Drug Targets in COVID-19
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Bruce D. Uhal, David Connolly, Farzaneh Darbeheshti, Yong-Hui Zheng, Ifeanyichukwu E. Eke, Yutein Chung, Lobelia Samavati
This drug has been used for several years in malaria therapy with acceptable safety and efficacy. In the current global crisis, CLQ and HCQ were among the early options of repurposing drugs. Several clinical trials investigated the therapeutic potential of CLQ and HCQ in COVID-19 patients. The results indicated inconsistent outcomes, and the randomized controlled trials have failed to confirm its therapeutic usefulness in patients [25, 26]. Moreover, some reports imply probable cardiomyopathy as a severe adverse effect caused by CLQ. HCQ remains among the available candidates to prevent the severity of SARS-CoV-2 infections in humans, and additional clinical and molecular observations are needed to identify relevant subgroups that may benefit from HCQ, if any such groups exist. This seems unlikely, as the study of Elavarasi et al. [27], based on a systematic meta-analysis of 12 observational and 3 randomized trials including 10,659 patients, revealed that HCQ did not generate a significant reduction in mortality, time to fever resolution, or clinical deterioration or development of acute respiratory distress syndrome (ARDS).
Malaria
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Prompt parenteral anti-malarial therapy should be initiated for severe malaria with either artesunate or, if this is unavailable, quinine or quinidine. Respiratory support ranging from supplemental oxygen to mechanical ventilation may be required. Hypoglycemia is common and should be assessed for and treated. Seizures occur in a majority of cases and should be treated with benzodiazepines. Anemia is a common associated symptom and should be addressed with PRBCs (packed red blood cells) transfusion, in general for Hb <7 gm/dL.
The value of lamp to rule out imported malaria diagnosis: a retrospective observational study in Milan, Italy
Published in Infectious Diseases, 2022
Andrea Giacomelli, Maria Elena Monti, Romualdo Grande, Letizia Oreni, Laura Galimberti, Anna Lisa Ridolfo, Cecilia Bonazzetti, Federico Sabaini, Laura Cordier, Agostino Zambelli, Giuliano Rizzardini, Massimo Galli, Spinello Antinori
In our experience, no invalid or discordant result related to the LAMP test were found. It should be noted that invalid or between LAMP and PCR discordant results were found in a study by Polley et al., in which some false positive LAMP results compared to PCR were due to tubes contamination [23]. Vincent et al. found two discordant results in two patients with a history of recent anti-malarial therapy [25]. Several invalid results were observed in some studies [9,10,27] but they could be easily solved by repeating the test as described by Ljolje et al. [20]. Moreover, the performance of molecular tests (i.e. LAMP or PCR) in patient with a recent anti-malarial treatment could be challenging and the results should be carefully interpreted in light of the patient’s medical history, type of anti-malarial treatment and disease course. In fact, it has been shown that Plasmodium spp. DNA, especially for P. falciparum, could persists in a not negligible percentage of patients (up to 20%) 28 days after the initiation of the treatment [31]. Consequently, molecular methods should only be used as first screening methods whereas the traditional microscopy remains the cornerstone to assess treatment efficacy.
Plasmodium infection and drug cure for malaria vaccine development
Published in Expert Review of Vaccines, 2021
Reshma J. Nevagi, Michael F. Good, Danielle I. Stanisic
Historically, deliberate infection of humans with Plasmodium parasites has been employed for a number of reasons including as a treatment (malariotherapy) for neurosyphilis in the 1920–1960s [12,13] and to test novel anti-malarial drugs and vaccines (reviewed in [11]). Malariotherapy relied on the malaria parasites inducing fever which is thought to kill the Treponema pallidum organisms. Retrospective analyses of the malariotherapy studies suggest that the observed decrease in parasitemia and febrile episodes during second infections with the same or different strain/species of Plasmodium reflected the induction of partial clinical and/or anti-parasite immunity [14]. Together with observations regarding the development of clinical immunity following multiple infections in individuals living in malaria endemic areas (reviewed in [15]), these data support developing deliberate, controlled malaria infection as a vaccine approach.
Humanized mouse models infected with human Plasmodium species for antimalarial drug discovery
Published in Expert Opinion on Drug Discovery, 2018
Alicia Moreno-Sabater, Jean Louis Pérignon, Dominique Mazier, Catherine Lavazec, Valerie Soulard
There has been a dramatic increase in malaria drug discovery in the last 10 years and efforts are expected to increase in the coming years, for two main reasons. The first reason is that the present armamentarium against Plasmodium falciparum (P. falciparum), the parasite responsible for the large majority of malaria mortality (ca. 429,000 in 2015, 92% in Africa, and 70% in children under 5 years old) [1], may soon become insufficient. Indeed, due to worldwide resistance to chloroquine, artemisinin-based combination therapies (ACTs) are the mainstay in the current malaria therapy. ACTs are recommended in most malaria-endemic countries as first-line treatment of uncomplicated P. falciparum malaria. However, it is well known that P. falciparum can become resistant against almost any drug that is in widespread use. Unfortunately, this has been confirmed 8 years ago, when first cases of reduced sensitivity of P. falciparum against artemisinins were reported from South-East Asia, which were characterized by a prolonged clearance time of the parasite [2]. In addition, laboratory strains have been rendered resistant to artemisinin, allowing the identification of a genetic marker of resistance and K13 propeller mutations were found to correlate with delayed in vivo clearance times [3]. The emergence and spread of resistance to antimalarial drugs are of major concern and are globally monitored, e.g. by the WorldWide Antimalarial Resistance Network, in order to inform the malaria community of potential efficacy loss of antimalarials [4]. This situation highlights the urgent need to find new drugs to treat the disease.