Host biology drives malaria treatment failures, reveals RGCB study

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The study, published in the Journal of Infectious Diseases, reveals that immature red blood cells, called reticulocytes, create a protective environment for the malaria parasite, Plasmodium falciparum. | Photo Credit: Getty Images/iStockphoto

For decades now, combination therapies with Artemisinin, a potent anti-malarial drug, have been the cornerstone of malaria treatment worldwide. It has always vexed scientists that some malaria patients failed to clear the parasite and went into relapse despite receiving the right treatment.

This happened even when scientists could not detect any genetic mutations in the parasite (Plasmodium falciparum) which might have rendered it resistant to drugs

Researchers at the Rajiv Gandhi Centre for Biotechnology (RGCB) might just have unravelled this mystery with their discovery that it was host factors rather than genetic mutations acquired by the parasite which led to drug resistance and treatment failure.

Christeen Davis and colleagues at the RGCB, established through their research that malaria parasites were able to withstand or resist artemisinin because of the protective biochemical environment created by the immature or young red blood cells known as reticulocytes in the patient’s own blood.

These findings may add an entirely new dimension to how scientists may think about drug resistance and offer a new perspective on how host biology influences a disease and its treatment.

The study, titled “Host Reticulocyte Redox Attenuation Creates a Protective Niche for Artemisinin Tolerance in Plasmodium falciparum”, was published in the latest (June 16) issue of the Journal of Infectious Diseases as an Editor’s Choice article.

Artemisinin kills the parasite by a biochemical assault. It generates a flood of free radicals which lead to oxidative damage inside the parasite.

Reticulocytes, the new, freshly minted red blood cells released from the bone marrow, are loaded with antioxidants, nutrients and protective enzymes, capable of neutralising