Bengaluru, Feb 3: Detection of malaria parasites resistant to the frontline artemisinin (ART) combition therapy in some south Asian countries should worry India, Govindarajan Padmabhan a top biochemist and malaria researcher at the Indian Institute of Science here has warned.
“Africa and India can as well be the superbug’s next destition and, if it spreads, this will pose a disaster,” Padmabhan told this correspondent, adding: “Sri Lanka is supposed to be malaria-free and it too should start worrying.”
The British jourl “Lancet Infectious Diseases” had recently reported that P. falciparum malaria parasites resistant to both ART and its widely used partner drug, piperaquine, are now spreading quickly throughout western Cambodia, southern Laos and northeastern Thailand.
The study, by researchers at Mahidol University in Thailand and Oxford University, warned that “the consequences of resistance spreading further into India and Africa could be grave if drug resistance is not tackled from a global public health emergency perspective”.
Artemisinin, also known as qinghaosu — extracted from the “Artemisia annua” plant — is a powerful and perhaps the only really effective anti-malarial at present. But because ART has a very short half-life, the World Health Organisation had insisted that it should only be used as a combition with another long-acting anti-malarial.
Thus came the combition therapies: ART-lumefantrine, ART-meflaquine, ART- Sulfadoxine/pyrimethamine (ART-SP) and Dihydroartemisinin-piperaquine (DHA-PPQ).
Padmabhan said that over the years, the malaria parasite had developed resistance even to many combition therapies, except DHA-PPQ, that had remained very effective.
“Now the recent report of the parasite’s resistance to this combition also is really worrisome.”
“The spread of resistance will be a huge challenge to health workers,” he said. “This challenge will always go on and that is why I really want to try ART-curcumin combition, which may be an answer to resistance development,” the scientist noted.
Curcumin, is the compound that gives turmeric (haldi) its trademark bright yellow colour.
The ART-curcumin combition is unique, with potential advantages over the known combition therapies, Padmabhan said. In trials carried out on mice, three oral doses of curcumin following a single injection of artemisinin to infected mice were able to ensure almost 100 per cent survival of the animals.
In addition to having a direct killing effect as an anti-malarial, curcumin is also able to prime the immune system against malaria parasites in mice “rendering the combition to act like a therapeutic vaccine”, Padmabhan said.
“Thus, this combition has unique potential to prevent parasite recrudescence and relapse. Besides it is cheap and no resistance against it is known since it is a dietary supplement.”
Padmaban and his team are hoping to start human trials of an artemisinin-curcumin combition therapy in both simple malaria cases and in the treatment of the deadly cerebral malaria. He said regulatory clearances are awaited. (IANS)