Cargando…

Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?

Background: Artemisinin-based treatment in malaria patients with abnormal hemoglobin may be ineffective because of their genetic particularity, which could lead to resistance. The main purpose of this study was to assess the effect of artemisinin derivatives on in vivo parasite clearance according t...

Descripción completa

Detalles Bibliográficos
Autores principales: Gbessi, Eric A., Toure, Offianan A., Gnondjui, Albert, Koui, Tossea S., Coulibaly, Baba, Ako, Berenger A., Tiacoh, Nguessan L., Assi, Serge-Brice, Sanogo, Ibrahima, Sokouri, Didier-Paulin, Jambou, Ronan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475499/
https://www.ncbi.nlm.nih.gov/pubmed/34569928
http://dx.doi.org/10.1051/parasite/2021063
_version_ 1784575435393204224
author Gbessi, Eric A.
Toure, Offianan A.
Gnondjui, Albert
Koui, Tossea S.
Coulibaly, Baba
Ako, Berenger A.
Tiacoh, Nguessan L.
Assi, Serge-Brice
Sanogo, Ibrahima
Sokouri, Didier-Paulin
Jambou, Ronan
author_facet Gbessi, Eric A.
Toure, Offianan A.
Gnondjui, Albert
Koui, Tossea S.
Coulibaly, Baba
Ako, Berenger A.
Tiacoh, Nguessan L.
Assi, Serge-Brice
Sanogo, Ibrahima
Sokouri, Didier-Paulin
Jambou, Ronan
author_sort Gbessi, Eric A.
collection PubMed
description Background: Artemisinin-based treatment in malaria patients with abnormal hemoglobin may be ineffective because of their genetic particularity, which could lead to resistance. The main purpose of this study was to assess the effect of artemisinin derivatives on in vivo parasite clearance according to erythrocyte variants. In vivo response was investigated through retrospective data obtained over a 42-day artemether-lumefantrine/artesunate amodiaquine efficacy protocol conducted from 2012 to 2016. Results: A total of 770 patients in Côte d’Ivoire attending the hospitals of Anonkoua-koute (Abidjan), Petit Paris (Korhogo), Libreville (Man), Dar es salam (Bouaké), Ayamé and Yamoussoukro with acute uncomplicated falciparum malaria were selected for successful hemoglobin typing. HbAS, HbSS, HbAC, and HbSC genotypes were found. Parasite clearance time was obtained for 414 patients. In the population with abnormal hemoglobin, parasite densities on admission and parasite clearance rates were significantly lower in the HbSC group compared to HbAA (p = 0.02 and p = 0.007, respectively). After PCR correction on day 42, the acute treatment rate was 100% for each group. Parasite half-life and time for initial parasitaemia to decline by 50 and 99% were longer for the HbSC group (p < 0.05). The study also investigated the prevalence of K13-propeller polymorphisms across different hemoglobin genotype groups. A total of 185 and 63 samples were sequenced in the HbAA group and patients with abnormal Hb, respectively. Only two nonsynonymous mutations D559N and V510M were found in the HbAA group. Conclusion: Although this study proved good efficacy of artemether-lumefantrine and artesunate amodiaquine in the treatment of uncomplicated Plasmodium falciparum malaria in patients with abnormal hemoglobin, the increased delay of parasite clearance may represent a threat to health in these patients in relation with sickle cell crisis, which could support selection of parasites resistant to artemisinin.
format Online
Article
Text
id pubmed-8475499
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher EDP Sciences
record_format MEDLINE/PubMed
spelling pubmed-84754992021-10-18 Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment? Gbessi, Eric A. Toure, Offianan A. Gnondjui, Albert Koui, Tossea S. Coulibaly, Baba Ako, Berenger A. Tiacoh, Nguessan L. Assi, Serge-Brice Sanogo, Ibrahima Sokouri, Didier-Paulin Jambou, Ronan Parasite Research Article Background: Artemisinin-based treatment in malaria patients with abnormal hemoglobin may be ineffective because of their genetic particularity, which could lead to resistance. The main purpose of this study was to assess the effect of artemisinin derivatives on in vivo parasite clearance according to erythrocyte variants. In vivo response was investigated through retrospective data obtained over a 42-day artemether-lumefantrine/artesunate amodiaquine efficacy protocol conducted from 2012 to 2016. Results: A total of 770 patients in Côte d’Ivoire attending the hospitals of Anonkoua-koute (Abidjan), Petit Paris (Korhogo), Libreville (Man), Dar es salam (Bouaké), Ayamé and Yamoussoukro with acute uncomplicated falciparum malaria were selected for successful hemoglobin typing. HbAS, HbSS, HbAC, and HbSC genotypes were found. Parasite clearance time was obtained for 414 patients. In the population with abnormal hemoglobin, parasite densities on admission and parasite clearance rates were significantly lower in the HbSC group compared to HbAA (p = 0.02 and p = 0.007, respectively). After PCR correction on day 42, the acute treatment rate was 100% for each group. Parasite half-life and time for initial parasitaemia to decline by 50 and 99% were longer for the HbSC group (p < 0.05). The study also investigated the prevalence of K13-propeller polymorphisms across different hemoglobin genotype groups. A total of 185 and 63 samples were sequenced in the HbAA group and patients with abnormal Hb, respectively. Only two nonsynonymous mutations D559N and V510M were found in the HbAA group. Conclusion: Although this study proved good efficacy of artemether-lumefantrine and artesunate amodiaquine in the treatment of uncomplicated Plasmodium falciparum malaria in patients with abnormal hemoglobin, the increased delay of parasite clearance may represent a threat to health in these patients in relation with sickle cell crisis, which could support selection of parasites resistant to artemisinin. EDP Sciences 2021-09-27 /pmc/articles/PMC8475499/ /pubmed/34569928 http://dx.doi.org/10.1051/parasite/2021063 Text en © E. Gbessi et al., published by EDP Sciences, 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Gbessi, Eric A.
Toure, Offianan A.
Gnondjui, Albert
Koui, Tossea S.
Coulibaly, Baba
Ako, Berenger A.
Tiacoh, Nguessan L.
Assi, Serge-Brice
Sanogo, Ibrahima
Sokouri, Didier-Paulin
Jambou, Ronan
Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?
title Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?
title_full Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?
title_fullStr Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?
title_full_unstemmed Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?
title_short Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?
title_sort artemisinin derivative-containing therapies and abnormal hemoglobin: do we need to adapt the treatment?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475499/
https://www.ncbi.nlm.nih.gov/pubmed/34569928
http://dx.doi.org/10.1051/parasite/2021063
work_keys_str_mv AT gbessierica artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT toureoffianana artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT gnondjuialbert artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT kouitosseas artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT coulibalybaba artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT akoberengera artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT tiacohnguessanl artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT assisergebrice artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT sanogoibrahima artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT sokourididierpaulin artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment
AT jambouronan artemisininderivativecontainingtherapiesandabnormalhemoglobindoweneedtoadaptthetreatment