Chapter 7 : Reversal of Fortune

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Drug resistance is the result of natural selection; i.e., individuals with a particular genetic makeup (genotype) that are the most able to survive and reproduce their kind pass on their genes to future generations and increase in frequency over time. Detailed information on the number and size of malaria parasite chromosomes became available only after the development of pulsed-field gel electrophoresis, a clever technique that permits separation of very large molecules. Using this novel approach, it was possible to separate the 14 chromosomes of . The recombinant DNA method (as originally developed by Boyer and Cohen) used plasmids-small circles of naked DNA. Resistance to quinine, used for more than 350 years to treat malaria infections, had been observed in the late 1890s and early 1900s. Today approximately 300 to 500 tons of quinine and quinidine is produced each year by extraction of the bark from cinchona trees. Approximately 40% of the quinine is used in pharmaceuticals, while the remainder is used by the food industry as the bitter principle in soft drinks such as bitter lemon and tonic water. Multidrug resistance (MDR) in tumor cells (i.e., reduced drug accumulation) has some features in common with drug resistance in malarial parasites.

Citation: Sherman I. 2011. Reversal of Fortune, p 150-167. In Magic Bullets to Conquer Malaria. ASM Press, Washington, DC. doi: 10.1128/9781555816889.ch7
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