Plasmodium falciparum histidine rich protein 2 (pfhrp2): An additional genetic marker suitable for anti-malarial drug efficacy trials
Document Type
Article
Publication Date
1-4-2022
Abstract
Background Genotyping of the three Plasmodium falciparum polymorphic genes, msp1, msp2 and glurp, has been adopted as a standard strategy to distinguish recrudescence from new infection in drug efficacy clinical trials. However, the suitability of a particular gene is compromised in areas where its allelic variants distribution is significantly skewed, a phenomenon that might occur in isolated parasite populations or in areas of very low transmission. Moreover, observation of amplification bias has diminished the value of glurp as a marker. Methods The suitability of the polymorphic P. falciparum histidine-rich protein 2 (pfhrp2) gene was assessed to serve as an alternative marker using a PCR-sequencing or a PCR-RFLP protocol for genotyping of samples in drug efficacy clinical trials. The value of pfhrp2 was validated by side-by-side analyses of 5 admission-recrudescence sample pairs from Yemeni malaria patients. Results The outcome of the single pfhrp2 gene discrimination analysis has been found consistent with msp1, msp2 and glurp pool genotyping analysis for the differentiation of recrudescence from new infection. Conclusion The findings suggest that under the appropriate circumstances, pfhrp2 can serve as an additional molecular marker for monitoring anti-malarials efficacy. However, its use is restricted to endemic areas where only a minority of P. falciparum parasites lack the pfhrp2 gene.
Keywords
Malaria, Plasmodium falciparum, Drug efficacy clinical trial, hrp2, msp1, msp2, Glurp
Divisions
fac_med
Funders
Universiti Malaya High Impact Research Grant UM-MOHE [Grant No: UM.C/625/1/HIR/MOHE/MED/16],Ministry of Education, Malaysia
Publication Title
Malaria Journal
Volume
21
Issue
1
Publisher
BioMed Central
Publisher Location
CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND