Table 2.
Molecular markers of antimalarial drug resistance in P. falciparum.
| Class | Drug | Gene (s) | Mutation |
|---|---|---|---|
| 4-aminoquinolines | Chloroquine | pfcrt | Necessary but not sufficient: K76Ta Other mutations include C72S, M74I, N75E, A220S, Q271E, N326S, I356T, and R371I |
| pfmdrl (in combination with mutant pfcrt only) | N86Y, Y184F, S1034C, N1042D, and D1246Y | ||
| Amodiaquine | pfcrt and pfmdrl | PfMDR1 N86Y and PfCRT K76T contribute to decreased parasite susceptibility | |
| Piperaquine | pm2/3 | Increased copy number | |
| pfcrt | T93S, H97Y, F145I, I218F, M343L, C350R, or G353V | ||
| Pyronaridine | Yet to be identified | - | |
| Amino alcohols | Lumefantrine | Yet to be identified | Selects for PfMDR1 N86 and PfCRT K76 |
| Mefloquine | pfmdrl | Increased copy number | |
| Endoperoxide | Artemisinin derivatives | k13 | Validated: P413A, F446I, N458Y, C469Y, M476I, Y493H, R539T, I543T, P553L, R561H, P574L, C580Y, and A675Vb Candidate or associated: P441L, G449A, C469F, A481V, R515K, P527H, N537I/D, G538V, and R622I |
a
Chloroquine resistance requires at least four mutations that include K76T.
b
Validated K13 markers have a statistically significant association between the mutation and delayed clearance as well as survival > 1% in the ring-stage survival assay. Candidate or associated markers fulfill one of these conditions to date.