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Phase II Clinical Tests of New Anti-Malaria Drug Cures 83 People

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By combining the drugs Fosmidomycin and Piperaquine, an international research team has cured 83 people of malaria. Professor Peter Kremsner, of the Tübingen Institute of Tropical Medicine, developed the new combination of drugs.

The team administered the combination of two drugs for three days to patients aged 1 to 30 infected with malaria through the Plasmodium falciparum pathogen. They tested the medication’s efficacy, tolerability, and safety.

100 % rate

Science Daily reported that in the 83 evaluable cases, the cure rate was 100 percent. The study, published in Clinical Infectious Diseases, said that the patients tolerated the treatment well. It led to a swift reduction of clinical symptoms.

There were safety issues, but it was limited to changes in electrocardiogram readings. Kremsner said that the research represents a milestone in the clinical study into Fosmidomycin. It was originally extracted from Streptomyces lavendulae which can be synthetically produced today.

The substance blocks a metabolic pathway to produce Isoprenoid in the malaria pathogen. Due to the substance, the malaria pathogen is unable to reproduce or metabolize. However, since the Isoprenoids are formed through a different synthesis path in the human body, people have no target structures for Fosmydomycin.

It explained why the malaria patients tolerated Fosmidomycin well and barely suffered any side effects. The unique mechanism of the drug excludes the possibility of cross-resistance to medication used in earlier malaria treatments.

Kremsner said that the combination meets the World Health Organization guidelines for combination therapies. Because the mechanism of the two drugs versus differing target structures means the two medications attack the parasites in the bloodstream independently of each other. It also meets WHO requirements for a fast and effective treatment of the acute phase of infection as well as protection against relapse because the infection reappeared.

Toothpaste compound

Meanwhile, The Independent reported that triclosan, a compound commonly found in toothpaste, can be used to fight malaria parasites that are drug-resistant. The discovery was made by a laboratory robot that was powered by artificial intelligence.

The compound can be deployed against the strains of Plasmodium malaria parasites which evolved resistance to pyrimethamine, a widely used drug, University of Cambridge researchers said. DHFR, an enzyme, is inhibited by pyrimethamine, while triclosan can be used to target ENR, another enzyme.

Eve, the robot, using its fast-moving AI routines, discovered that triclosan likewise attacks DHFR even in parasites that are resistant to pyrimethamine. The AI formulates, tests, and re-evaluates the hypothesis in quick succession.

The researchers are now hoping that triclosan can be developed for use in a two-pronged attack on Plasmodium in the blood and liver. Dr. Elizabeth Bilsland, an assistant professor at the University of Campinas in Brazil, said that Eve’s discovery on how triclosan is effective against malaria brings hope that it could be used in the future to develop a new medication.

Synthetic malaria vaccine

In Philadelphia, the Bill and Melinda Gates Foundation awarded a $1.4 million grant to the Watar Institute. In collaboration with the John Hopkins Malaria Research Institute and Inovio Pharmaceuticals, the Watar Institute will create a synthetic DNA-based vaccine for malaria, Forbes reported.

It is in the laboratory of David Weiner, the executive director of the Vaccine & Immunotherapy Center of the Watar Institute, where the research initiative was created. He is a molecular immunologist and considered a DNA vaccine pioneer.

The vaccine will be created against Plasmodium falciparum, the deadliest microorganism which causes malaria. The synthetic vaccine is designed to instruct the body to produce antigens that are malaria-specific. It will activate the immune system to generate a more effective immune response.

Weiner will use an electroporation device that Inovio Pharmaceutical created to generate small, directional electric currents in the skin. It will mix the DNA vaccine platform with the delivery device. According to the team, they hope that it will create an effective strategy to help eradicate malaria.

Data from the World Health Organization said that in 2016, the number of malaria cases reached 216 million. It was a 5-million increase from 2015 cases. Two years ago, 445,000 malaria deaths were reported. 

To combat the mosquito-borne disease, governments of countries where malaria is endemic and their largest international source of funds in 2016 was the US which financed $1 billion. It was followed by the UK, France, Germany, and Japan.

A study by researchers at the University of Melbourne in Australia showed that DNA fingerprinting revealed malaria’s ability to hide in the human body’s immune system. It shuffles genes to create various strains that enable the parasite to go undetected. Similar to the flu, it can re-infect the same patients.

By 2018, GlaxoSmithKline is scheduled to launch Mosquirix, the first malaria vaccine in the world, the pharmaceutical giant announced in 2017. The company had completed Phase 3 testing of the vaccine and it will be implemented in various pilot areas administered by WHO.

[메디컬리포트=​Vittorio Hernandez 기자]

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