Single-Nucleotide Polymorphisms in Glucose-6-Phosphate Dehydrogenase and their Relevance for the Deployment of Primaquine as a Radical Cure for Malaria

Minu Nain ICMR-National Institute of Malaria Research, New Delhi, India;

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Jasmita Gill ICMR-National Institute of Malaria Research, New Delhi, India;

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Mradul Mohan ICMR-National Institute of Malaria Research, New Delhi, India;
Academy of Scientific and Innovative Research, Ghaziabad, India;

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Amit Sharma ICMR-National Institute of Malaria Research, New Delhi, India;
Academy of Scientific and Innovative Research, Ghaziabad, India;
Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India

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ABSTRACT.

Malaria remains an important public health problem despite efforts to control it. Besides active transmission, relapsing malaria caused by dormant liver stages of Plasmodium vivax and Plasmodium ovale hypnozoites is a major hurdle in malaria control and elimination programs. Primaquine (PQ) is the most widely used drug for radical cure of malaria. Due to its anti-hypnozoite and gametocidal activity, PQ plays a key role in malaria relapse and transmission. The human enzyme glucose-6-phosphate dehydrogenase (G6PD) is crucial in determining the safety of PQ because G6PD-deficient individuals are prone to hemolysis if treated with PQ. Therefore, there is a need to study the prevalence of G6PD-deficient genetic variants in endemic populations to assess the risk of PQ treatment and the necessity to develop alternative treatments. In this work, we discuss the common G6PD variants, their varying enzymatic activity, and their distribution on the three-dimensional structure of G6PD. Our work highlights the important G6PD variants and the need for large-scale G6PD gene polymorphism studies to predict populations at risk of PQ-induced toxicity.

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Author Notes

Address correspondence to Amit Sharma, Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, Delhi 110067. E-mail: amit.icgeb@gmail.com

The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

Authors’ addresses: Minu Nain and Jasmita Gill, ICMR-National Institute of Malaria Research, New Delhi, India, E-mails: minu345r@gmail.com and jasmita.gill@gmail.com. Mradul Mohan, ICMR-National Institute of Malaria Research, New Delhi, India, and Academy of Scientific and Innovative Research, Ghaziabad, India, E-mail: mradul_mohan@yahoo.com. Amit Sharma, ICMR-National Institute of Malaria Research, New Delhi, India, Academy of Scientific and Innovative Research, Ghaziabad, India, and Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India, E-mail: amit.icgeb@gmail.com.

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