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Plasmodium falciparum Na+/H+ Exchanger (pfnhe-1) Genetic Polymorphism in Indian Ocean Malaria-Endemic Areas
To date, 11 studies conducted in different countries to test the association between Plasmodium falciparum Na+/H+ exchanger gene (pfnhe-1; PF13_0019) polymorphisms and in vitro susceptibility to quinine have generated conflicting data. In this context and to extend our knowledge of the genetic polymorphism of Pfnhe gene, we have sequenced the ms4760 locus from 595 isolates collected in the Comoros (N = 250; an area with a high prevalence of chloroquine and sulfadoxine-pyrimethamine resistance) and Madagascar (N = 345; a low drug-resistance area). Among them, 29 different alleles were observed, including 8 (27%) alleles not previously described. Isolates from the Comoros showed more repeats in block II (DNNND), which some studies have found to be positively associated with in vitro resistance to quinine, compared with isolates from Madagascar. Additional studies are required to better define the mechanisms underlying quinine resistance, which involve multiple gene interactions.
Author Notes
Authors' addresses: Valérie Andriantsoanirina and Rémy Durand, Hôpital Avicenne, AP-HP, Laboratoire de Parasitologie-Mycologie, Bobigny, France, E-mails: landyvalerie@gmail.com and remy.durand@avc.aphp.fr. Nimol Khim, Benoit Witkowski, Lydie Canier, Christophe Benedet, and Didier Ménard, Institut Pasteur du Cambodge, Malaria Molecular Epidemiology Unit, Phnom Penh, Cambodia, E-mails: knimol@pasteur-kh.org, bwitkowski@pasteur-kh.org, lcanier@pasteur-kh.org, christophe.benedet@pasteur-kh.org, and dmenard@pasteur-kh.org. Arsene Ratsimbasoa, Ministère de la Santé, du Planning Familial et de la Protection Sociale—National Malaria Control Programme, Antananarivo, Madagascar, E-mail: arsene.ratsimbasoa@laposte.net. Christiane Bouchier and Magali Tichit, Institut Pasteur, Génopôle de l'Ile de France, Plate-Forme Génomique, Paris, France, E-mails: bouchier@pasteur.fr and mtichit@pasteur.fr.