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duminică, 5 august 2012

A Better Understanding Of Rhomboid Proteases May Lead To New Therapies For Malaria And Other Parasitic Diseases

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Main Category: Tropical Diseases
Also Included In: Infectious Diseases / Bacteria / Viruses;  Biology / Biochemistry
Article Date: 05 Aug 2012 - 0:00 PDT Current ratings for:
A Better Understanding Of Rhomboid Proteases May Lead To New Therapies For Malaria And Other Parasitic Diseases
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Johns Hopkins scientists have decoded for the first time the "stability blueprint" of an enzyme that resides in a cell's membrane, mapping which parts of the enzyme are important for its shape and function. These studies, published in advance online in Structure and in Nature Chemical Biology, could eventually lead to the development of drugs to treat malaria and other parasitic diseases.

"[It's] the first time we really understand the architectural logic behind the structure of the enzyme," says Sinisa Urban, Ph.D., an associate professor of molecular biology and genetics at the Johns Hopkins University School of Medicine and an investigator at the Howard Hughes Medical Institute, who with his team has unlocked the mysteries of a special class of enzymes called rhomboid proteases.

Rhomboid proteases are present in many different organisms, and are a unique type of enzyme that resides in the cell's membrane where they cut proteins. Previously Urban and his colleagues demonstrated that the rhomboid enzyme is critical for Plasmodium falciparum, the parasite that causes malaria, to successfully invade red blood cells, a step that ultimately leads to infection. Urban says understanding the stability of rhomboid protease shape may impact the design of enzyme inhibitors - potential drugs. "These enzymes have no selective inhibitors," says Urban. "We really need to understand how [the enzyme] works - is it as stiff as a rock, or is it more gummy, like Jell-O?"

One challenge of studying rhomboid enzymes is that they are surrounded by membranes, making them more difficult to manipulate and work with. To address this, Urban's research team turned to a technique known as thermal light scattering, which heats enzyme samples to progressively higher temperatures while measuring the amount of light bouncing back off of the molecules. Enzymes that have broken from their normal shape will scatter light differently, and the temperature at which this occurs (in effect, the breaking point of the enzyme) indicates the inherent stability of the enzyme.

The researchers first precisely measured the stability of the rhomboid enzyme from E. coli bacteria. Surprisingly, says Urban, the rhomboid enzyme was more "Jell-O-like" than other membrane proteins with similar shapes. He guesses that this "jiggly shape" may help rhomboid proteases interact with other proteins that it cuts. To find which parts of the enzyme are most important for maintaining shape and which parts are more crucial for function, the researchers then made and tested 150 differently altered versions of the enzyme. They found four main regions important for maintaining shape and at least two regions important for function.

The researchers also took advantage of computer simulations to test their ideas about how the enzyme functions. Using a computer program model of the enzyme, they programmed in features of its natural membrane environment, which consists mostly of fats and is very limited in water. The computer program then simulated how this environment might influence the enzyme. Researchers found that the enzyme contains a special internal pocket for holding water molecules - a great advantage in its natural, water-limiting environment.

"We're very excited about our findings and are especially curious about the versions of the enzyme that lost function despite no obvious change in stability or shape," says Urban. Ultimately he hopes that a better understanding of rhomboid proteases will lead to new therapies for treating malaria and other parasitic diseases.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our tropical diseases section for the latest news on this subject. These studies were supported by the Howard Hughes Medical Institute, a National Institute of General Medical Sciences grant (GM079223), a National Institute of Allergy and Infectious Diseases grant (AI066025), the National Science Foundation (NSF) and the David and Lucile Packard Foundation.
Other researchers who participated in this study include Rosanna Baker, Yanzi Zhou, Syed Moin and Yingkai Zhang.
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'A Better Understanding Of Rhomboid Proteases May Lead To New Therapies For Malaria And Other Parasitic Diseases'

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joi, 15 decembrie 2011

Malaria In Africa - A Logistics Approach

Main Category: Tropical Diseases
Also Included In: Public Health
Article Date: 15 Dec 2011 - 0:00 PST

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The problems of archaic logistics infrastructure, inefficient distribution channels and disruptive black markets must all be addressed urgently if Africa is to cope with the growing problem of malaria, according to a study published in the International Journal of Logistics Systems and Management.

Historically, malaria is humanity's biggest killer and although it has been eradicated in some regions it remains the biggest infectious threat in many parts of the world. Malaria kills 1.1 million people every year and afflicts 300 million with acute illness. The vast majority of those infected are children under the age of five years. Getting anti-malarial drugs to those at risk across Africa is an enormous problem of economics, politics and infrastructure. Now, Hokey Min of the College of Business Administration, at Bowling Green State University, in Ohio, has identified the various factors that must be considered if this situation is to be remedied.

Min has developed a comprehensive supply chain map that reveals the labyrinths of African logistics infrastructure, distribution channels, government regulations and business customs. This map could help improve access to anti-malarial drugs as well as avoiding disruption to the drug supply chain. He points out that there are countless challenges posed by trade and regulatory barriers across Africa. Communication difficulties, seasonal variations in logistics infrastructure and a high rate of theft and damage during storage and transit also potentially overwhelm any company hoping to distribute anti-malarial drugs in the African market. He suggests that outsourcing of logistics functions to control such risks and costs might be the only solution.

Moreover, African legal and ethical codes have many "subtleties" he says, so it is potentially beneficial to find local partners that can assist with such subtleties. In addition, the chronically poor roads suggest that local transport options, such as donkey carts and bicycles should also be considered as viable modes of distribution rather than a company expecting to transport antimalarials to rural areas in trucks.

Recognizing the idiosyncrasies of drug distribution in Africa is essential to coping with the lethal problem of malaria. "Supply chain efficiency for distribution of anti-malarial drugs is a matter of life and death to many malaria-endemic countries in Africa," says Min. And, although few attempts have been made to tackle the problem, an understanding of the African distribution system and the unique but complicated socioeconomic and regulatory environments affecting African logistics operations is essential. Min's preliminary study on addressing the issues points the way forward to improving a disheartening situation.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our tropical diseases section for the latest news on this subject. "Mapping the supply chain of anti-malarial drugs in Sub-Saharan African countries" in Int. J. Logistics Systems and Management, 2012, 11, 1-23
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miercuri, 14 decembrie 2011

One Malaria Episode Early In Pregnancy Triples Miscarriage Risk

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Main Category: Tropical Diseases
Also Included In: Pregnancy / Obstetrics
Article Date: 14 Dec 2011 - 9:00 PST

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According to the largest study on the effects of malaria and different anti-malarial drugs in early pregnancy to date, just one episode of malaria in the first trimester is linked to a three-fold greater risk of miscarriage. Researchers also discovered that women treated with anti-malarial drugs did not suffer any serious side effects or increase their likelihood of miscarriage. The study was published Online First in The Lancet Infectious Diseases.

According to estimates each year, 125 million pregnancies are at risk of malaria. During pregnancy, malaria can cause both severe anemia and parasitic infection in the fetus and increase the risk of low birth-weight, preterm birth, and maternal death.

Until now, scientists know little about the effects of malaria in early pregnancy or the benefits and harms of anti-malarial drugs during the early stages of pregnancy. The treatment of all falciparum malaria is artesunate-based combination therapy (ACT), however, it is not recommend during the first pregnancy trimester as it has been proven toxic in animal studies, potentially causing birth defects or miscarriage.

Leading author Rose McGready from Shoklo Malaria Research Unit in Thailand, explained:

"Both vivax and falciparum malaria contribute significantly to avoidable fetal and infant death. These results suggest that the adverse effects of malaria in the first trimester substantially outweigh any adverse effects of its treatment...[and] emphasizes the importance of early detection of malaria and prompt effective treatment for all pregnant women."

McGready and his team set out to provide more evidence and reviewed records of pregnant women who attended antenatal clinics of the Shoklo Malaria Research Unit on the northwestern border of Thailand between May 1986 and October 2010. They compared outcomes of 16,668 women who no malaria during pregnancy with 945 women who had only a single episode in the first trimester, i.e. at less than 14 weeks into their pregnancy, and discovered that asymptomatic malaria, showing no noticeable symptoms, was linked to almost a three times higher risk of miscarriage compared with those who did not contract malaria, whilst the risk of miscarriage for those with symptomatic malaria tended to be at least four-times more likely. In women with vivax and falciparum malaria the risk of miscarriage was similar.

The researchers discovered that the chances of miscarriage was comparable in women who received chloroquine (26%), quinine (27%), and artesunate (31%) during the first-trimester, with no substantial difference reported between treatments in other birth outcomes, such as still birth or low birth weights. Unlike the findings from animal studies, the researchers detected no additional toxic effects in women treated with artesunate.

The authors comment: "Miscarriage in 24 first-trimester episodes of hyperparasitaemia or severe malaria was high but artesunate did not result in higher rates of miscarriage than did quinine," and conclude saying, that: "These findings have serious implications for malaria treatment and prevention policies, which currently ignore the first trimester...A randomized trial of first-trimester artemisinin-based treatment is now needed to make firm recommendations on the safety of first-trimester malaria treatments with this class of anti-malarial drug."

Meghna Desai and Stephanie Dellicour from the Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya write in an associated comment:

"This study provides a level of reassurance regarding the potential risk associated with artemisinin exposure in early pregnancy, compared with the established risk of malaria. This study, combined with data from ongoing studies done in sub-Saharan Africa, will for the first time allow an informed risk/benefit assessment of disease versus treatment with artemisinin combination treatments in pregnancy."

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our tropical diseases section for the latest news on this subject. ”Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study”
Dr R McGready et al.
The Lancet Infectious Diseases, Early Online Publication, 13 December 2011 doi:10.1016/S1473-3099(11)70339-5 Please use one of the following formats to cite this article in your essay, paper or report:

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marți, 13 decembrie 2011

Malaria Global Mortality Down 25% In Ten Years

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Main Category: Tropical Diseases
Article Date: 13 Dec 2011 - 10:00 PST

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Mortality rates for malaria have dropped by over 25% worldwide since the beginning of the millennium, according to World Malaria Report 2011, issued by WHO (World Health Organization). Progress in Africa has been especially impressive, where death rates have dropped by 33% since 2000. WHO says these encouraging figures are mainly due to a considerable scaling up of prevention and control measures over the last ten years. Examples include much wider usage of bed nets, improved diagnostics, and better access to effective malaria medications.

However, as funding slows down and actually shrinks, WHO warns that all these gains could easily be lost, especially as drug and insecticide resistance are becoming ever-growing problems.

Dr Margaret Chan, WHO Director-General, said:
"We are making significant progress in battling a major public health problem. Coverage of at-risk populations with malaria prevention and control measures increased again in 2010, and resulted in a further decline in estimated malaria cases and deaths. But there are worrisome signs that suggest progress might slow."

The reports states that death rates and the incidence of malaria have both fallen in all regions around the world. In 106 endemic countries and territories there were 216 million malaria cases in 2010. Approximately 91% of malaria deaths in 2010 occurred in Africa - 86% of all malaria cases last year also occurred in Africa.

36,000 fewer people died from Malaria in 2010 compared to the 655,000 in 2010. The authors of the report say that while this annual-5%-decline is encouraging, figures are still far too high for a disease that is both treatable and preventable.

Raymond G. Chambers, the UN Secretary General's Special Envoy for Malaria, said:

"With malaria deaths in Africa having fallen significantly since 2000, the return on our investment to end malaria deaths has been greater than any I have experienced in the business world. But one child still dies every minute from malaria - and that is one child and one minute too many.

The toll taken by the current economic crisis must not result in our gains being reversed, or progress slowed. With Secretary-General Ban Ki-moon's charge for near zero deaths by end of 2015, turning back now is not an option."


Mosquito Netting
Mosquito netting - ceiling hung

Nets - low-cost, durable insecticidal nets have been extremely effective in combating malaria. 885 million bed-nets were delivered to sub-Saharan Africa in 2009; this figure jumped to 145 million in 2010. Approximately half of all homes in this part of the world now have at least one bed net. 96% of those who are able to access bed nets use them.

Diagnostic testing, a vital part of the combat against malaria, has also become more widely available. This is important, because health care professionals and local services can accurately distinguish malaria from other febrile illnesses. In 2008, about 45 million diagnostic tests were delivered by manufacturers, this figure rose to 88 million in 2010. WHO reports that "the testing rate in the public sector in the WHO African Region rose from 20% in 2005 to 45% in 2010."

Anti-malarial drugs - 181 million courses of ACTs (artemisinin-based combination therapies) were procured by WHO in 2010, compared to 158 million in 2009 and 11 million in 2005. Health bodies around the world recommend ACTs as the first-line treatment for Plasmodium falciparum, the most aggressive and deadly malaria parasite.

Funding from all governments and organizations around the world reached $1.7 billion in 2010, and $2 billion in 2011. However, in order to achieve annual global malaria targets, between $5 and $6 billion are needed.

Even though some countries have increased funding this year and next, a slight decrease is expected globally in 2012 and 2013 when all donors totals are added up. If the current trend continues, 2015 will see funding dropping to $1.5 billion.

A fall in funding will rapidly widen the shortfall, which could seriously undermine the malaria control landscape. In order to build on past progress, or at least sustain whatever has been achieved so far, more money is needed.

Without these donations, the following vital components of malaria control will not be supplied in proper amounts: bed netsdiagnostic testingindoor residual sprayingresearch and innovation.treatmentDr Robert Newman, Director of WHO's Global Malaria Program, said:

"We need a fully-resourced Global Fund, new donors, and endemic countries to join forces and address the vast challenges that lie ahead. Millions of bed nets will need replacement in the coming years, and the goal of universal access to diagnostic testing and effective treatment must be realized. We need to act with urgency and resolve to ensure that no-one dies from malaria for lack of a 5 dollar bed net, 1 dollar antimalarial drug and a 50 cent diagnostic test."
Plasmodium falciparum is becoming resistant to artemisinins. There were cases confirmed in 2009 in the border between Thailand and Cambodia, and then in other sites in Viet Nam and Myanmar.

Artemisinins and their derivatives are a group of medications that contain the fastest action of all available medications against falciparum malaria.

WHO is asking nations to stop the marketing of oral artemisinin-based monotherapies, because it is thought to have been one of the main factors contributing to the emergence of resistance, as well as its spread.

Twenty-five nations still allow the marketing of oral artemisinin-based monotherapies, despite international pressure. Twenty-eight drug companies still market them (in 2010 there were 39).

Resistance to insecticides is also a growing problem. The report informs that over 45 countries have reported cases of resistance to at least one of four types of insecticides currently used for malaria (vector) control - twenty-seven of them in sub-Saharan Africa.

Pyrethroids are the most commonly used compounds for spraying indoors. They are the only type of insecticide used for spraying on nets.

Written by Christian Nordqvist
Copyright: Medical News Today
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vineri, 9 decembrie 2011

Deadliest Malaria Parasite Wiped Out By Novel Drug Leading To Starvation

Main Category: Tropical Diseases
Article Date: 09 Dec 2011 - 1:00 PST

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An antimalarial agent developed by researchers at Albert Einstein College of Medicine of Yeshiva University proved effective at clearing infections caused by the malaria parasite most lethal to humans - by literally starving the parasites to death. The novel research, carried out on a small number of non-human primates, could bolster efforts to develop more potent therapies against one of the world's leading killers. The study, published in the November 11, 2011 issue of PLoS ONE, was led by senior author Vern Schramm, Ph.D., professor and Ruth Merns Chair in Biochemistry at Einstein.

Malaria is a mosquito-borne disease caused by single-celled parasites belonging to the Plasmodium genus. The U.S. Centers for Disease Control and Prevention estimated that in 2008 (the latest year for which figures are available) between 190 million and 311 million cases of malaria occurred worldwide and between 708,000 and 1.003 million people died, most of them young children in sub-Saharan Africa. Plasmodium falciparum, the malaria species most likely to cause severe infections and death, is very common in many countries in Africa south of the Sahara desert.

The Einstein researchers exploited what is arguably P. falciparum's Achilles' heel: it can't synthesize purines, vital building blocks for making DNA. Instead, the parasite must make purines indirectly, by using an enzyme called purine nucleoside phosphorylase (PNP) to make a purine precursor called hypoxanthine. By inhibiting PNP, the drug BCX4945 kills the parasites by starving them of the purines they need to survive.

After BCX4945 showed potency against laboratory cultures of P. falciparum, owl monkeys were chosen as the non-human primate model for further testing of the drug. Three animals were infected with a strain of P. falciparum that is consistently lethal without antimalarial therapy. Orally administering BCX4945 twice a day for seven days cleared the infections from all the animals between the fourth and seventh day of treatment. The monkeys remained parasite-negative for up to nine days post-treatment. Parasitic infection eventually returned in all three monkeys after treatment ended, although a lower rate of parasitic growth was observed. No signs of toxicity were observed during the study period (30 days after the first dose).

BCX4945 belongs to a class of drugs known as transition state analogs that Dr. Schramm has been developing since 1994. Transition states form in every chemical change and whenever an enzyme does its job of converting one chemical (the substrate) into another (the product). The fleeting transition-state molecule is neither substrate nor product, but something in between - a ghostly intermediate to which the enzyme clings for just one billionth of a millionth of a second.

After figuring out the brief-lived transition-state structure for a particular enzyme, Dr. Schramm is able to design transition-state analogs to knock that enzyme out of action. The analogs closely resemble the actual transition-state structure but with one big difference: they powerfully inhibit the enzyme by binding to it and not letting go.

The transition-state analog BCX4945 was chosen for this study because of its high affinity for both P. falciparum PNP and human PNP (which the parasite obtains from the red blood cells it infects). Since PNP is abundant in mammalian red blood cells and those cells are constantly replaced, BCX4945 is toxic only to the parasite and not its mammalian hosts. (Two of Dr. Schramm's other PNP inhibitors - one for T-cell cancers, the other for gout - are being evaluated in clinical trials.)

"Inhibiting PNP differs from all other current approaches for treating malaria," said Dr. Schramm. "For that reason, BCX4945 fits well with the current World Health Organization protocols for malaria treatment, which call for using combination-therapy approaches against the disease."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our tropical diseases section for the latest news on this subject. The paper is titled "Plasmodium falciparum Parasites Are Killed by a Transition State Analogue of Purine Nucleoside Phosphorylase in a Primate Animal Model." Other Einstein researchers involved in the study were Steven Almo, Ph.D., lead author Maria Cassera, Ph.D. (now at Virginia Polytechnic Institute and State University), Keith Hazleton, M.D./Ph.D. candidate, Emilio Merino (now at Virginia Polytechnic Institute and State University), Meng-Chiao Ho, Ph.D., (now at Academia Sinica), Andrew Murkin, Ph.D., (now at SUNY Buffalo), and Jemy Gutierrez, Ph.D., (now at Pfizer). This research was supported primarily by the National Institute of Allergy and Infectious Disease, part of the National Institutes of Health, and early aspects of the study were funded by Medicines for Malaria.
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Malaria Transmission-blocking Vaccine Assessment

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Main Category: Tropical Diseases
Also Included In: Immune System / Vaccines
Article Date: 09 Dec 2011 - 11:00 PST

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At a presentation during the 60th annual meeting of the American Society of Tropical Medicine and Hygiene, three leaders in malaria vaccine development announced their collaboration of assessing a potential vaccine candidate designed to prevent transmission of malaria from mosquitoes to humans. Researchers believe that the type of vaccine could contribute to the eventual eradication of malaria.

The partners - the PATH Malaria Vaccine Initiative (MVI), the National Institute of Allergy and Infectious Diseases (NIAID) and the Johns Hopkins Bloomberg School of Public Health Center for Immunization Research (CIR) - will collaborate on conducting a Phase 1 clinical trial in healthy adults to assess the safety and immunogenicity of the protein Pfs25 in a conjugated vaccine developed at NIAID.

Malaria claims almost 800,000 lives each year, with most of the victims being African children younger than 5 years. The battle against the disease has been challenging, as both the parasite and the mosquito host are highly adaptive and have survived for thousands of years. Even though drugs and insecticides have had a substantial effect on the burden of disease, the resistance of the parasite and mosquito continues to pose an ongoing threat.

The TBV Pfs25 approach aims to block malaria from being transmitted from mosquitoes to humans by preventing the malaria parasite from developing in the mosquito, and although such a vaccine would not directly protect an immunized individual from developing clinical malaria, it would reduce the chances that others in the community contract malaria by preventing the spread of infection by the mosquito.

A transmission-blocking vaccine (TBV) would work in combination with drugs and insecticides by blocking the transmission of the parasite. This would decrease the demand on other measures, therefore slowing the development of resistance and subsequently extend their effectiveness.
v Ashley Birkett, PhD, director of research and development at MVI, said:

"This is the first clinical trial supported by MVI to use a transmission-blocking approach. This is the first step in what is typically a long process of evaluation. Nonetheless, we are excited by the potential of TBVs to significantly limit the spread of malaria infection. Eradication of malaria may be decades away, but we believe a successful TBV - used alongside safe and effective drugs, insecticides, bed nets, and possibly a malaria vaccine that protects the individual against infection and disease - would be essential to achieving that goal."

Kawsar Talaat, MD, clinical principal investigator and assistant scientist at the Bloomberg School added:

"The Pfs25 vaccine and other transmission blocking vaccines are unique in their approach in that they target a key stage of the malaria parasite's lifecycle rather than attempting to build immunity to malaria in humans. We'll need many tools to defeat malaria and an effective transmission-blocking vaccine could go a long way toward achieving that goal."

Petra Rattue
Copyright: Medical News Today
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