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Steps for right malaria treatment

mumbai Updated: Nov 09, 2009 00:58 IST
Snehal Rebello

A team of researchers in Mumbai are developing a new mechanism to identify the strain of malarial parasite as soon as it infects a person in order to help doctors begin the correct treatment as early as possible.

The Indian Institute of Technology – Bombay (IITB) has joined hands with the state-run KEM Hospital in Parel to identify malaria-specific “protein biomarkers” in patients. These are proteins that indicate a patient’s physiological state. Since they change along with the disease’s progress, they can help in identify which of the two virulent strains of the malarial parasite, vivax or falciparum, has infected a patient.

“Doctors generally take a long time to figure out whether the malaria is a falciparum, vivax or mixed infection,” said Professor Sanjeeva Srivastava who heads proteomics research at IITB’s department of biosciences and bioengineering.

Proteomics is an emerging field that aims to study and understand the functions of all proteins in the human body.

“When someone has a disease, the structure of proteins in their blood change,” said Srivastava. “If the unique proteins that the parasites affect are identified, it will help medical practitioners administer targeted treatment.”

Malaria can lead to kidney failure, seizures, permanent neurological damage, coma and even death. While both strains cause fever and flu like symptoms, falciparum gives rise to more severe symptoms.

To start with, KEM hospital will collect blood serum samples of around a hundred patients – 50 affected by the vivax strain and 50 by falciparum – and send it to IITB, where researchers will extract proteins from these blood samples and then compare them with proteins extracted from healthy people.

“If we find a pattern in the way proteins of those infected have changed, then we know they are protein biomarkers,” said Srivastava.

Said Dr Sanjay Oak, dean of KEM Hospital: “The marker, if identified, will supplement early diagnosis and follow-up treatment. It can lead to better drug delivery and design of the treatment at the molecular level. The goal is to avoid death.”

The second part of the IITB project involves studying proteins present in the parasite, and the findings could help drug companies develop medicines targeting the disease-causing proteins. This is significant because there is growing concern about malarial parasites developing resistance to the standard drug chloroquine.

“If you know a patient has chloroquine-resistant falciparum malaria, then you would start them on artemisinin (a stronger drug) or some other treatment,” said John Yates, a professor at the US-based Scripps Research Institute.

Along with 18 other researchers from US and Britain, Yates had identified the proteins in the falciparum parasite. “The comparison of proteins in each of two strains (falciparum and vivax) is highly significant,” said Dr Johanna Daily, associate professor at the department of medicine (infectious diseases), Albert Einstein College of Medicine, Yeshiva University, New York.

“Understanding why falciparum kills, and vivax doesn’t, would help target the features of falciparum that causes death.”