A single gene in the malaria parasite is mostly responsible for it becoming drug-resistant, British researchers reveal today.
The discovery may play a key role in developing new ways to tackle malaria – but researchers warn the next steps may be difficult.
This is because they found a huge variety of mutations in the kelch13 gene.
One mutation, known as C580Y, seemed to surface independently on several occasions.
The scientists at the Wellcome Trust Sanger Institute, Cambridge, UK, say their work, reported in Nature Genetics, has unveiled "complex genetic architecture."
This reveals four "well-defined" mutations in four genes, the fd, arps10, mrdr2 and crt genes.
These might help scientists track mutations in the parasite, they say.
The scientists say kelch13 has mostly hardly changed in 50 million years – suggesting the drug resistant mutations might make the parasite vulnerable in other ways.
Studies of malaria in Africa, found that kelch13 mutations were rare.
Researcher Nick Day, director of the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok, Thailand, said: “We are at a pivotal point for malaria control. While malaria deaths have been halved, this progress is at risk if artemisinin ceases to be effective.
“We need to use every tool at our disposal to protect this drug. Monitoring parasites for background mutations could provide an early warning system to identify areas at risk for artemisinin resistance.”
Professor Dominic Kwiatkowski, of Oxford University, head of the Malaria Programme at the Wellcome Trust Sanger, said: “At present artemisinin resistance appears to be largely confined to Southeast Asia but the situation might change as the parasite population continues to evolve.
"By linking genomic data with clinical data we’re developing a better understanding of the multiple genetic factors involved in the emergence of resistance, and that is starting to provide vital clues about how to prevent its spread."
Miotto O, Amato R, et al. Genetic architecture of artemisinin resistant Plasmodium falciparum. Nature Genetics 20 January 2015; doi: 10.1038/ng.3189
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