1. Tafenoquine: A Step toward Malaria Elimination.
- Author
-
Lu KY and Derbyshire ER
- Subjects
- Aminoquinolines adverse effects, Anemia, Hemolytic chemically induced, Animals, Antimalarials adverse effects, Cytochrome P-450 CYP2D6 genetics, Cytochrome P-450 CYP2D6 metabolism, Gene Knockdown Techniques, Glucosephosphate Dehydrogenase Deficiency metabolism, Haplorhini, Humans, Methemoglobinemia chemically induced, Mice, Plasmodium cynomolgi drug effects, Plasmodium vivax drug effects, Zebrafish, Aminoquinolines therapeutic use, Antimalarials therapeutic use, Malaria, Vivax drug therapy
- Abstract
There is a pressing need for compounds with broad-spectrum activity against malaria parasites at various life cycle stages to achieve malaria elimination. However, this goal cannot be accomplished without targeting the tenacious dormant liver-stage hypnozoite that causes multiple relapses after the first episode of illness. In the search for the magic bullet to radically cure Plasmodium vivax malaria, tafenoquine outperformed other candidate drugs and was approved by the U.S. Food and Drug Administration in 2018. Tafenoquine is an 8-aminoquinoline that inhibits multiple life stages of various Plasmodium species. Additionally, its much longer half-life allows for single-dose treatment, which will improve the compliance rate. Despite its approval and the long-time use of other 8-aminoquinolines, the mechanisms behind tafenoquine's activity and adverse effects are still largely unknown. In this Perspective, we discuss the plausible underlying mechanisms of tafenoquine's antiparasitic activity and highlight its role as a cellular stressor. We also discuss potential drug combinations and the development of next-generation 8-aminoquinolines to further improve the therapeutic index of tafenoquine for malaria treatment and prevention.
- Published
- 2020
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