Detection of K76T Mutation in pfcrt Gene as an Applicable Ge-netic Marker for Prediction of Chloroquine Resistant falciparum Malaria in Isolates from an Endemic District of Iran

Abstract

Background: This study investigated the association between pfcrt, T76 allele and chloroquine resistance in patients with falciparum malaria. Molecular assays for point mutations on drugs resistance-related genes are applied tools for monitoring emerging resistance and surveillance malaria control strategies in endemic areas. The mutant genotype at codon 76 of Plasmodium falciparum chloroquine resistance transporter gene (pfcrt) has been proposed as a molecular marker for the faster detection of chloroquine resistance in field.

Methods: In 64 samples from patients with uncomplicated falciparum malaria from Sarbaz district in southeast of Iran,  the clinical response to chloroquine and the prevalence of K76T  mutations in pfcrt gene were investigated by in vivo and nested-PCR  followed restriction enzyme digestion methods.

Results:  The occurrence of the K76T mutation was very high (60 of 64, i.e. 93.75%) among these filed isolates. Only 4 of 64 isolates harbored wild type K76 codon and no case was a mixed of K76 and 76T codons. All of the 22 (100%) chloroquine-resistant and 16.7% of sensitive isolates were found to harbor the 76T mutation and none was found to contain the wild type (K76) allele.

Conclusions: The frequency of chloroquine resistance associated point mutation K76T, in pfcrt gene in this region suggest that detection of this mutation can be applied for predicting chloroquine resistance in epidemiologic settings with sufficiently high sensitivity to make it an attractive alternative to time and labor-consuming in vivo trials.