Abstract
Background: Malaria is a major health issues in a number of countries in the world, especially tropical countries. Over the past 50 years, the resistance of Plasmodium falciparum has expanded against the antimalarial drugs that had been used to treat the disease. Recently resistance to some derivatives of artemisinin and the failure of artemisinin combination therapy (ACT) has threatened all major achievements in malaria control. Resistant strains are limited around the world, but it may spread very soon, hence the necessary to be prepared for any event regarding this matter, it is needed to organize more investigations about resistant strains and related genes. Preparation of a new resistant strain in the laboratory can provide opportunity to predict genes responsible for resistance. The aim of this study was to induce resistance to artesunate in Plasmodium falciparum 3D7 strain using intermittent exposure method and comparing P.fk13 gene sequence between susceptible and resistance strains.Methods: Plasmodium falciparum 3D7 strain was cultured according to Trager & Jensen method with some modifications. Serial concentrations between 10-2 mol/l, to 10-7mol/l were prepared, then P.falciparum 3D7 was exposed to each of the dilution to determine IC50 and lethal dose. After 24 hours exposure the rate of parasitemia and mean of growth inhibitory percent were evaluated. Sensitivity reduction process was started from the concentration of 10-7mol/l and ended at 10-2mol/l. Exposed parasites were collected after at least 27 days after cultivation in each drug concentration. DNA extraction, PCR and sequencing process were performed to investigate any possible mutations in the pfk13 gene sequence.Results: Effectiveness of 10-2mol/l concentration of artemisinin was found as a lethal dose. The resistant strain was provided in the lab, sequenced and registered in the gene bank as P.f Art -2, (accession number MH796123. 1). Alignment of this registered sample showed no mutation in P.f kelch13 gene in comparison with standard strain submitted in the Genebank. Conclusions: Results of this study showed that resistance to artesunate in malaria parasite may occur but with no mutation in the P.f kelch13 gene. Therefore, whole genome sequencing should be applied to determine mutations in resistant strains.