Antimalarial metabolization: what have we learnt so far?

Considering malaria is a highly devastating disease of mankind, total eradication of malaria seems to be an uphill task, the only relief from this disease is achieved by usage of antimalarial drugs. Since malaria is associated with humans from time immemorial, usage of traditional substances to most presently effective antimalarial have been recorded to cure this disease. With the advent of modern biological techniques aided the understanding of the biochemical pathways of antimalarial metabolism thereby helping in designing successful usage of many antimalarials. Nevertheless, improper usages of certain drugs have led to the origin and spread of drug resistant malaria parasites (chloroquine resistant Plasmodium falciparum). Also, the genetic basis of antimalarial metabolism in humans is now well understood and frequent mutations in genes of malarial parasites are well associated with drug resistance. The entire scenario of antimalarial usage in the field have become complicated, partly due to poor understanding between antimalarial metabolism in humans and drug fighting mechanism in parasites, by which resistance to even combined therapy (e.g. Artemisinin Combination Therapy) have started emerging. Vital basic understanding from human and parasite population genetics (involving antimalarial both metabolizing genes in human and resistant genes in parasite) could be an ideal starting point to malaria control.