“Old” and current antimalarial drugs, mechanism of action, significance of fever and therapeutic hyperthermia

Abstract

It is reported that according to WHO report (2020), more than 229 million people in 87 countries have malaria despite the use of antimalarial drugs. Moreover, modern combination therapy cannot exclude this disease either. The fact is that malaria pathogens, as well as pathogens of other infectious diseases, gradually acquire resistance to anti-infective drugs. And such resistance of parasites to antimalarial drugs increases with increasing duration of use of these drugs in the community. In other words, antimalarial drugs used in the treatment and prevention of malaria are not only factors in the treatment and prevention of malaria, but gradually acquire the role of factors affecting the “natural” selection of pathogens. It is with the help of applied antimalarial drugs that parasites gradually adapt to existence in the organism of malaria patients, trying to survive despite the availability of drugs. It is shown that the intensity of mutations of malaria pathogens in their population, parasite load, choice of antimalarial drugs, accounting and control of antimalarial activity of the drugs used, the effectiveness and safety of the drugs used, their single and course doses, the effectiveness of individual course antimalarial therapy and control of drug-parasite interaction are the main factors in the effectiveness of treatment and prevention of malaria, as well as the factors of drug resistance of parasites. The review reiterates the importance of knowledge of the basic metabolism and life cycle of both parasite and host in understanding the mechanism of drug action and drug resistance in parasites. This knowledge is very important for the selection of new drug targets for the search and development of new antimalarial drugs. It is reported that fever, diurnal rhythm of body temperature, and therapeutic hyperthermia are not only factors in preventing infection, keeping patients healthy, and the course of malaria, but also factors in the mechanism of action of antimalarial drugs, the efficacy of drug therapy for infection, and the resistance of malaria pathogens to antimalarial drugs.