Ambiguous role of pfcrt K76 in Plasmodium falciparum: a marker of resistance or increased susceptibility

Arternisinin combination therapy for the treatment of uncomplicated malaria infections has been rolled out almost all over the world. Although artemisinin combination therapy is very effective to date, there are concerns that resistance might occur against these drugs, as has been the case with many monotherapies in the past. Indeed, in some areas, combination therapies are starting to lose their effectiveness already. The exact mechanisms of action of many substances used in malaria treatment remain largely unknown, and the susceptibility of parasites to given compounds is in many cases, hard to predict. The article under evaluation has investigated the pfcrt K76T allele, which, when mutated, is known to cause resistance against chloroquine, in relation to the susceptibility to lumefantrine. This work sheds light on the possible mechanism of action of lumefantrine. Potential implications on treatment guidelines and malaria control are discussed in the light of this recent finding