Clinical Activity – A New Starting-Point for Antimalaria Medicines

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Natural products for the control of malaria

Malar J. 2011 Mar 15;10 Suppl 1:S1
BioMed Central

III. Natural products as starting points for future anti-malarial therapies: going back to our roots?

Wells TN
Malar J. 2011 Mar 15;10 Suppl 1:S3
PubMed Central PMCID: PMC3059461

Timothy NC Wells of MMV: Medicines for Malaria Venture reviews the history of “natural product scaffolds” that “have been the basis of the majority of current anti-malarial medicines” and recommends a change of approach in the search for new antimalarials:

“The relative paucity of new herbal medicinal product scaffolds active against malaria results discovered in recent years suggest it is time to re-evaluate the ‘smash and grab’ approach of randomly testing purified natural products and replace it with a patient-data led approach. This will require a change of perspective [from] many in the field. It will require an investment in standardisation in several areas, including: the ethnopharmacology and design and reporting of clinical observation studies, systems for characterizing anti-malarial activity of patient plasma samples ex vivo followed by chemical and pharmacological characterisation of extracts from promising sources. Such work falls outside of the core mandate of the product development partnerships, such as MMV, and so will require additional support. This call is timely, given the strong interest from researchers in disease endemic countries to support the research arm of a malaria eradication agenda. Para-national institutions such as the African Network for Drugs and Diagnostics Innovation (ANDi) will play a major role in facilitating the development of their natural products patrimony and possibly clinical best practice to bring forward new therapeutics. As in the past, with quinine, lapinone and artemisinin, once the activity of herbal medicinal products in humans is characterised, it can be used to identify new molecular scaffolds which will form the basis of the next generation of anti-malarial therapies.”

Specifically, Wells proposes better exploitation of a key strategic advantage of herbal antimalarials; i.e., “that in several cases we know that there is an activity in patients”:

“Once the clinical activity of a herbal medicinal product is verified in observational studies, the anti-parasitic activity of the plasma samples on parasites could be confirmed ex vivo, and characterization of the decoction and the plasma samples using mass spectrometry and HLPC separations. Once the active ingredients are identified it is likely that medicinal chemistry will be needed to optimize it for clinical use.”

“By making the most of the potential for clinical data,” Wells concludes, “It is possible that [natural products] could continue to influence our thinking for the next century.”

Read the complete article at PubMed Central.

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