Abstract

Malaria is a parasite infection affecting millions of people worldwide. Even though progress has been made in prevention and treatment of the disease; an estimated 214 million cases of malaria occurred in 2015, resulting in 438,000 estimated deaths; most of them occurring in Africa among children under the age of five. This article aims to review the epidemiology, future risk factors and current treatments of malaria, with particular focus on the promising potential of molecular farming that uses metabolic engineering in plants as an effective anti-malarial solution. Malaria represents an example of how a health problem may, on one hand, influence the proper development of a country, due to its burden of the disease. On the other hand, it constitutes an opportunity for lucrative business of diverse stakeholders. In contrast, plant biofarming is proposed here as a sustainable, promising, alternative for the production, not only of natural herbal repellents for malaria prevention but also for the production of sustainable anti-malarial drugs, like artemisinin (AN), used for primary parasite infection treatments. AN, a sesquiterpene lactone, is a natural anti-malarial compound that can be found in Artemisia annua. However, the low concentration of AN in the plant makes this molecule relatively expensive and difficult to produce in order to meet the current worldwide demand of Artemisinin Combination Therapies (ACTs), especially for economically disadvantaged people in developing countries. The biosynthetic pathway of AN, a process that takes place only in glandular secretory trichomes of A. annua, is relatively well elucidated. Significant efforts have been made using plant genetic engineering to increase production of this compound. These include diverse genetic manipulation approaches, such as studies on diverse transcription factors which have been shown to regulate the AN genetic pathway and other biological processes. Results look promising; however, further efforts should be addressed toward optimization of the most cost-effective biofarming approaches for synthesis and production of medicines against the malaria parasite.

Highlights

  • Malaria is a parasite infection that still affects millions of people worldwide

  • Real-time detection and monitoring of the distribution of drug-resistant malaria parasites can help to prevent the spread (Miotto et al, 2014; World Health Organization (WHO), 2014a, Status report on artemisinin resistance, Menard and Ariey, 2015; Tun et al, 2015)

  • farnesyl diphosphate (FDP), which generally serves as a precursor for sesquiterpenes including AN, is converted into amorpha-4,11-diene through the activity of amorpha4,11- diene synthase (ADS), and this is the first step of AN biosynthesis proper (Bouwmeester et al, 1999; Mercke et al, 2000)

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Summary

INTRODUCTION

Malaria is a parasite infection that still affects millions of people worldwide. According to the annual World Health Organization (WHO) report (WHO, 2014b, Malaria World Report), about 90% of all malaria deaths occur in Africa, mostly among children under the age of five. The onset of resistance to anti-malarial drugs: the Plasmodium parasite developed resistance to different treatments, especially when only a single drug, quinine, was being administered (White and Olliaro, 1996). This evidence pushed toward the search for new treatments, while WHO (2008) suggested the use of “combination therapies” to treat malaria. Uncontrolled drug distribution and use, and phenomena such as migratory events and climate changes, have contributed to the development of drug resistance This is the reason why WHO first recommended the use of a combination of anti-malarial treatments as ACT, based on AN, (WHO, 2008) as an attempt to avoid, or at least reduce, parasite resistance. Real-time detection and monitoring of the distribution of drug-resistant malaria parasites can help to prevent the spread (Miotto et al, 2014; WHO, 2014a, Status report on artemisinin resistance, Menard and Ariey, 2015; Tun et al, 2015)

FROM TRADITIONAL MEDICINE TOWARD BIOFARMING
Most used medicinal plants used to prevent malaria
Eucalyptus camaldulensis Lippia uckambensis Ocinum suave
ARTEMISIA ANNUA PLANT FOR TREATING MALARIA
ARTEMISIA ANNUA BIOFARMING APPROACHES USING METABOLIC ENGINEERING
Genetically Modified Fast Growing Organisms
Nicotiana tabacum Biofarming
Endogenous and Exogenous Factors that Induce AN Production
Artemisia annua New Varieties and Vegetative Propagation
Unraveling the Artemisia annua Transcription Factor Genetic Engineering Network
Terpenoid Enzymes Studies in Artemisia annua
BIOFARMING ARTEMISIA ANNUA FUTURE STRATEGIES
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