Evidence map›Paper›PMID 38870082›Full record

ArticleThe Journal of antimicrobial chemotherapy2024

Monoamine oxidase-A (MAO-A) low-expression variants and increased risk of Plasmodium vivax malaria relapses.

Maria Carolina Silva De Barros Puça, Danielle Fonseca Rodrigues, Yanka Evellyn Alves Rodrigues Salazar, Jaime Louzada, Cor Jesus Fernandes Fontes, André Daher, Dhélio Batista Pereira, José Luiz Fernandes Vieira, Luzia Helena Carvalho, Cristiana Ferreira Alves de Brito and 2 more

Abstract read
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Maria Carolina Silva De Barros PuçaMolecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil.
Danielle Fonseca RodriguesMolecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil.
Yanka Evellyn Alves Rodrigues SalazarMolecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil.
Jaime LouzadaUniversidade Federal de Roraima, Boa Vista, Roraima, Brazil.
Cor Jesus Fernandes FontesUniversidade Federal do Mato Grosso, Faculdade de Medicina, Departamento de Medicina Interna, Cuiabá, Mato Grosso, Brazil.
André DaherVice Presidency of Research and Biological Collections, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brazil.
Dhélio Batista PereiraCentro de Pesquisa em Medicina Tropical de Rondônia, CEPEM, Porto Velho, Rondônia, Brazil.
José Luiz Fernandes VieiraUniversidade Federal do Pará, Faculdade de Farmácia, Laboratório de Toxicologia, Belém, Pará, Brazil.
Luzia Helena CarvalhoMolecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil.
Cristiana Ferreira Alves de BritoMolecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil.
José Pedro GilDepartment of Microbiology, Tumor and Cell biology, Karolinska Institutet, Solna, Sweden.
Tais Nobrega de SousaMolecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil.ORCID 0000-0002-6874-9427

Funding

Conselho Nacional de Desenvolvimento Científico e TecnológicoFundação de Amparo à Pesquisa do Estado de Minas GeraisPrograma PrInt-Fiocruz-CAPESSwedish Research Council 200075/2022-5
6 · The paper itself

Abstract

objectivesPrimaquine is essential for the radical cure of Plasmodium vivax malaria and must be metabolized into its bioactive metabolites. Accordingly, polymorphisms in primaquine-metabolizing enzymes can impact the treatment efficacy. This pioneering study explores the influence of monoamine oxidase-A (MAO-A) on primaquine metabolism and its impact on malaria relapses.

methodsSamples from 205 patients with P. vivax malaria were retrospectively analysed by genotyping polymorphisms in MAO-A and cytochrome P450 2D6 (CYP2D6) genes. We measured the primaquine and carboxyprimaquine blood levels in 100 subjects for whom blood samples were available on the third day of treatment. We also examined the relationship between the enzyme variants and P. vivax malaria relapses in a group of subjects with well-documented relapses.

resultsThe median carboxyprimaquine level was significantly reduced in individuals carrying low-expression MAO-A alleles plus impaired CYP2D6. In addition, this group experienced significantly more P. vivax relapses. The low-expression MAO-A status was not associated with malaria relapses when CYP2D6 had normal activity. This suggests that the putative carboxyprimaquine contribution is irrelevant when the CYP2D6 pathway is fully active.

conclusionsWe found evidence that the low-expression MAO-A variants can potentiate the negative impact of impaired CYP2D6 activity, resulting in lower levels of carboxyprimaquine metabolite and multiple relapses. The findings support the hypothesis that carboxyprimaquine may be further metabolized through CYP-mediated pathways generating bioactive metabolites that act against the parasite.

Indexed as

AntimalarialsCytochrome P-450 CYP2D6Malaria, VivaxMonoamine OxidasePrimaquineAdultFemaleGenotypeHumansMaleMiddle AgedPlasmodium vivaxPolymorphism, GeneticRecurrenceRetrospective StudiesAntimalarialsCytochrome P-450 CYP2D6Monoamine Oxidasemonoamine oxidase A, humanPrimaquine

Identifiers

PMID38870082
PMCPMC11290872

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.