Artemisinin is the most widely-used compound against malaria and plays a critical role in the treatment of malaria worldwide. Resistance to artemisinin emerged about a decade ago in Southeast Asia and it is paramount to prevent its spread or emergence in Africa. Artemisinin has a complex mode of action and can cause widespread injury to many components of the parasite. In this review, we outline the different metabolic pathways affected by artemisinin, including the unfolded protein response, protein polyubiquitination, proteasome, phosphatidylinositol-3-kinase, and the eukaryotic translation initiation factor 2α. Based on recently published data, we present a model of how these different pathways interplay and how mutations in K13, the main identified resistance marker, may help parasites survive under artemisinin pressure.

中文翻译：

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疟疾寄生虫的青蒿素生物活性和抗性。

青蒿素是最广泛使用的抗疟疾化合物，在世界范围内的疟疾治疗中发挥着关键作用。大约十年前，东南亚出现了对青蒿素的抗药性，防止其在非洲传播或出现至关重要。青蒿素具有复杂的作用方式，可以对寄生虫的许多成分造成广泛的伤害。在这篇综述中，我们概述了受青蒿素影响的不同代谢途径，包括未折叠蛋白反应、蛋白多泛素化、蛋白酶体、磷脂酰肌醇 3-激酶和真核翻译起始因子 2α。根据最近公布的数据，我们提出了一个模型，说明这些不同途径如何相互作用以及 K13（主要确定的抗性标记）中的突变如何帮助寄生虫在青蒿素压力下存活。