A Time Travel with Anti-Malarial Drugs: Then, Now and Beyond

Major progress has been made in the last five years to reduce the suffering and death caused by malaria infection worldwide. In the absence of effective preventative tools, such as vaccines, chemotherapy is a principal option to treat malaria. To date, Artemisinin-based combination therapy (ACT) is used as the most effective treatment strategy against malaria infection, which made a significant impact in reducing overall mortality and morbidity. Nevertheless, the current armamentarium of anti-malarial drugs is far from satisfactory as they have unacceptable toxic sideeffects, along with resistance to the conventional treatment regime, emphasizing the need to identify new compounds and alternative treatment strategies to stay one step ahead in this evolutionary arms race between host and parasites. Developing a vaccine would be the most desirable remedy for eliminating this deadliest parasitic disease. Furthermore, immunotherapy can also be the future to treat the inflammatory disease caused by the intracellular pathogen of the genus Plasmodium. In this pursuit, regulation of pro-inflammatory and anti-inflammatory pathways in a correct manner by maintaining optimal Treg/Th17 balance may be the key to successful immunotherapeutic treatment against malaria. In this chapter, the history and mechanism of action of some important anti-malarial drugs have been narrated, along with the future possibilities of potential therapeutic approaches against malaria.

Keywords: Malaria, Anti-malarial drugs, Artemisinin, Autophagy, Dendritic cell, Drug resistance, Immunotherapy, Inflammation, Macrophages, Severe Malaria, T cell, Treg/Th17 balance, Vaccine.