Using an age-fractionated RBC model, we investigated the in
vitro sensitivity of artemether in β-thalassaemic RBC infected
with the K1 and FC27 strains of Plasmodium falciparum and, to
study the role of oxidant stress in modulating the sensitivity
pattern, pro-oxidant (riboflavin) and antioxidant (vitamin E) agents were
added to cultures in the presence of artemether.
With the FC27 strain, the artemether IC50 doses in thalassaemic
samples (whole blood and fractions) were significantly
higher compared to equivalent normal RBC samples (P<0·05).
However, with the K1 strain, such a significant difference
was not demonstrable. The addition of vitamin E reduced the antimalarial
effect of artemether in both the FC27 and
K1 strains (P<0·0001). In contrast, the addition of
riboflavin resulted in a significant increase in antimalarial activity
(P<0·0001). This effect of the drug combinations was
not influenced by the red cell type (P<0·0001) and there
was
no interaction between red cell type and drug type (P<0·0001).
These findings show that reduced sensitivity to artemether
occurs in whole blood and age-fractionated β-thalassaemic trait RBC.
It appears that the RBC redox status does not
influence the sensitivity to artemether.