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Redox metabolism in malaria: from genes, through biochemistry and pathology, to drugs

Malaria still constitutes one of the most important infectious diseases, affecting 300‐ 500 million people and causing the death of 1.5‐ 2.5 million people annually, many of whom are young children. The total population at risk represents about 40% of the world’ s inhabitants. A major reason for this devastating situation is the emergence of drug resistance to classical and affordable antimalarial drugs. The ceaseless quest for new drugs requires the identification of new potential targets for chemotherapeutic intervention. The redox status of malaria-infected erythrocytes has been the subject of intense investigations and reviews. 1‐6 It is generally accepted that the intra-erythrocytic malaria parasite exerts oxidative stress on its host erythrocyte and, therefore, pro-oxidant agents are effective inhibitors of parasite growth in vitro and in vivo. 7,8 Redox metabolism is also involved in the pathology of malaria and has been demonstrated to play a major role in the action of antimalarial drugs. Given the vast amount of knowledge that has been accumulated in recent years, the time was ripe to attempt a synthesis of present knowledge and expertise to delineate directions for future development.