Genetic background determines allele-specific Pfkelch13-mediated artemisinin tolerance and persistence in Plasmodium falciparum

Artemisinin partial resistance (ARTR) in Plasmodium falciparum is mediated by Pfkelch13 mutations but has not emerged in West Africa. Using gene editing, we introduced four Pfkelch13 mutations into a recent Senegalese isolate, evaluating the receptivity of this genetic background to ARTR using the ring-stage survival assay (RSA), a proxy for clinical resistance. One allele conferred the RSA phenotype but was rapidly outcompeted, whereas three conferred stable resistance, revealing allele-specific permissiveness

Ullah, I., Martin, M. C., Ndiaye, D., Volkman, S. K., Wirth, D. F.

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