Tropic acid malaria

An example of sequential blocking is the use of a sulfadiazine with pyrimethamine 9.31) in toxoplasmosis, a protozoal disease (Wettingfeld, Rowe and Eyles, 1956). In this sequence, the sulfonamide blocks the incorporation of / -aminobenzoic acid into dihydrofolic acid, and the pyrimethamine prevents the reduction of this pteridine to tetrahydrofolic acid (Sections 9.3.2 and 9.3.3). In malaria, as early as 1959, Hurly made the observation that pyrimethamine and sulfadiazine potentiated one another to such a degree that the combination could actually cure Pl.falciparum infections. Thus, less than 0.1 m.e.d. (minimal effective dose) of pyrimethamine and 0.25 m.e.d. of sulfadiazine were, together, as effective as 1.0 m.e.d. of either drug separately. In current tropical medicine, Maloprim , a combination of pyrimethamine and dapsone 9.17) (the latter chosen because of its slow rate of excretion which matches that of pyrimethamine), forms an excellent replacement for chloroquine in cases of Pl.falciparum... 

To use a more sophisticated example, we can look to the products of the neem tree (Azadirzchta indica), a tropical plant that is known for its pesticidal properties. The seed of this tree is abundant with limonoids and simple terpenoids that are responsible for its biological activity. One particular limonoid found in the seed is Azadirachtin (2.134). The bioactivity of Azadirachtin potentially leads to a wide range of applications in herbal medicine and healthcare products for the treatment of malaria and tuberculosis and in anti-worm, clotting, and blood-detoxification preparations. These uses of Azadirachtin as a biopesticide or herbal medicine is limited due to solubility constraints in water and its instability as a result of its propensity to undergo complicated, irreversible rearrangements under acidic, basic and photolytic conditions. Consequently, there has been much research in the structural modification of Azadirachtin to overcome its solubility constraints to increase stability. This process normally involves many protection and deprotection synthetic steps and chromatographic separations. 

Looking at the problem from another viewpoint, Corkill (1950) points out that in a number of diseases such as kala-azar, malaria, trypanosomiasis, and amebic dysentery in which periods of latency exist, there may be breakdown of resistance or disturbance of host-parasite balance leading to relapse or exacerbation in response to a variety of stress conditions. Such stresses are trauma, intercurrent infection, malnutrition, and pregnancy. Corkill puts forward the hypothesis that an important factor in this lowered resistance is failure of the host to synthesize antibody 7-globulin under conditions in which there is excessive breakdown of tissue protein or insufficient intake of dietary essential amino acids. Particularly he incriminates lysine, in which a number of widely used tropical staple cereals are notably deficient. 

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