D. Wirth

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

Artemisinin partial resistance (ART R ) 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 ART R 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