Quinine and Related Topics

Cinchona

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Genus of flowering plants in the family Rubiaceae containing at least 23 species of trees and shrubs.

Cortex peruvianus study by Antonie van Leeuwenhoek, 1706

Cinchona officinalis, the harvested bark

Peru offers a branch of cinchona to science (from a 17th-century engraving).

A 19th-century illustration of Cinchona calisaya

Cinchona has been historically sought after for its medicinal value, as the bark of several species yields quinine and other alkaloids that were the only effective treatments against malaria during the height of European colonialism, which made them of great economic and political importance.

Malaria

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Mosquito-borne infectious disease that affects humans and other animals.

The life cycle of malaria parasites. Sporozoites are introduced by a mosquito bite. They migrate to the liver, where they multiply into thousands of merozoites. The merozoites infect red blood cells and replicate, infecting more and more red blood cells. Some parasites form gametocytes, which are taken up by a mosquito, continuing the life cycle.

Micrograph of a placenta from a stillbirth due to maternal malaria. H&E stain. Red blood cells are anuclear; blue/black staining in bright red structures (red blood cells) indicate foreign nuclei from the parasites.

Electron micrograph of a Plasmodium falciparum-infected red blood cell (center), illustrating adhesion protein "knobs"

The blood film is the gold standard for malaria diagnosis.

Ring-forms and gametocytes of Plasmodium falciparum in human blood

An Anopheles stephensi mosquito shortly after obtaining blood from a human (the droplet of blood is expelled as a surplus). This mosquito is a vector of malaria, and mosquito control is an effective way of reducing its incidence.

Man spraying kerosene oil in standing water, Panama Canal Zone, 1912

Walls where indoor residual spraying of DDT has been applied. The mosquitoes remain on the wall until they fall down dead on the floor.

An advertisement for quinine as a malaria treatment from 1927.

Deaths due to malaria per million persons in 2012

Past and current malaria prevalence in 2009

Ancient malaria oocysts preserved in Dominican amber

British doctor Ronald Ross received the Nobel Prize for Physiology or Medicine in 1902 for his work on malaria.

Chinese medical researcher Tu Youyou received the Nobel Prize for Physiology or Medicine in 2015 for her work on the antimalarial drug artemisinin.

Artemisia annua, source of the antimalarial drug artemisinin

U.S. Marines with malaria in a field hospital on Guadalcanal, October 1942

Members of the Malaria Commission of the League of Nations collecting larvae on the Danube delta, 1929

1962 Pakistani postage stamp promoting malaria eradication program

Disability-adjusted life year for malaria per 100,000 inhabitants in 2004
no data
<10
0–100
100–500
500–1000
1000–1500
1500–2000
2000–2500
2500–2750
2750–3000
3000–3250
3250–3500
≥3500

Quinine, along with doxycycline, may be used if artemisinin is not available.

Tonic water

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Gin and Tonic with Hendrick's Gin and Fentimans Tonic Water

Tonic water (or Indian tonic water) is a carbonated soft drink in which quinine is dissolved.

Alkaloid

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Alkaloids are a class of basic, naturally occurring organic compounds that contain at least one nitrogen atom.

The article that introduced the concept of "alkaloid".

Friedrich Sertürner, the German chemist who first isolated morphine from opium.

Bufotenin, an alkaloid from some toads, contains an indole core, and is produced in living organisms from the amino acid tryptophan.

The nicotine molecule contains both pyridine (left) and pyrrolidine rings (right).

Head of a lamb born by a sheep that ate leaves of the corn lily plant. The cyclopia is induced by the cyclopamine present in the plant.

Strychnine tree. Its seeds are rich in strychnine and brucine.

Crystals of piperine extracted from black pepper.

Alkaloids have a wide range of pharmacological activities including antimalarial (e.g. quinine), antiasthma (e.g. ephedrine), anticancer (e.g. homoharringtonine), cholinomimetic (e.g. galantamine), vasodilatory (e.g. vincamine), antiarrhythmic (e.g. quinidine), analgesic (e.g. morphine), antibacterial (e.g. chelerythrine), and antihyperglycemic activities (e.g. piperine).

Artesunate

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Medication used to treat malaria.

The intravenous form is preferred to quinine for severe malaria.

Artemisinin

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Artemisinin and its semisynthetic derivatives are a group of drugs used in the treatment of malaria due to Plasmodium falciparum.

Instead the WHO recommends a seven-day course of clindamycin and quinine.

Quinidine

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Class IA antiarrhythmic agent used to treat heart rhythm disturbances.

It is a stereoisomer of antimalarial agent quinine, originally derived from the bark of the cinchona tree.

Plasmodium falciparum

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Unicellular protozoan parasite of humans, and the deadliest species of Plasmodium that causes malaria in humans.

Laveran's drawing of various stages of P. falciparum as seen on fresh blood (1880).

Blood smear from a P. falciparum culture (K1 strain - asexual forms) - several red blood cells have ring stages inside them. Close to the center is a schizont and on the left a trophozoite.

Ring forms in red blood cells (Giemsa stain)

Gize (1816) studied the extraction of crystalline quinine from the cinchona bark and Pelletier and Caventou (1820) in France extracted pure quinine alkaloids, which they named quinine and cinchonine.