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The mitochondrial electron transport chain of Plasmodium species is an essential multi-enzyme system located in the inner mitochondrial membrane, performing two key roles: providing electrons required for pyrimidine biosynthesis (mainly via supporting dihydroorotate dehydrogenase activity) and generating a transmembrane proton gradient that can be used for ATP synthesis, especially during transmission stages[1][3][7]. Structurally, it includes a type II NADH dehydrogenase (NDH2), malate:quinone oxidoreductase (MQO), succinate dehydrogenase (Complex II), cytochrome bc1 complex (Complex III), cytochrome c, and cytochrome c oxidase (Complex IV), with significant differences compared to the mammalian ETC that provide selective drug targeting opportunities[1][7]. It is validated as a critical antimalarial drug target, with several clinically used (e.g., atovaquone, proguanil) and investigational compounds specifically inhibiting its components, particularly Complex III and DHODH[6][8][10]. Resistance can arise via mutations, especially in cytochrome b, and combination therapies are commonly used to address this challenge.
Inhibition of cytochrome bc1 complex (prevents electron transfer and ubiquinone recycling)[3][6][7]; Inhibition of DHODH (blocks pyrimidine biosynthesis)[1][8]; Disruption of proton gradient/electrochemical membrane potential[3][6]; Collapse of mitochondrial membrane potential (especially with atovaquone + proguanil)[3]
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