A comprehensive review of artesunate-induced organ toxicity: mechanisms, resistance, biomarkers, and protective strategies

This paper provides a comprehensive analysis of artesunate (ART), highlighting its dual role as a highly effective antimalarial agent and its potential to induce organ toxicity under certain conditions, particularly with prolonged use over an extended period. This review highlights the favorable pharmacological properties of ART and its derivatives, while also addressing growing concerns over their associated adverse effects. It provides an in-depth exploration of the underlying mechanisms of ART-induced toxicity and discusses potential protective strategies and mitigation approaches aimed at minimizing these toxicities. This systematic review compiles recent studies on ART-induced organ toxicity, with a particular focus on key underlying mechanisms, including oxidative stress, inflammation, and apoptotic signaling pathways. It also explores the various diagnostic methods used to assess toxicity, providing insight into how organ damage related to ART is identified and evaluated. Overall, this paper underscores the need for more comprehensive research, including well-designed clinical trials, to better understand and manage the potential toxic effects of ART. Strengthening this knowledge is essential to ensure that the risk of organ damage does not compromise the life-saving benefits of malaria treatment.