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The widespread use of chloroquine predictably resulted in the development of drug-resistant malaria and the most highly implicated resistance mediators are the transporter proteins P-glycoprotein (P-gp) homologue 1 (P-gh1) and Plasmodium falciparum chloroquine-resistance transporter (PfCRT), which reside on the parasite\u2019s digestive vacuole. The presence of PfCRT and P-gh1 on the vacuole membrane is analogous to the two-headed fictional creature known as the \u201cPushmi-Pullyu\u201d. P-gh1 (Pushmi) increases influx of chloroquine into the vacuole, while PfCRT (Pullmi) causes efflux of chloroquine from the vacuole. This review describes how drug-resistant malarial parasites co-ordinate chloroquine distribution through adaptive mutations to promote their survival in the presence of this cytotoxic drug.<\/jats:p>","DOI":"10.1042\/ebc20160060","type":"journal-article","created":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T11:55:13Z","timestamp":1488542113000},"page":"167-175","update-policy":"http:\/\/dx.doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The \u201cpushmi-pullyu\u201d of resistance to chloroquine in malaria"],"prefix":"10.1042","volume":"61","author":[{"given":"Ruth","family":"Skrzypek","sequence":"additional","affiliation":[{"name":"Division of Biomedical Sciences and Biochemistry, Research School of Biology and Medical School, Australian National University, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Division of Biomedical Sciences and Biochemistry, Research School of Biology and Medical School, Australian National University, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"288","published-online":{"date-parts":[[2017,3,3]]},"reference":[{"key":"2021111610224499400_B1","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1111\/j.1365-2125.2006.02673.x","article-title":"Reflections on the \u2018discovery\u2019 of the antimalarial qinghao","volume":"61","author":"Hsu","year":"2006","journal-title":"Br. 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