Drug resistance and treatment failure in leishmaniasis: A 21st century challenge

Ponte-Sucre, A., Gamarro, F., Dujardin, J.-C., Barrett, M. P. , López-Vélez, R., García-Hernández, R., Pountain, A. W. and Mwenechanya, R. (2017) Drug resistance and treatment failure in leishmaniasis: A 21st century challenge. PLoS Neglected Tropical Diseases, 11(12), e0006052. (doi: 10.1371/journal.pntd.0006052) (PMID:29240765) (PMCID:PMC5730103)

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Abstract

Reevaluation of treatment guidelines for Old and New World leishmaniasis is urgently needed on a global basis because treatment failure is an increasing problem. Drug resistance is a fundamental determinant of treatment failure, although other factors also contribute to this phenomenon, including the global HIV/AIDS epidemic with its accompanying impact on the immune system. Pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis since the first half of the 20th century, but the last 10 to 20 years have witnessed an increase in clinical resistance, e.g., in North Bihar in India. In this review, we discuss the meaning of “resistance” related to leishmaniasis and discuss its molecular epidemiology, particularly for Leishmania donovani that causes visceral leishmaniasis. We also discuss how resistance can affect drug combination therapies. Molecular mechanisms known to contribute to resistance to antimonials, amphotericin B, and miltefosine are also outlined.

Item Type:Articles
Keywords:Review, Biology and life sciences, Medicine and health sciences, Physical sciences
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pountain, Andrew and Barrett, Professor Michael
Authors: Ponte-Sucre, A., Gamarro, F., Dujardin, J.-C., Barrett, M. P., López-Vélez, R., García-Hernández, R., Pountain, A. W., and Mwenechanya, R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Copyright Holders:Copyright © 2017 Ponte-Sucre et al.
First Published:First published in PLoS Neglected Tropical Diseases 11(12):e0006052
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
371799The Wellcome Centre for Molecular Parasitology ( Core Support )Andrew WatersWellcome Trust (WELLCOTR)104111/Z/14/Z & AIII - PARASITOLOGY