The trypanosomiases

Barrett, M. , Burchmore, R. , Stich, A., Lazzari, J., Frasch, A., Cazzulo, J. and Krishna, S. (2003) The trypanosomiases. Lancet, 362(9394), pp. 1469-1480. (doi: 10.1016/S0140-6736(03)14694-6)

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Abstract

The trypanosomiases consist of a group of important animal and human diseases caused by parasitic protozoa of the genus Trypanosoma. In sub-Saharan Africa, the final decade of the 20th century witnessed an alarming resurgence in sleeping sickness (human African trypanosomiasis). In South and Central America, Chagas' disease (American trypanosomiasis) remains one of the most prevalent infectious diseases. Arthropod vectors transmit African and American trypanosomiases, and disease containment through insect control programmes is an achievable goal. Chemotherapy is available for both diseases, but existing drugs are far from ideal. The trypanosomes are some of the earliest diverging members of the Eukaryotae and share several biochemical peculiarities that have stimulated research into new drug targets. However, differences in the ways in which trypanosome species interact with their hosts have frustrated efforts to design drugs effective against both species. Growth in recognition of these neglected diseases might result in progress towards control through increased funding for drug development and vector elimination. Parasitic protozoa infect hundreds of millions of people every year and are collectively some of the most important causes of human misery. The protozoan order Kinetoplastida includes the genus Trypanosoma, species that cause some of the most neglected human diseases. There are many species of trypanosome, and the group infects most vertebrate genera. Several trypanosome species cause important veterinary diseases, but only two cause significant human diseases (table).1 In sub-Saharan Africa, Trypanosoma brucei causes sleeping sickness or human African trypanosomiasis, 2 and in America, Trypanosoma cruzi causes Chagas' disease ( figure 1). 3 Both diseases have been considerably neglected, disproportionately affecting poor and marginalised populations. Despite this neglect, the basic biology of trypanosomes has been the subject of intense study. The kinetoplastida also contains species of the genus Leishmania that cause a range of diseases in the tropics and subtropics. 4 These evolutionarily ancient eukaryotic organisms display many fascinating and unique molecular and biochemical phenomena. A key challenge facing trypanosome research is to exploit this knowledge in clinical advances. A substantial amount of similarity exists between these organisms: both are transmitted by insect vectors and share many aspects of their basic biochemical physiology. However, profound differences at the level of the host-parasite interface have frustrated most efforts to use information gained about one species to assist in control of the other.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Burchmore, Dr Richard and Barrett, Professor Michael
Authors: Barrett, M., Burchmore, R., Stich, A., Lazzari, J., Frasch, A., Cazzulo, J., and Krishna, S.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Journal Name:Lancet
Publisher:The Lancet Publishing Group
ISSN:0140-6736

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