Drug Resistance in Leishmaniasis
نویسندگان
چکیده
Leishmaniasis is a complex disease, with visceral and cutaneous manifestations, and is caused by over 15 different species of the protozoan parasite genus Leishmania. There are significant differences in the sensitivity of these species both to the standard drugs, for example, pentavalent antimonials and miltefosine, and those on clinical trial, for example, paromomycin. Over 60% of patients with visceral leishmaniasis in Bihar State, India, do not respond to treatment with pentavalent antimonials. This is now considered to be due to acquired resistance. Although this class of drugs has been used for over 60 years for leishmaniasis treatment, it is only in the past 2 years that the mechanisms of action and resistance have been identified, related to drug metabolism, thiol metabolism, and drug efflux. With the introduction of new therapies, including miltefosine in 2002 and paromomycin in 2005-2006, it is essential that there be a strategy to prevent the emergence of resistance to new drugs; combination therapy, monitoring of therapy, and improved diagnostics could play an essential role in this strategy.
منابع مشابه
Frequency of resistance to systemically administered Meglumine Antimoniate (Glucantime) in patients with acute cutaneous Leishmaniasis: A cross-sectional study
Background and aim: Pentavalent antimony compounds are the first line treatment for cutaneous leishmaniasis. Clinical resistance to pentavalent antimony in the form of meglumine antimoniate (Glucantime) has been recognized as a problem in leishmaniasis. Herein, clinical response to Glucantime were studied in patients suffered from cutaneous leishmaniasis.Materials and Methods: In a cross-sectio...
متن کاملمروری بر میزان شیوع و علل مقاومت دارویی در بیماری سالک به ترکیبات آنتیموان در جوامع مختلف مقاله مروری
Cutaneous leishmaniasis (CL) is an endemic parasitic disease of major health impact in many parts of the world and is caused by several species of the protozoan parasite Leishmania. Antimonial compounds (i.e glucantime and pentostam) are the first-line treatment for cutaneous leishmaniasis with emerging drug resistance as a problem. The control of Leishmania is further complicated by the emerge...
متن کاملDrug resistance and treatment failure in leishmaniasis: A 21st century challenge
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 antimon...
متن کاملDetection of Drug Resistance Gene in Cutaneous Leishmaniasis by PCR in Some Endemic Areas of Iran
BACKGROUND Cutaneous leishmaniasis is still a health problem in many rural and urban regions of Iran and drug resistance has emerged as a major impediment in the treatment of leishmaniasis. This study aims to determine the drug resistance gene in cutaneous leishmaniasis by PCR in some endemic areas of Iran. METHODS Ninety seven samples were collected from ulcers of leishmaniasis patients from...
متن کاملOral Zinc Sulfate in the treatment of acute cutaneous Leishmaniasis
Background: Different local and systemic modalities are suggested in the treatment of cutaneous leishmaniasis (CL), but the pentavalent antimony compounds are still considered as the first line of treatment. Regarding to increase in clinical drug resistance, adverse effects and low compliance of patient, efforts for finding a more effective and safer drug continue. Objectives: To evaluate...
متن کاملLeishmaniasis: drug resistance and natural products (review).
Epidemics of fatal visceral leishmaniasis caused by the intracellular protozoan Leishmania are a severe public health problem in tropical and subtropical regions of the world. One major drawback in the treatment of leishmaniasis is the emergence of resistance to current chemotherapeutics. Leishmanicidals have to be administered in low doses since commonly used drugs exhibit severe side effects,...
متن کامل