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

AutorPonte-Sucre, Alicia; Gamarro, Francisco; Dujardin, J.C.; Barrett, Michael P.; López-Vélez, Rogelio; García-Hernández, Raquel; Pountain, Andrew W.; Mwenechanya, Roy; Papadopoulou, Barbara
Palabras claveAMPHOTERICIN-B RESISTANCE
PROTOZOAN PARASITE LEISHMANIA
ABC-TRANSPORTER MRPA
VISCERAL LEISHMANIASIS
DONOVANI PROMASTIGOTES
CUTANEOUS LEISHMANIASIS
MILTEFOSINE RESISTANCE
ANTIMONY-RESISTANT
MEGLUMINE ANTIMONIATE
SODIUM STIBOGLUCONATE
Fecha de publicación14-dic-2017
EditorPublic Library of Science
CitaciónPLoS Neglected Tropical Diseases
ResumenReevaluation 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.
Versión del editorhttp://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006052
URIhttp://hdl.handle.net/10261/167426
DOI10.1371/journal.pntd.0006052
ISSN1935-2727
E-ISSN1935-2735
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