Prognostic Value Of Physiological Changes Associated With The Chemo-resistance In Leishmania

摘要

Therapeutic failure in leishmaniasis is a common problem in endemic areas. This could be attributed to altered drug pharmacokinetics, re-infection, or immunologic compromise of the host. However, strong indicators suggest that it may be partly due to drug resistance. Until now, there are no markers of chemo-resistance against leishmanicidal drugs, and the only reliable method for monitoring resistance of individual isolates is the in vitro amastigote-macrophage model. It is thus necessary to find cellular and molecular indicators that can be used to identify the drug-resistant phenotype of the infecting parasites. Herein we postulate that drug resistance in Leishmania is a phenomena accompanied by physiological changes that might serve as markers of chemo-resistance and helpful for designing strategies to circumvent Leishmania drug-resistance and successfully treating leishmaniasis. If this conclusion holds true in particularly, in isolates obtained from patients, its prognostic value for the treatment outcome might be extremely useful.