Recent advances and new strategies on leishmaniasis treatment
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MINI-REVIEW
Recent advances and new strategies on leishmaniasis treatment Bruno Mendes Roatt 1,2,3 & Jamille Mirelle de Oliveira Cardoso 1 & Rory Cristiane Fortes De Brito 1 & Wendel Coura-Vital 1,4 & Rodrigo Dian de Oliveira Aguiar-Soares 1,4 & Alexandre Barbosa Reis 1,3,4 Received: 21 May 2020 / Revised: 13 August 2020 / Accepted: 23 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Leishmaniasis is one of the most important tropical neglected diseases according to the World Health Organization. Even after more than a century, we still have few drugs for the disease therapy and their great toxicity and side effects put in check the treatment control program around the world. Moreover, the emergence of strains resistant to conventional drugs, co-infections such as HIV/Leishmania spp., the small therapeutic arsenal (pentavalent antimonials, amphotericin B and formulations, and miltefosine), and the low investment for the discovery/development of new drugs force researchers and world health agencies to seek new strategies to combat and control this important neglected disease. In this context, the aim of this review is to summarize new advances and new strategies used on leishmaniasis therapy addressing alternative and innovative treatment paths such as physical and local/topical therapies, combination or multi-drug uses, immunomodulation, drug repurposing, and the nanotechnology-based drug delivery systems. Key points • The treatment of leishmaniasis is a challenge for global health agencies. • Toxicity, side effects, reduced therapeutic arsenal, and drug resistance are the main problems. • New strategies and recent advances on leishmaniasis treatment are urgent. • Immunomodulators, nanotechnology, and drug repurposing are the future of leishmaniasis treatment. Keywords Leishmaniasis . Conventional chemotherapy . Multi-drug therapy . Immunomodulators . Drug repurposing . Nanotechnology
Introduction Leishmaniasis constitutes a group of human and animal diseases caused by Leishmania, a protozoan parasite from the Trypanosomatidae family. More than 20 Leishmania species,
* Alexandre Barbosa Reis [email protected]; [email protected] 1
Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais 35400-000, Brazil
2
Departamento de Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais 35400-000, Brazil
3
Instituto de Ciência e Tecnologia de Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
4
Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais 35400-00, Brazil
around the world, are known to be transmitted to humans by the bite of infected phlebotomine sandflies during their blood meal. Distinct species of Leishmania spp. cause different clinical manifestations of the disease, which can be characterized by at least three synd
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