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Recent advances and new strategies on leishmaniasis treatment

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.

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Funding

This work was financially supported by the Brazilian agencies, CNPq (grant number 435224/2018-2), FAPEMIG (grant number APQ-03505-13 - PROGRAMA DE PESQUISA PARA O SUS–PPSUS, APQ-01373-14 – PRONEX, APQ 02577-18 and APQ-02556-18), CAPES (this study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES) - Finance Code 001), and Universidade Federal de Ouro Preto – UFOP for funding (TO 072018020, TO 222019019). R.C.F.B. are grateful for CAPES fellowship, and A.B.R. and B.M.R. are also grateful to CNPq for fellowships.

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Authors and Affiliations

Authors

Contributions

All the authors participated with suggestions during the development of this manuscript; B.M.R and J.M.O.C. performed all the literature search and participated in drafting the manuscript. All the authors participated in the critical revising process for important intellectual content and created the tables. The authors B.M.R., J.M.O.C., R.D.O.A.-S, R.C.F.B., W.C-V., and A.B.R. participated in the study conception and critical revision of the article. B.M.R and A.B.R. contributed to the supervision.

Corresponding author

Correspondence to Alexandre Barbosa Reis.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Roatt, B.M., de Oliveira Cardoso, J.M., De Brito, R.C.F. et al. Recent advances and new strategies on leishmaniasis treatment. Appl Microbiol Biotechnol 104, 8965–8977 (2020). https://doi.org/10.1007/s00253-020-10856-w

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  • DOI: https://doi.org/10.1007/s00253-020-10856-w

Keywords

  • Leishmaniasis
  • Conventional chemotherapy
  • Multi-drug therapy
  • Immunomodulators
  • Drug repurposing
  • Nanotechnology