Current Status of Existing and Emerging Chemotherapy and Drug Resistance Mechanisms in Leishmania

Leishmaniasis is a well known fatal disease that is caused by the protozoan species belonging to the genus Leishmania. The causative organism is transmitted through female sandflies. It is considered as a neglected tropical disease and targeted for the worldwide elimination by the World Health Organization. It is the major cause of significant morbidity and mortality in several countries of the world. Leishmania parasites cause a wide spectrum of human and animal infections ranging from the life threatening visceral disease to the disfiguring mucosal and cutaneous forms of the disease. Currently, the control of the disease totally relies on chemotherapy, as the vaccine is still under the process of development. Organic pentavalentantimonials [Sb (V)] have been the first-line drugs for the treatment of Leishmaniasis for the last seven decades. Alternatively, Amphotericin B, pentamidine and miltefosine can be used for the treatment of leishmaniasis. However, these drugs have serious limitations, such as high cost, toxicity and resistance has emerged as a major problem.Therefore, the development of new, effective antileishmanial drugs is an urgent need. The new drugs are required in an affordable price in order to control leishmaniasis worldwide. The aim of this article is to review the status of existing and emerging chemotherapy for the prevention and treatment of leishmaniasis and also focuses on the various mechanisms which may lead to antimony resistance in leishmaniasis. Keyword: Leishmaniasis, Drug resistance, Antileishmanial drugs