Progress in antileishmanial drugs: Mechanisms, challenges, and prospects.

IF 3.4 2区医学 Q1 PARASITOLOGY PLoS Neglected Tropical Diseases Pub Date : 2025-01-03 eCollection Date: 2025-01-01 DOI:10.1371/journal.pntd.0012735

Haoran Zhang, Ruixi Yan, Yahui Liu, Mengtao Yu, Ziyi He, Junfeng Xiao, Kaijie Li, Gang Liu, Qin Ning, Yan Li

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Abstract

Leishmaniasis, a neglected tropical disease caused by Leishmania parasites, continues to pose global health challenges. Current treatments face issues like resistance, safety, efficacy, and cost. This review covers the discovery, mechanisms of action, clinical applications, and limitations of key antileishmanial agents: pentavalent antimonials, amphotericin B, miltefosine, paromomycin, and pentamidine. Despite toxicity and resistance (antimonials), hospitalization needs and side effects (amphotericin B), regional efficacy variability (miltefosine), inconsistent outcomes (paromomycin), and severe side effects (pentamidine), these drugs are vital. Novel strategies to overcome the deficiencies of current therapies are highlighted, including combination regimens, advanced drug delivery systems, and immunomodulatory approaches. Comprehensive and cooperative efforts are crucial to fully realize the potential of advancements in antileishmanial pharmacotherapy and to reduce the unacceptable worldwide burden imposed by this neglected disease.

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抗利什曼病药物的进展：机制、挑战和前景。

利什曼病是由利什曼原虫寄生虫引起的一种被忽视的热带病，继续构成全球卫生挑战。目前的治疗方法面临耐药性、安全性、有效性和成本等问题。本文综述了主要抗利什曼原虫药物的发现、作用机制、临床应用和局限性：五价锑、两性霉素B、米特福辛、帕罗霉素和喷他脒。尽管这些药物具有毒性和耐药性（锑类药物）、住院需求和副作用（两性霉素B）、区域疗效差异（米替福辛）、不一致的结果（帕罗霉素）和严重的副作用（喷他脒），但这些药物至关重要。强调了克服当前治疗方法缺陷的新策略，包括联合治疗方案、先进的药物输送系统和免疫调节方法。全面和合作的努力对于充分发挥抗利什曼药物治疗进展的潜力和减轻这一被忽视疾病给全世界造成的不可接受的负担至关重要。

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来源期刊

PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

自引率

10.50%

发文量

723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).