Current and prospective chemotherapy options for schistosomiasis

Abstract

Introduction: Schistosomiasis remains one of the most insidious and serious of the tropical parasitic diseases. There is currently no anti-schistosome vaccine, but praziquantel (PZQ), the only drug currently used for treatment, is cheap, highly effective against all species of schistosomes, and has limited side effects. However, the emergence of PZQ drug resistance remains a concern and represents a significant threat to public health.

Areas covered: This review discusses potential mechanisms of PZQ action and how molecular changes in schistosome parasites may lead to resistance. We emphasize new molecular and cellular approaches to characterize and quantitate schistosome responses to both current and newly developed antischistosomals. Further, we discuss the identification of new drug targets impacting on key biological functions in schistosome parasites. These include the apoptosis pathway, kinase signaling and key components of biological significance such as thioredoxin, glutathione reductase and septins.

Expert opinion: The identification of critical molecular targets in schistosomes leading to the development of new drugs is urgently needed for the future treatment of schistosomiasis. An additional strategy for consideration is to increase and broaden the efficacy of PZQ, which may involve combination therapy with new antischistosomals so as to target multiple molecular components of schistosomes.

Keywords:

• drug targets
• parasitic helminth
• praziquantel
• schistosoma
• schistosome
• schistosomiasis

Declaration of interest

G Gobert has received a project grant from the Australian National Health and Medical Research Council (NHMRC) number 1080007 APPJD. H You has received an Early Career Fellowship from the NHMRC and D McManus is a Senior Principal Research fellow for the NHMRC. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Notes

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