Researchers at the University of York are a step closer to identifying ways to support clinicians in predicting drug treatment outcomes for patients with visceral leishmaniasis in Brazil.
Scientists at York had previously shown that the absence of four particular genes in some strains of Leishmania infantum parasite found in Brazil makes it less susceptible to an oral drug called miltefosine.
The absence of these genes correlates with resistance to the drug, which means that Brazilian patients would benefit from a prognostic test, but in order to do this scientists first had to identify what it was about the gene that made the parasite drug-resistant.
During a clinical trial using miltefosine treatment, 40% of patients relapsed within six months, but the presence of the genes in the parasite found in India, however, meant that after a month of treatment, the disease could be cured with a lower risk of relapse.
As a result of its ‘failure’ in Brazil the medication is not licensed in the country and therefore there is very little that can be done to manage the disease in patients, other than intravenous drugs which can prove to be a burden on medical facilities who have to deliver it.
The team, in collaboration with colleagues from the Universidade Federal do Piauí and and the Universidade Federal do Espírito Santo, have now taken the work a step further and identified the enzymes that make the difference between treatment success and failure.
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