Current and emerging therapies for the treatment of leishmaniasis

Abstract

Introduction: Leishmaniasis, a neglected protozoan illness caused by kinetoplastid pathogens encompasses three major clinical subtypes: visceral, cutaneous and mucocutaneous leishmaniasis. Pentavalent antimonials (SbV) have long been the preferred treatment worldwide but increased drug resistance, and significant side effects, including cardiotoxicity have limited their use, particularly in visceral leishmaniasis in India. Similarly, other approved alternatives have concerns such as teratogenicity, high cost, and drug resistance. Areas covered: This review aims to provide an overview of emerging therapy for leishmaniasis, highlighting the latest advancements in the field and discuss their potential impact on the treatment and prevention of this neglected tropical disease. It also discusses the limitation of current treatments and need for novel approaches to address them effectively. Expert opinion: For almost eight decades, treatment for all forms of leishmaniasis was solely dependent on SbV, despite several drawbacks like long treatment regimens, cardiotoxicity, and drug resistance. In the past 20 years, three drugs with antileishmanial activity were developed for human disease, but their distribution to endemic regions and accessibility for patients remain neglected. We sorely need new antileishmanial drugs, and we present here the emerging targets for developing new antileishmanial compounds that could be brought into the clinics. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.