Chemotherapy Resistance Status of Common Human Pathogenic Protozoa

Fig. 1.

Giardia treatment and possible resistance proteins summary

Giardia
Commonly used compounds for treatment
MTZ, ALB orTNZ
Possible proteins involved in resistance
ALB: ROD domain of the β-tubulin and ABC-C1
Available human vaccine
No human vaccine is available

Toxoplasma treatment and possible resistance proteins summary

Toxoplasma
Commonly used compounds for treatment
- If fetal illness was negative: SPI (in some cases AQ) - If fetal illness was positive: PYR + SDZ + FA
Proteins involved in resistance
AQ: Toxoplasma cyt-bc1
Available human vaccine
No human vaccine is available

Entamoeba treatment and possible resistance proteins summary

Entamoeba
Commonly used compounds for treatment
MTZ or TNZ
Proteins involved in resistance
No clear evidence yet
Available human vaccine
No human vaccine is available

Leishmania treatment and possible resistance proteins summary

Leishmania
Compounds usually used for treatment
Sbv, AMB, PMD, FLZ or MT
Possible proteins involved in resistance
- Sbv: gene products of ABCI4, ABCG2, MRP1 and AQP1 - MT: gene products of LdMT gene and LdRos, and ABCB4, ABCG4, and ABCG6 - AMB: gene products of CYP51, SC5D, and SMT
Available human vaccine
No human vaccine is available

Plasmodium species treatment and possible resistance proteins summary

Plasmodium
Uncomplicated malaria by CQS P. vivax, P. ovale, P. malariae, P. knowlesi, and P. falciparum
CQ phosphate; is also the drug of choice for pregnant women
Uncomplicated malaria by CQR P. falciparum, P. vivax, and P. ovale
An ACT combination such as ARM-LF; is also the drug of choice for pregnant women
Anti-relapse treatment P. vivax and P. ovale
PRQ phosphate or TFQ; Anti-relapse is risky during pregnancy
Complicated malaria regardless of the species or drug susceptibility
Administer intravenous ARN
Possible proteins involved in resistance
P. vivax: PvMDRI (CQ, ARN, and MQ), PvDFHR-TS, and PvDHPS (SP)
P. falciparum: PfCRT (CQ, PPQ, ADQ), PfMDRI (CQ, QN, ART, and MQ), PfMRPI (CQ and QN), PfK13 (ART), Pfcytb (AQ), Pfnhe-1 (QN), PfDHPS, and PfDHFR-TS (SP)
Available human vaccine
RTS,S/AS01 (Mosquirix™) by GlaxoSmithKline Biologicals

African Trypanosoma treatment and possible resistance proteins summary

African Trypanosoma
Commonly used compounds for treatment
T.b.g: 1st stage: PMD or FXZ 2nd stage: NECT or FXZ T.b.r 1st stage: SUR 2nd stage: Melb
Possible proteins involved in resistance
PMD and Melb: TbAT1 and TbAQP2
Available human vaccine
No human vaccine is available