Human antiprotozoal therapy: past, present, and future

M Khaw1, C B Panosian

  • 1Division of Infectious Diseases, UCLA School of Medicine 90024-1688, USA.

Insights

Human protozoal infections are common globally. This review covers historical, current, and future treatments for these diseases, focusing on drug resistance and toxicity.

Area of Science:

  • Parasitology
  • Infectious Diseases
  • Pharmacology

Background:

  • Human protozoal infections are widespread globally.
  • Current antiprotozoal treatments largely originate from before the modern antibiotic era.
  • Recent years show increased interest due to global travel, drug resistance, and immunocompromised hosts.

Observation:

  • The development of new antiprotozoal agents has lagged behind other antimicrobial classes.
  • Protozoal infections pose significant challenges, particularly in specific patient populations.
  • Awareness of antiprotozoal drug resistance is growing.

Findings:

  • This review details past, present, and future therapeutic strategies for common human protozoal infections.
  • It examines the pharmacologic mechanisms of action and resistance for antiprotozoal drugs.
  • Common toxicities associated with these agents are also summarized.

Implications:

  • Understanding treatment evolution is crucial for managing protozoal diseases.
  • Knowledge of resistance mechanisms informs the development of novel therapies.
  • This review provides valuable insights for nonclinician readers on protozoal infection management.

Related Concept Videos

Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy01:16

Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy

Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
Microorganisms in Medicine and Therapeutics01:29

Microorganisms in Medicine and Therapeutics

Microorganisms play a fundamental role in vaccine development, gene therapy, and therapeutic production. Their biological properties are harnessed to advance medicine and public health. Beyond immunization, microorganisms contribute to gut health, antibiotic synthesis, and genetic disease treatment.Live Attenuated and Inactivated VaccinesLive attenuated vaccines, such as the measles, mumps, and rubella (MMR) vaccine, utilize weakened forms of pathogens to closely resemble natural infections.
Toxoplasmosis01:28

Toxoplasmosis

Toxoplasmosis, a zoonotic disease caused by the protozoan Toxoplasma gondii, poses significant public health challenges globally due to its high seroprevalence and varied clinical manifestations. As an obligate intracellular parasite, T. gondii can infect all warm-blooded vertebrates, but felids are its only definitive hosts, shedding unsporulated oocysts into the environment. Humans typically acquire the infection through ingestion of tissue cysts in undercooked meat or oocysts from...
Trichomoniasis01:18

Trichomoniasis

Trichomonas vaginalis is a flagellated protozoan parasite and the causative agent of trichomoniasis, one of the most prevalent non-viral sexually transmitted infections in the United States. This extracellular parasite primarily colonizes the lower genitourinary tract in women—particularly the vagina—and in men, the urethra and prostate. Its structural and functional adaptations enable its survival, motility, and pathogenicity within the host environment.Structural Features and Host EntryT.
Anthelminthic Agents01:15

Anthelminthic Agents

Anthelmintic drugs differ significantly from antiparasitic therapies targeting protozoa, primarily due to differences in parasite biology. Whereas most protozoal treatments act on proliferating cells, anthelmintics are typically directed against mature, nonproliferative helminths. The therapeutic approach considers the helminth's reliance on neuromuscular coordination, glucose metabolism, and microtubular integrity for survival, reproduction, and localization within the host. Most anthelmintics...
Antiprotozoal Agents01:21

Antiprotozoal Agents

Leishmaniasis is a widespread parasitic disease caused by several Leishmania species. It affects millions of people each year and remains a major public health problem in endemic regions. First-line treatment relies on pentavalent antimonials, including meglumine antimoniate and sodium stibogluconate. Even so, how these drugs work has not been fully clear, especially their interaction with parasite-specific biochemical pathways. One key target is trypanothione reductase (TR), an enzyme that...