Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi 110029, India.
Int J Antimicrob Agents. 2010 Jul;36(1):50-7. doi: 10.1016/j.ijantimicag.2010.03.012. Epub 2010 Apr 27.
Resistance to antimonials has emerged as a major hurdle to the treatment and control of visceral leishmaniasis (VL), also know as kala-azar (KA), the disease caused by Leishmania donovani, in India where >60% of KA patients are unresponsive to sodium antimony gluconate (SAG) treatment. Determinants of resistance in laboratory strains are partly known, however the mechanism operating in field isolates is not well understood. In microarray-based expression profiling with RNA isolated from field isolates of drug-resistant and -sensitive L. donovani parasites, genes encoding histone 1 (H1), histone 2A (H2A), histone 4 (H4), mitogen-activated protein kinase 1 (MAPK1) and two hypothetical proteins showed significantly higher expression in antimony-resistant parasites, whilst genes encoding an amino acid transporter showed higher expression in sensitive parasites. The expression level of these genes was validated by semiquantitative polymerase chain reaction (PCR). Furthermore, the higher expression of H1, H2A and MAPK1 was confirmed at the protein level in resistant isolates. Overexpression of H2A in a drug-sensitive laboratory strain as well as a field isolate of L. donovani resulted in conversion of SAG-sensitive Leishmania parasites into a resistant phenotype. Moreover, H2A overexpression resulted in a significant decrease in susceptibility towards other antileishmanial drugs currently in use, i.e. amphotericin B and miltefosine, pointing to its role in drug resistance.
抗锑药物的出现已成为印度内脏利什曼病(VL)治疗和控制的主要障碍,该病也称为黑热病,由利什曼原虫引起,印度超过 60%的黑热病患者对葡萄糖酸锑钠(SAG)治疗无反应。虽然已知实验室菌株的耐药决定因素部分,但对现场分离株中起作用的机制还了解甚少。在使用从耐药和敏感利什曼原虫寄生虫的现场分离株中分离的 RNA 进行基于微阵列的表达谱分析中,编码组蛋白 1(H1)、组蛋白 2A(H2A)、组蛋白 4(H4)、丝裂原活化蛋白激酶 1(MAPK1)和两种假定蛋白的基因在耐锑寄生虫中表达明显更高,而编码氨基酸转运蛋白的基因在敏感寄生虫中表达更高。通过半定量聚合酶链反应(PCR)验证了这些基因的表达水平。此外,在耐药分离株中还在蛋白质水平上证实了 H1、H2A 和 MAPK1 的高表达。在药物敏感的实验室株和利什曼原虫的现场分离株中过表达 H2A 可将 SAG 敏感的利什曼原虫转化为耐药表型。此外,H2A 的过表达导致对目前使用的其他抗利什曼原虫药物(即两性霉素 B 和米替福新)的敏感性显著降低,表明其在耐药性中的作用。
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