System-based insights into parasitological and clinical treatment failure in Chagas disease

ABSTRACT Infectious disease treatment success requires symptom resolution (clinical treatment success), which often but not always involves pathogen clearance. Both of these treatment goals face disease-specific and general challenges. In this review, we summarize the current state of knowledge in m...

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Main Authors: Luis Ernst, Giovana C. Macedo, Laura-Isobel McCall
Format: Article
Language:English
Published: American Society for Microbiology 2025-02-01
Series:mSystems
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Online Access:https://journals.asm.org/doi/10.1128/msystems.00038-24
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author Luis Ernst
Giovana C. Macedo
Laura-Isobel McCall
author_facet Luis Ernst
Giovana C. Macedo
Laura-Isobel McCall
author_sort Luis Ernst
collection DOAJ
description ABSTRACT Infectious disease treatment success requires symptom resolution (clinical treatment success), which often but not always involves pathogen clearance. Both of these treatment goals face disease-specific and general challenges. In this review, we summarize the current state of knowledge in mechanisms of clinical and parasitological treatment failure in the context of Chagas disease, a neglected tropical disease causing cardiac and gastrointestinal symptoms. Parasite drug resistance and persistence, drug pharmacokinetics and dynamics, as well as persistently altered host immune responses and tissue damage are the most common reasons for Chagas disease treatment failure. We discuss the therapeutics that failed before regulatory approval, limitations of current therapeutic options and new treatment strategies to overcome persistent parasites, inflammatory responses, and metabolic alterations. Large-scale omics analyses were critical in generating these insights and will continue to play a prominent role in addressing the challenges still facing Chagas disease drug treatment.
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spelling doaj-art-8fd3a9d7d51e46198478e04fec8ec4a72025-08-20T03:16:22ZengAmerican Society for MicrobiologymSystems2379-50772025-02-0110210.1128/msystems.00038-24System-based insights into parasitological and clinical treatment failure in Chagas diseaseLuis Ernst0Giovana C. Macedo1Laura-Isobel McCall2Department of Chemistry and Biochemistry, San Diego State University, San Diego, California, USADepartment of Chemistry and Biochemistry, San Diego State University, San Diego, California, USADepartment of Chemistry and Biochemistry, San Diego State University, San Diego, California, USAABSTRACT Infectious disease treatment success requires symptom resolution (clinical treatment success), which often but not always involves pathogen clearance. Both of these treatment goals face disease-specific and general challenges. In this review, we summarize the current state of knowledge in mechanisms of clinical and parasitological treatment failure in the context of Chagas disease, a neglected tropical disease causing cardiac and gastrointestinal symptoms. Parasite drug resistance and persistence, drug pharmacokinetics and dynamics, as well as persistently altered host immune responses and tissue damage are the most common reasons for Chagas disease treatment failure. We discuss the therapeutics that failed before regulatory approval, limitations of current therapeutic options and new treatment strategies to overcome persistent parasites, inflammatory responses, and metabolic alterations. Large-scale omics analyses were critical in generating these insights and will continue to play a prominent role in addressing the challenges still facing Chagas disease drug treatment.https://journals.asm.org/doi/10.1128/msystems.00038-24drug developmentantiparasitic treatmenttreatment failureChagas diseaseTrypanosoma cruzidrug resistance
spellingShingle Luis Ernst
Giovana C. Macedo
Laura-Isobel McCall
System-based insights into parasitological and clinical treatment failure in Chagas disease
mSystems
drug development
antiparasitic treatment
treatment failure
Chagas disease
Trypanosoma cruzi
drug resistance
title System-based insights into parasitological and clinical treatment failure in Chagas disease
title_full System-based insights into parasitological and clinical treatment failure in Chagas disease
title_fullStr System-based insights into parasitological and clinical treatment failure in Chagas disease
title_full_unstemmed System-based insights into parasitological and clinical treatment failure in Chagas disease
title_short System-based insights into parasitological and clinical treatment failure in Chagas disease
title_sort system based insights into parasitological and clinical treatment failure in chagas disease
topic drug development
antiparasitic treatment
treatment failure
Chagas disease
Trypanosoma cruzi
drug resistance
url https://journals.asm.org/doi/10.1128/msystems.00038-24
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