title: Characterisation of atovaquone resistance in Leishmania infantum promastigotes.
abstract: Atovaquone, an antiparasitic agent, could possibly represent an alternative therapy after relapse following classical treatment for visceral leishmaniasis. Atovaquone-resistant strains were selected in vitro by stepwise drug pressure to study the mechanism of resistance in Leishmania. Characteristics of a promastigote strain resistant to 250 microg/ml of atovaquone were compared with those of the wild type (WT) strain. Resistant strains were shown to have a high level of resistance (45 times). They were stable in drug-free medium for 6 months, and showed no cross-resistance with other antileishmanial drugs. Rhodamine uptake and efflux were studied. They were not modified in the resistant strain, indicating the absence of P-glycoprotein overexpession. The effect of atovaquone on membrane lipidic composition was determined in both WT and atovaquone-resistant promastigotes. Analysis of lipid composition of the atovaquone-resistant strain showed that sterol biosynthesis was decreased in atovaquone-resistant parasites. Cholesterol was found to be the major membrane sterol as opposed to the WT strain. Cholesterol, due to its ordering effect, could decrease membrane fluidity and subsequently block the passage of atovaquone through the membrane. Increased membrane cholesterol content and altered drug membrane fluidity resulted from possible decrease of ergosterol biosynthesis by atovaquone, incorporation of cholesterol by promastigotes in the culture medium, solubilisation of atovaquone by cholesterol and co-passage of the two compounds or influence of dimethylsulfoxide. These results indicate that different cellular alterations may participate in the resistant phenotype, by altering drug membrane permeability.
authors.affiliation: Laboratoire de Pharmacotechnie, Service Pharmacie, C.H.U. H.Mondor, AP-HP, 94010 Créteil, France. ecauchetier@ch-argenteuil.fr
authors.forename: E
authors.initials: E
authors.lastname: Cauchetier
authors.forename: P M
authors.initials: PM
authors.lastname: Loiseau
authors.forename: J
authors.initials: J
authors.lastname: Lehman
authors.forename: D
authors.initials: D
authors.lastname: Rivollet
authors.forename: J
authors.initials: J
authors.lastname: Fleury
authors.forename: A
authors.initials: A
authors.lastname: Astier
authors.forename: M
authors.initials: M
authors.lastname: Deniau
authors.forename: M
authors.initials: M
authors.lastname: Paul
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism; D000818:Animals; D000981:Antiprotozoal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D053626:Atovaquone; D001692:Biological Transport; D002462:Cell Membrane / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D005227:Fatty Acids / Q000378:metabolism; D018314:Leishmania infantum / Q000166:cytology / Q000187:drug effects* / Q000254:growth & development* / Q000502:physiology; D007896:Leishmaniasis / Q000188:drug therapy / Q000469:parasitology; D009285:Naphthoquinones / Q000494:pharmacology* / Q000627:therapeutic use; D012235:Rhodamines / Q000378:metabolism; D013997:Time Factors
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000981:Antiprotozoal Agents; D005227:Fatty Acids; D009285:Naphthoquinones; D012235:Rhodamines; D002784:Cholesterol; D053626:Atovaquone