title: Leishmania vaccines: progress and problems.
abstract: Leishmania are protozoan parasites spread by a sandfly insect vector and causing a spectrum of diseases collectively known as leishmaniasis. The disease is a significant health problem in many parts of the world resulting in an estimated 12 million new cases each year. Current treatment is based on chemotherapy, which is difficult to administer, expensive and becoming ineffective due to the emergence of drug resistance. Leishmaniasis is considered one of a few parasitic diseases likely to be controllable by vaccination. The relatively uncomplicated leishmanial life cycle and the fact that recovery from infection renders the host resistant to subsequent infection indicate that a successful vaccine is feasible. Extensive evidence from studies in animal models indicates that solid protection can be achieved by immunisation with protein or DNA vaccines. However, to date no such vaccine is available despite substantial efforts by many laboratories. Advances in our understanding of Leishmania pathogenesis and generation of host protective immunity, together with the completed Leishmania genome sequence open new avenues for vaccine research. The major remaining challenges are the translation of data from animal models to human disease and the transition from the laboratory to the field. This review focuses on advances in anti-leishmania vaccine development over the recent years and examines current problems hampering vaccine development and implementation.
authors.affiliation: Infection and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville 3050, Melbourne, Australia. kedzierski@wehi.edu.au
authors.forename: L
authors.initials: L
authors.lastname: Kedzierski
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
authors.forename: E
authors.initials: E
authors.lastname: Handman
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D004351:Drug Resistance; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology; D007891:Leishmania; D007896:Leishmaniasis / Q000517:prevention & control*; D008018:Life Cycle Stages; D016052:Protozoan Vaccines / Q000276:immunology*; D011576:Psychodidae / Q000469:parasitology; D014613:Vaccines, Attenuated; D019444:Vaccines, DNA
chemical_list: D000981:Antiprotozoal Agents; D016052:Protozoan Vaccines; D014613:Vaccines, Attenuated; D019444:Vaccines, DNA