title: (Post-) Genomic approaches to tackle drug resistance in Leishmania.
abstract: Leishmaniasis, like other neglected diseases is characterized by a small arsenal of drugs for its control. To safeguard the efficacy of current drugs and guide the development of new ones it is thus of utmost importance to acquire a deep understanding of the phenomenon of drug resistance and its link with treatment outcome. We discuss here how (post-)genomic approaches may contribute to this purpose. We highlight the need for a clear definition of the phenotypes under consideration: innate and acquired resistance versus treatment failure. We provide a recent update of our knowledge on the Leishmania genome structure and dynamics, and compare the contribution of targeted and untargeted methods for the understanding of drug resistance and show their limits. We also present the main assays allowing the experimental validation of the genes putatively involved in drug resistance. The importance of analysing information downstream of the genome is stressed and further illustrated by recent metabolomics findings. Finally, the attention is called onto the challenges for implementing the acquired knowledge to the benefit of the patients and the population at risk.
authors.affiliation: Molecular Parasitology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium.
authors.forename: Maya
authors.initials: M
authors.lastname: Berg
authors.forename: An
authors.initials: A
authors.lastname: Mannaert
authors.forename: Manu
authors.initials: M
authors.lastname: Vanaerschot
authors.forename: Gert
authors.initials: G
authors.lastname: Van Der Auwera
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Dujardin
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000494:pharmacology*; D004351:Drug Resistance / Q000235:genetics*; D018503:Genome, Protozoan / Q000235:genetics*; D023281:Genomics; D006801:Humans; D007891:Leishmania / Q000187:drug effects / Q000235:genetics*; D007896:Leishmaniasis / Q000188:drug therapy / Q000469:parasitology*; D055432:Metabolomics; D010641:Phenotype; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine