RESISTANCE TO CLINICAL DRUGS IN AFRICAN TRYPANOSOMES

Drug resistance in African trypanosomes continues to confound clinicians and to stymy development of equatorial Africa, taking its toll in lives and economic development. Drugs in current, widespread use hove been employed continuously for over 60 years in some instances. The recent studies of Fairlamb and colleagues1,2 have outlined o defective purine-transport system in drug-resistant trypanosomes, which appears to explain resistance to several established trypanocides and suggests a guide for the development of new drugs. The recently developed agent DL-alpha-difluoromethylornithine (DFMO) is effective against West African, but not East African, disease3 and its activity may be the result of the unregulated synthesis of S-adenosylmethionine in trypanosomes4. In this report, Cyrus Bacchi outlines recent developments in the elucidation of mechanisms or resistance to established drugs and naturally occurring resistance to DFMO.