The Role of ATP-binding Cassette Transporter Genes Expression for Treatment Failure in Cutaneous Leishmaniasis
Abstract Background: Leishmaniasis is one of the common diseases transmitted by sand flies in tropical and subtropical regions of the world. Currently, antimonal derivatives are the first line of treatment. Some of the members of the ATP-binding cassette (ABC) family of Leishmania are shown to be associated with resistance to antimonial. In this study, we evaluated ABCI4, ABCG2, ABCC7, and ABCC3 gene expression in Leishmania isolated from patients with non-healing cutaneous leishmaniasis. Results: Five cases were treatment failure that all of them were identified as L. major. All treatment failure clinical isolates were L. major. Gene expression analysis in treatment failure isolates showed that the ABC transported genes had a different pattern in each isolate. ABCC7 had overexpression in all isolates. Among the treatment failure isolates, only one sample had overexpression in all ABC transporter genes under study. Conclusions: Treatment failure has been reported for cutaneous leishmaniasis worldwide. Knowledge of the molecular mechanisms of treatment failure could solve this problem. ABC transporter genes are considered controversy over the mechanisms of treatment failure outcomes. In this study, we showed that ABC transporter genes could be considered one the important mechanisms.