Nanobiotechnological Strategies for Treatment of Tegumentary and Visceral Leishmaniasis Including Resistance Strains

Leishmaniasis is a vector-borne chronic infectious disease caused by a group of protozoan parasites of the genus Leishmania. The most severe form of the disease is visceral leishmaniasis, which is fatal if not treated properly. Leishmaniasis is one of the neglected tropical diseases caused by different species of the protozoan parasite Leishmania, and leishmaniasis is a major public health problem worldwide. Leishmania, in the amastigote development period, lives inside tissue-resident macrophages as well as migrating monocytes in distinct anatomical locations. Their hidden location is responsible for impairing the accession of drug therapy. Drug delivery systems should allow the adverse effects caused by parenteral routes of administration to be avoided as well as enhancing the antileishmanial activity and reducing the toxicity of the medication. Access to essential drugs for the treatment of leishmaniasis is challenging in the developing countries that have the highest burden of cases. In the absence of effective vector control measures, drug treatment of the host associated with the nano-theranostic vaccines is the most promising alternative against leishmaniasis. Development of vaccines against leishmaniasis does not appear to follow any specific pattern. However, it is possible to notice an effort from countries developing vaccines in recent years. Research efforts regarding the development of DNA vaccines, recombinant proteins or peptides, and adjuvants are increasing and seem to be among the best feasible alternatives for a successful vaccine. Advances in research, development, and innovation in drug delivery systems show that new dosage forms can enhance the efficacy, safety, and amenability of the old drugs including antimonials, amphotericin B, imiquimod, and buparvaquone. However, the strategy of vaccination by the cutaneous route has been an exponential development, allowing immunization against cutaneous, mucocutaneous, and visceral leishmaniasis.