Antiparasitic resistance to anthelmintics in humans
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Published:
Nov 13, 2025
Keywords:
anthelmintics, resistance, helminths, parasitosis, public health
Main Article Content
Abstract
Introduction: Antiparasitic resistance to anthelmintics in humans is a health problem that compromises the effectiveness of pharmacological treatments, caused by self-medication and the inappropriate use of these drugs, which promotes parasite resistance. Evaluating antiparasitic resistance and its implications on treatment efficacy is essential to understand the magnitude of the problem and to design effective strategies. Therefore, the collection and analysis of data on anthelmintic resistance will allow healthcare professionals to make informed decisions about the most appropriate treatments, ensuring better outcomes for patients and reducing the spread of resistant parasites. Objective: This study aims to analyze anthelmintic resistance in humans, as well as the mechanisms involved. Methodology: This was conducted through a literature review using various databases and reliable sources such as PubMed, ProQuest, Scopus, Taylor & Francis, and ScienceDirect, employing Boolean operators and key terms to obtain high-quality information. The PRISMA method was used to facilitate data collection and analysis. Results: Studies have shown that anthelmintic resistance in humans occurs due to mutations in the beta-tubulin gene, which affects the action of the drugs. This, combined with environmental factors such as their inappropriate use, leads to modifications in their mechanisms of action, rendering them ineffective for treatment. Conclusion: This research promotes the rational use of medications, avoiding self-medication and the overuse of anthelmintics by raising awareness among the population and healthcare professionals about the importance of a responsible approach to the treatment of parasitic infections. Study area: Parasitology. Type of study: Systematic bibliographic review.
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How to Cite
Cepeda Naranjo, D. F., & Tenesaca Serpa, A. E. (2025). Antiparasitic resistance to anthelmintics in humans. Anatomía Digital, 8(4), 38-56. https://doi.org/10.33262/anatomiadigital.v8i4.3557
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Articulos de revisión bibliográfica
References
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3. Fissiha W, Kinde MZ. Anthelmintic resistance and its mechanism: a review. Infection and Drug Resistance [Internet]. 2021 [cited 2025 Mar 6]; 14: 5403–5410. Available from: https://pubmed.ncbi.nlm.nih.gov/34938088/
4. Acosta Ulle LA. Factores asociados a la automedicación con antiparasitarios en la población infantil entre 0 y 10 años del área urbana y rural de Pelileo [Tesis de pregrado, Universidad Técnica de Ambato, Ambato, Ecuador]. 2014 [cited 2025 Feb 22]; Available from: https://repositorio.uta.edu.ec/server/api/core/bitstreams/e74b6c41-f7ef-4b8a-abbc-f07f66dc6f23/content
5. Podolak M, Holota S, Deyak Y, Dziduch K, Dudchak R, Wujec M, et al. Tubulin inhibitors. Selected scaffolds and main trends in the design of novel anticancer and antiparasitic agents. Bioorganic Chemistry [Internet]. 2024 [cited 2025 Mar 6]; 143:107076. Available from: https://www.sciencedirect.com/science/article/pii/S004520682300737X?via%3Dihub
6. Satyavan Sharma, Nitya Anand. Chapter 8 - Benzimidazoles. Pharmacochemistry Library [Internet]. 1997 [cited 2025 Feb 27]; 25(C):195–238. Available from: https://doi.org/10.1016/S0165-7208(97)80030-X
7. Lacey E, Gill JH. Biochemistry of benzimidazole resistance. Acta Tropica [Internet]. 1994 [cited 2025 Mar 6];56(2–3):245–62. Available from: https://doi.org/10.1016/0001-706X(94)90066-3
8. Rashwan N, Scott M, Prichard R. Rapid Genotyping of β-tubulin Polymorphisms in Trichuris trichiura and Ascaris lumbricoides. Plos Neglected Tropical Diseases [Internet]. 2017 [cited 2025 Apr 21];11(1): e0005205. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5230752/
9. Hansen TV, Thamsborg SM, Olsen A, Prichard RK, Nejsum P. Genetic variations in the beta-tubulin gene and the internal transcribed spacer 2 region of Trichuris species from man and baboons. Parasites & Vectors [Internet]. 2013 [cited 2025 Apr 21];6(1):236. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3751491/
10. Mina Ortiz JB, Choéz Del Valle JO, Ganchozo Zambrano JP, Acebo Gómez CA. Infección intestinal por helmintos en habitantes de Latinoamérica. Revista Investigación y Educación en Salud [Internet]. 2023 [cited 2025 Feb 23]; 2(2):37–50. Available from: https://revistas.unesum.edu.ec/salud/index.php/revista/article/view/30/73
11. Jeon HK, Eom KS. Cestodes and cestodiasis. Molecular Medical Microbiology, Third Edition [Internet]. 2024 [cited 2025 Feb 26];2941–63. Available from: https://www.sciencedirect.com/science/article/abs/pii/B9780128186190000447
12. Antolová D, Jarošová J, Víchová B, Avdičová M, Rosoľanka R, Ondriska F, et al. Human Taeniases in Slovakia (2010-2019): genetic analysis of Taenia saginata Isolates. Foodborne Pathogens and Disease [Internet]. 2020 [cited 2025 Feb 26];17(12):735–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32552077/
13. Alcoser Pulig RJ. Determinar la presencia de nematodos, cestodos y trematodos en cerdos mestizos de la comunidad Corazón de Jesús - San Luis [Tesis de pregrado, Escuela Superior Politécnica de Chimborazo, Riobamba, Ecuador]. 2023 [cited 2025 Feb 27]. Disponible en: http://dspace.espoch.edu.ec/bitstream/123456789/20892/1/17T01944.pdf
14. Villasante Ferrer A, Iranzo Tatay A, Aznar Oroval E, Mollar Maseres J. Estudio de la situación actual de la infección por Schistosoma haematobium en la Unión Europea. Una aproximación al posible riesgo en España. Revista Española de Salud Pública [Internet]. 2018 [cited 2025 Feb 26]; 92. Available from: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1135-57272018000100136
15. López-Rodríguez G, Zaragoza-Bastida A, Olmedo-Juárez A, Rosenfeld Miranda C, Rivero-Perez N. Nematodos gastrointestinales en ovinos y su resistencia antihelmíntica. Un tema en discusión dé México. Journal of the Selva Andina Animal Science [Internet]. 2023 [cited 2025 Feb 27];10(2):116–29. Available from: https://doi.org/10.36610/j.jsaas.2023.100200116
16. Uribe Herrera AM, Rojas AP, Reyes Harker P, Rodríguez López ML, Desarrollo de fármacos antihelmínticos: actualización de candidatos a fármacos y dianas terapéuticas en el manejo de las geohelmintiasis. Revista Med [Internet]. 2022 [cited 2025 Feb 22]; 30(2):9–22. Available from: https://doi.org/10.18359/rmed.6465
17. Rodríguez DJ, Arece J, Olivares JL, Alemán Y, Sánchez Castilleja Y. Antihelmínticos, resistencia y método FAMACHA: experiencia cubana en ovinos. Revista de Salud Animal [Internet]. 2015 [citado 2025 febrero 25]; 37( 1 ): 57-63. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0253-570X2015000100009&lng=es.
18. Aveiga Hidalgo MV, Alonzo Pico OM, Villarreal Ger MC. Complicaciones asociadas a la automedicación y sus efectos adversos en los adultos jóvenes que acuden al centro de salud Huaca. Dilemas Contemporáneos: Educación, Política y Valores [Internet]. 2021 [cited 2025 Feb 22]; 8(SPE4). Available from: https://doi.org/10.46377/dilemas.v8i.2813
19. Martínez Sánchez R, Domenech Cañete I, Millán Marcelo JC, Pino Santos A. Fascioliasis, revisión clínico-epidemiológica y diagnóstico. Revista Cubana de Higiene y Epidemiologia [Internet]. 2012 [cited 2025 Feb 26];50(1):88–96. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-30032012000100011&lng=es&nrm=iso&tlng=es
20. Kiontke K, Fitch DH. Nematodes. Current Biology [Internet]. 2013 [cited 2025 Feb 22]; 23(19): R862–R864. Available from: https://doi.org/10.1016/j.cub.2013.08.009
21. Nogueira RA, Lira MGS, Licá ICL, Frazão GCCG, Dos Santos VAF, Filho ACCM, et al. Praziquantel: an update on the mechanism of its action against schistosomiasis and new therapeutic perspectives. Molecular and Biochemical Parasitology [Internet]. 2022 [cited 2025 Jun 1];252. Available from: https://doi.org/10.1016/j.molbiopara.2022.111531
22. Chen W, Mook RA, Premont RT, Wang J. Niclosamide: beyond an antihelminthic drug. Cellular Signalling [Internet]. 2018 [cited 2025 Jun 1];41: 89-96. Available from: https://doi.org/10.1016/j.cellsig.2017.04.001
23. Gebremedhn HG, Tsegay AK. Review on distribution of endo-parasites of fish in Ethiopia. Parasite Epidemiology and Control [Internet]. 2017 [cited 2025 Feb 26]; 2(4):42–7. Available from: https://www.sciencedirect.com/science/article/pii/S2405673117300399
24. Edar Onam PS. Identificación de proteínas asociadas a la biotransformación del Albendazol y su posible relación con la resistencia en Giardia duodenalis a este fármaco [Tesis de maestría, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Acional, Ciudad de México, México]. 2018 [cited 2025 Apr 21]; Disponible en: https://repositorio.cinvestav.mx/handle/cinvestav/2473
25. Fan F, Li XB, Yang YY, Zhang JY, Zhu YX, Yin WX, et al. Benzimidazole-Resistant Isolates with E198A/V/K Mutations in the β-Tubulin gene possess different fitness and competitive ability in botrytis cinerea. Phytopathology [Internet]. 2022 [cited 2025 Apr 21];112(11):2321–2328. Available from: https://apsjournals.apsnet.org/doi/10.1094/PHYTO-04-22-0120-R
26. Pinto-Almeida A, Mendes T, Armada A, Belo S, Carrilho E, Viveiros M, et al. The role of efflux pumps in schistosoma mansoni praziquantel resistant phenotype. PLoS One [Internet]. 2015 [cited 2025 Apr 21];10(10): e0140147. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4596880/
27. Sarai RS, Kopp SR, Coleman GT, Kotze AC. Drug-efflux and target-site gene expression patterns in Haemonchus contortus larvae able to survive increasing concentrations of levamisole in vitro. International Journal for Parasitology, Drugs and Drug Resistance [Internet]. 2014 [cited 2025 Apr 21]; 4(2):77-84. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4095050/
28. Choudhary S, Kashyap SS, Martin RJ, Robertson AP. Advances in our understanding of nematode ion channels as potential anthelmintic targets. International Journal for Parasitology: Drugs and Drug Resistance [Internet]. 2022 [cited 2025 Apr 21]; 18:52–86. Available from: https://www.sciencedirect.com/science/article/pii/S2211320721000543?via%3Dihub
29. Wolstenholme AJ. Ion channels and receptor as targets for the control of parasitic nematodes. International Journal for Parasitology. Drugs and Drug Resistance [Internet]. 2011 Dec [cited 2025 Apr 21];1(1):2. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3898135/
30. Rodríguez Palomares C, Obrador Vera GT. Capítulo 26: Antihelmínticos. En: Fichero Farmacológico. McGraw Hill [Internet]. 2013 [cited 2025 Feb 22]. Available from: https://accessmedicina.mhmedical.com/content.aspx?bookid=1510§ionid=98010822
31. García-Caicedo M, Torres Á, Ochoa Á. Evaluación de nematodos entomopatógenos para el control del picudo de la piña en el estado Táchira Venezuela. Agronomía Tropical [Internet]. 2013 [cited 2025 Feb 27];63(1–2):5–14. Available from: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0002-192X2013000100001&lng=es&nrm=iso&tlng=es
2. Lara DM. Resistencia a los antihelmínticos: origen, desarrollo y control. Ciencia y Tecnología Agropecuaria [Internet]. 2003 [cited 2025 Feb 22];4(1):55–71. Available from: https://revistacta.agrosavia.co/index.php/revista/article/view/14
3. Fissiha W, Kinde MZ. Anthelmintic resistance and its mechanism: a review. Infection and Drug Resistance [Internet]. 2021 [cited 2025 Mar 6]; 14: 5403–5410. Available from: https://pubmed.ncbi.nlm.nih.gov/34938088/
4. Acosta Ulle LA. Factores asociados a la automedicación con antiparasitarios en la población infantil entre 0 y 10 años del área urbana y rural de Pelileo [Tesis de pregrado, Universidad Técnica de Ambato, Ambato, Ecuador]. 2014 [cited 2025 Feb 22]; Available from: https://repositorio.uta.edu.ec/server/api/core/bitstreams/e74b6c41-f7ef-4b8a-abbc-f07f66dc6f23/content
5. Podolak M, Holota S, Deyak Y, Dziduch K, Dudchak R, Wujec M, et al. Tubulin inhibitors. Selected scaffolds and main trends in the design of novel anticancer and antiparasitic agents. Bioorganic Chemistry [Internet]. 2024 [cited 2025 Mar 6]; 143:107076. Available from: https://www.sciencedirect.com/science/article/pii/S004520682300737X?via%3Dihub
6. Satyavan Sharma, Nitya Anand. Chapter 8 - Benzimidazoles. Pharmacochemistry Library [Internet]. 1997 [cited 2025 Feb 27]; 25(C):195–238. Available from: https://doi.org/10.1016/S0165-7208(97)80030-X
7. Lacey E, Gill JH. Biochemistry of benzimidazole resistance. Acta Tropica [Internet]. 1994 [cited 2025 Mar 6];56(2–3):245–62. Available from: https://doi.org/10.1016/0001-706X(94)90066-3
8. Rashwan N, Scott M, Prichard R. Rapid Genotyping of β-tubulin Polymorphisms in Trichuris trichiura and Ascaris lumbricoides. Plos Neglected Tropical Diseases [Internet]. 2017 [cited 2025 Apr 21];11(1): e0005205. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5230752/
9. Hansen TV, Thamsborg SM, Olsen A, Prichard RK, Nejsum P. Genetic variations in the beta-tubulin gene and the internal transcribed spacer 2 region of Trichuris species from man and baboons. Parasites & Vectors [Internet]. 2013 [cited 2025 Apr 21];6(1):236. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3751491/
10. Mina Ortiz JB, Choéz Del Valle JO, Ganchozo Zambrano JP, Acebo Gómez CA. Infección intestinal por helmintos en habitantes de Latinoamérica. Revista Investigación y Educación en Salud [Internet]. 2023 [cited 2025 Feb 23]; 2(2):37–50. Available from: https://revistas.unesum.edu.ec/salud/index.php/revista/article/view/30/73
11. Jeon HK, Eom KS. Cestodes and cestodiasis. Molecular Medical Microbiology, Third Edition [Internet]. 2024 [cited 2025 Feb 26];2941–63. Available from: https://www.sciencedirect.com/science/article/abs/pii/B9780128186190000447
12. Antolová D, Jarošová J, Víchová B, Avdičová M, Rosoľanka R, Ondriska F, et al. Human Taeniases in Slovakia (2010-2019): genetic analysis of Taenia saginata Isolates. Foodborne Pathogens and Disease [Internet]. 2020 [cited 2025 Feb 26];17(12):735–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32552077/
13. Alcoser Pulig RJ. Determinar la presencia de nematodos, cestodos y trematodos en cerdos mestizos de la comunidad Corazón de Jesús - San Luis [Tesis de pregrado, Escuela Superior Politécnica de Chimborazo, Riobamba, Ecuador]. 2023 [cited 2025 Feb 27]. Disponible en: http://dspace.espoch.edu.ec/bitstream/123456789/20892/1/17T01944.pdf
14. Villasante Ferrer A, Iranzo Tatay A, Aznar Oroval E, Mollar Maseres J. Estudio de la situación actual de la infección por Schistosoma haematobium en la Unión Europea. Una aproximación al posible riesgo en España. Revista Española de Salud Pública [Internet]. 2018 [cited 2025 Feb 26]; 92. Available from: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1135-57272018000100136
15. López-Rodríguez G, Zaragoza-Bastida A, Olmedo-Juárez A, Rosenfeld Miranda C, Rivero-Perez N. Nematodos gastrointestinales en ovinos y su resistencia antihelmíntica. Un tema en discusión dé México. Journal of the Selva Andina Animal Science [Internet]. 2023 [cited 2025 Feb 27];10(2):116–29. Available from: https://doi.org/10.36610/j.jsaas.2023.100200116
16. Uribe Herrera AM, Rojas AP, Reyes Harker P, Rodríguez López ML, Desarrollo de fármacos antihelmínticos: actualización de candidatos a fármacos y dianas terapéuticas en el manejo de las geohelmintiasis. Revista Med [Internet]. 2022 [cited 2025 Feb 22]; 30(2):9–22. Available from: https://doi.org/10.18359/rmed.6465
17. Rodríguez DJ, Arece J, Olivares JL, Alemán Y, Sánchez Castilleja Y. Antihelmínticos, resistencia y método FAMACHA: experiencia cubana en ovinos. Revista de Salud Animal [Internet]. 2015 [citado 2025 febrero 25]; 37( 1 ): 57-63. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0253-570X2015000100009&lng=es.
18. Aveiga Hidalgo MV, Alonzo Pico OM, Villarreal Ger MC. Complicaciones asociadas a la automedicación y sus efectos adversos en los adultos jóvenes que acuden al centro de salud Huaca. Dilemas Contemporáneos: Educación, Política y Valores [Internet]. 2021 [cited 2025 Feb 22]; 8(SPE4). Available from: https://doi.org/10.46377/dilemas.v8i.2813
19. Martínez Sánchez R, Domenech Cañete I, Millán Marcelo JC, Pino Santos A. Fascioliasis, revisión clínico-epidemiológica y diagnóstico. Revista Cubana de Higiene y Epidemiologia [Internet]. 2012 [cited 2025 Feb 26];50(1):88–96. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-30032012000100011&lng=es&nrm=iso&tlng=es
20. Kiontke K, Fitch DH. Nematodes. Current Biology [Internet]. 2013 [cited 2025 Feb 22]; 23(19): R862–R864. Available from: https://doi.org/10.1016/j.cub.2013.08.009
21. Nogueira RA, Lira MGS, Licá ICL, Frazão GCCG, Dos Santos VAF, Filho ACCM, et al. Praziquantel: an update on the mechanism of its action against schistosomiasis and new therapeutic perspectives. Molecular and Biochemical Parasitology [Internet]. 2022 [cited 2025 Jun 1];252. Available from: https://doi.org/10.1016/j.molbiopara.2022.111531
22. Chen W, Mook RA, Premont RT, Wang J. Niclosamide: beyond an antihelminthic drug. Cellular Signalling [Internet]. 2018 [cited 2025 Jun 1];41: 89-96. Available from: https://doi.org/10.1016/j.cellsig.2017.04.001
23. Gebremedhn HG, Tsegay AK. Review on distribution of endo-parasites of fish in Ethiopia. Parasite Epidemiology and Control [Internet]. 2017 [cited 2025 Feb 26]; 2(4):42–7. Available from: https://www.sciencedirect.com/science/article/pii/S2405673117300399
24. Edar Onam PS. Identificación de proteínas asociadas a la biotransformación del Albendazol y su posible relación con la resistencia en Giardia duodenalis a este fármaco [Tesis de maestría, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Acional, Ciudad de México, México]. 2018 [cited 2025 Apr 21]; Disponible en: https://repositorio.cinvestav.mx/handle/cinvestav/2473
25. Fan F, Li XB, Yang YY, Zhang JY, Zhu YX, Yin WX, et al. Benzimidazole-Resistant Isolates with E198A/V/K Mutations in the β-Tubulin gene possess different fitness and competitive ability in botrytis cinerea. Phytopathology [Internet]. 2022 [cited 2025 Apr 21];112(11):2321–2328. Available from: https://apsjournals.apsnet.org/doi/10.1094/PHYTO-04-22-0120-R
26. Pinto-Almeida A, Mendes T, Armada A, Belo S, Carrilho E, Viveiros M, et al. The role of efflux pumps in schistosoma mansoni praziquantel resistant phenotype. PLoS One [Internet]. 2015 [cited 2025 Apr 21];10(10): e0140147. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4596880/
27. Sarai RS, Kopp SR, Coleman GT, Kotze AC. Drug-efflux and target-site gene expression patterns in Haemonchus contortus larvae able to survive increasing concentrations of levamisole in vitro. International Journal for Parasitology, Drugs and Drug Resistance [Internet]. 2014 [cited 2025 Apr 21]; 4(2):77-84. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4095050/
28. Choudhary S, Kashyap SS, Martin RJ, Robertson AP. Advances in our understanding of nematode ion channels as potential anthelmintic targets. International Journal for Parasitology: Drugs and Drug Resistance [Internet]. 2022 [cited 2025 Apr 21]; 18:52–86. Available from: https://www.sciencedirect.com/science/article/pii/S2211320721000543?via%3Dihub
29. Wolstenholme AJ. Ion channels and receptor as targets for the control of parasitic nematodes. International Journal for Parasitology. Drugs and Drug Resistance [Internet]. 2011 Dec [cited 2025 Apr 21];1(1):2. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3898135/
30. Rodríguez Palomares C, Obrador Vera GT. Capítulo 26: Antihelmínticos. En: Fichero Farmacológico. McGraw Hill [Internet]. 2013 [cited 2025 Feb 22]. Available from: https://accessmedicina.mhmedical.com/content.aspx?bookid=1510§ionid=98010822
31. García-Caicedo M, Torres Á, Ochoa Á. Evaluación de nematodos entomopatógenos para el control del picudo de la piña en el estado Táchira Venezuela. Agronomía Tropical [Internet]. 2013 [cited 2025 Feb 27];63(1–2):5–14. Available from: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0002-192X2013000100001&lng=es&nrm=iso&tlng=es