Leishmaniasis is one of the most important tropical neglected diseases according to the World Health Organization. Even after more than a century, we still have few drugs for the disease therapy and their great toxicity and side effects put in check the treatment control program around the world. Moreover, the emergence of strains resistant to conventional drugs, co-infections such as HIV/Leishmania spp., the small therapeutic arsenal (pentavalent antimonials, amphotericin B and formulations, and miltefosine), and the low investment for the discovery/development of new drugs force researchers and world health agencies to seek new strategies to combat and control this important neglected disease. In this context, the aim of this review is to summarize new advances and new strategies used on leishmaniasis therapy addressing alternative and innovative treatment paths such as physical and local/topical therapies, combination or multi-drug uses, immunomodulation, drug repurposing, and the nanotechnology-based drug delivery systems.

Key points

• The treatment of leishmaniasis is a challenge for global health agencies.

• Toxicity, side effects, reduced therapeutic arsenal, and drug resistance are the main problems.

• New strategies and recent advances on leishmaniasis treatment are urgent.

• Immunomodulators, nanotechnology, and drug repurposing are the future of leishmaniasis treatment.

根据世界卫生组织，利什曼病是最重要的被热带忽视的疾病之一。即使在一个多世纪之后，我们仍然很少有用于疾病治疗的药物，其巨大的毒性和副作用在世界范围内仍未纳入治疗控制计划。此外，出现了对常规药物具有抗药性的菌株，如HIV /利什曼原虫等合并感染spp。，小的治疗性武库（五价锑，两性霉素B及其制剂和miltefosine）以及对新药发现/开发的投资少，迫使研究人员和世界卫生机构寻求新的策略来对抗和控制这一重要的被忽视的疾病。在此背景下，本综述的目的是总结利什曼病治疗中使用的新进展和新策略，以解决替代和创新的治疗途径，例如物理和局部/局部治疗，联合或多种药物的使用，免疫调节，药物再利用以及基于纳米技术的药物输送系统。

关键点

•对利什曼病的治疗是全球卫生机构的一项挑战。

•毒性，副作用，减少的治疗性武库和耐药性是主要问题。

•利什曼病治疗的新策略和最新进展迫在眉睫。

•免疫调节剂，纳米技术和药物替代用途是利什曼病治疗的未来。