multilocularis metacestode (i.e. the target of BZ treatment) displays Tyr residues at positions 200 and 167 and might thus represent a potentially BZ-resistant isoform (Table 2). Highly homologous

isoforms with Tyr at these two positions are also encoded by the genomes of E. granulosus and T. solium (Table 2), and in the respective LY2606368 molecular weight EST databases, transcripts for this isoform are particularly abundant (data not shown), indicating high expression in the metacestodes of these species as well. Hence, limited bioavailability of the drug at the site of infection, which is particularly an issue for the infiltratively growing E. multilocularis metacestode, combined with a potentially

reduced affinity of BZs to the major β-tubulin isoform of the metacestode, could be the main reasons for limited efficacy of BZ treatment in AE. Employing in vitro cultivation systems for the E. multilocularis metacestode stage and classical approaches of testing selected compounds for anti-parasitic activities, Andrew Hemphill’s laboratory and others (71) have recently identified several compounds such LBH589 datasheet as nitazoxanide, isoflavones or amphotericin B that could be used as drugs in AE treatment, mostly in combination with BZs (reviewed in 68). However, compounds that act not only parasitostatic but truly parasitocidal against E. multilocularis in vivo have not been discovered to date, indicating that new chemotherapeutic strategies against AE are urgently needed. With the availability of the E. multilocularis whole genome together with those of E. granulosus and T. solium, targeted drug design should be one of the most promising approaches for the development of anti-cestode drugs in the next years. On the one hand, comparative genomics

can be employed to identify factors Flavopiridol (Alvocidib) that are unique to cestodes or flatworms and could serve as targets for compound screening. The drawback of this approach is that the function and biochemical properties of parasite-specific factors are usually unknown, which severely hampers the design of efficient inhibitors. Furthermore, many of these parasite-specific proteins have redundant functions and are often not essential. An alternative and much more promising approach should rather concentrate on drug targets that are, to a certain degree, homologous between parasite and host, thus providing information on function and biochemistry, but that display sufficient functional modification between both species to allow the development of parasite-specific inhibitors. A highly promising group of factors in this regard are protein kinases (Table 3) that are crucially involved in the regulation of metazoan development and that mediate cell–cell communication by participating in cellular signalling systems (72).