Evidence map›Paper›PMID 39937247›Full record

ArticleParasitology research2025

Roles of efflux pumps and nitroreductases in metronidazole-resistant Trichomonas vaginalis.

Ana Paunkov, Doris Strasser, Philipp Huber, David Leitsch

Abstract read
In one paragraph

Article in Parasitology research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ana PaunkovInstitute for Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria. ana.paunkov@meduniwien.ac.at.ORCID http://orcid.org/0000-0001-8094-3946
Doris StrasserInstitute for Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
Philipp HuberInstitute for Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
David LeitschInstitute for Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.

Funding

Austrian Science Fund P 35545
6 · The paper itself

Abstract

Trichomonas vaginalis infections significantly impact public health and are associated with increased likelihood of HIV infection, prostate cancer, and pregnancy complications. Current treatment relies almost exclusively on 5-nitroimidazoles, particularly metronidazole, raising concerns about drug resistance and treatment efficacy. This study is aimed at evaluating the effectiveness of metronidazole and tinidazole on metronidazole-resistant strains of T. vaginalis and at determining whether efflux pump inhibitors could reverse metronidazole resistance. Additionally, the roles of nitroreductases in metronidazole resistance were also studied. Metronidazole and tinidazole were tested on both metronidazole-sensitive and -resistant T. vaginalis strains. A checkerboard assay was conducted to assess the potential synergy between metronidazole or tinidazole and efflux pump inhibitors. Nitroreductase activity and ferric iron reduction assays were employed to study the functions of nitroreductases. Tinidazole demonstrated better effectiveness against metronidazole-resistant strains compared to metronidazole, with lower minimal lethal concentration levels. However, the tested efflux pump inhibitors did not significantly enhance the efficacy of metronidazole or tinidazole. Pyrimethamine showed some activity but did not improve the efficacy of the 5-nitroimidazoles in combination. Investigations into the role of nitroreductases and other enzymes in metronidazole resistance revealed no clear downregulation trend in resistant strains. Notably, nitroreductase 8 was capable of reducing ferric iron. While tinidazole remains a viable alternative for treating metronidazole-resistant T. vaginalis, efflux pump inhibitors do not effectively reverse resistance. The identification of nitroreductase's 8 iron-reducing activity suggests its involvement in metronidazole resistance mechanisms. This finding highlights the need for continued research to develop new treatment strategies and improve the management of trichomoniasis, ultimately reducing its public health burden.

Indexed as

Antiprotozoal AgentsDrug ResistanceMembrane Transport ProteinsMetronidazoleNitroreductasesTrichomonas vaginalisDrug SynergismFemaleHumansParasitic Sensitivity TestsTinidazoleAntiprotozoal AgentsMembrane Transport ProteinsMetronidazoleNitroreductasesTinidazoleAntimicrobial resistanceEfflux pump inhibitorsIron reductionMetronidazoleNitroreductaseTrichomonas vaginalis

Identifiers

PMID39937247
PMCPMC11821713

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.