TY - JOUR T1 - The New Anthelmintic Tribendimidine is an L-type (Levamisole and Pyrantel) Nicotinic Acetylcholine Receptor Agonist A1 - Hu, Yan A1 - Xiao, Shu-Hua A1 - Aroian, Raffi V. Y1 - 2009/08/11 N2 - Author Summary Intestinal parasitic nematodes or roundworms infect over 1 billion people in tropical countries. Overall, they are a huge source of morbidity in infected people, including children and pregnant women, and are increasingly being recognized as key poverty-promoting parasites. Despite their importance, few drugs for dealing with them exist. Furthermore, none has optimal efficacy, all can be resisted by the parasites, and, for practical reasons, only one is used for single-dose Mass Drug Administrations (MDAs). There is a dire need for better roundworm drugs (anthelmintics). In the past 30 years, only one anthelmintic, tribendimidine, developed by the Chinese CDC, has entered human clinical trials. Tribendimidine has good single-dose efficacy against some roundworm parasites. However, how tribendimidine works was unknown. Here, using the roundworm Caenorhabditis elegans to evolve resistance to tribendimidine in the lab, followed by genetic and molecular testing and cross-resistance drug studies, we demonstrate that tribendimidine is unequivocally in the same drug family as two known anthelmintics, levamisole and pyrantel. These results have important implications for how tribendimidine might be used in MDAs where resistance to current drugs is known or suspected and for how tribendimidine might be combined with other drugs to maximize therapy while minimizing resistance threats. JF - PLOS Neglected Tropical Diseases JA - PLOS Neglected Tropical Diseases VL - 3 IS - 8 UR - https://doi.org/10.1371/journal.pntd.0000499 SP - e499 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pntd.0000499 ER -